Test–retest repeatability and reproducibility of ADC measures by breast DWI

Results from the ACRIN 6698 trial

for the ACRIN Trial Team and I-SPY 2 TRIAL Investigators

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Quantitative diffusion-weighted imaging (DWI) MRI is a promising technique for cancer characterization and treatment monitoring. Knowledge of the reproducibility of DWI metrics in breast tumors is necessary to apply DWI as a clinical biomarker. Purpose: To evaluate the repeatability and reproducibility of breast tumor apparent diffusion coefficient (ADC) in a multi-institution clinical trial setting, using standardized DWI protocols and quality assurance (QA) procedures. Study Type: Prospective. Subjects: In all, 89 women from nine institutions undergoing neoadjuvant chemotherapy for invasive breast cancer. Field Strength/Sequence: DWI was acquired before and after patient repositioning using a four b-value, single-shot echo-planar sequence at 1.5T or 3.0T. Assessment: A QA procedure by trained operators assessed artifacts, fat suppression, and signal-to-noise ratio, and determine study analyzability. Mean tumor ADC was measured via manual segmentation of the multislice tumor region referencing DWI and contrast-enhanced images. Twenty cases were evaluated multiple times to assess intra- and interoperator variability. Segmentation similarity was assessed via the Sørenson–Dice similarity coefficient. Statistical Tests: Repeatability and reproducibility were evaluated using within-subject coefficient of variation (wCV), intraclass correlation coefficient (ICC), agreement index (AI), and repeatability coefficient (RC). Correlations were measured by Pearson's correlation coefficients. Results: In all, 71 cases (80%) passed QA evaluation: 44 at 1.5T, 27 at 3.0T; 60 pretreatment, 11 after 3 weeks of taxane-based treatment. ADC repeatability was excellent: wCV = 4.8% (95% confidence interval [CI] 4.0, 5.7%), ICC = 0.97 (95% CI 0.95, 0.98), AI = 0.83 (95% CI 0.76, 0.87), and RC = 0.16 * 10−3 mm2/sec (95% CI 0.13, 0.19). The results were similar across field strengths and timepoint subgroups. Reproducibility was excellent: interreader ICC = 0.92 (95% CI 0.80, 0.97) and intrareader ICC = 0.91 (95% CI 0.78, 0.96). Data Conclusion: Breast tumor ADC can be measured with excellent repeatability and reproducibility in a multi-institution setting using a standardized protocol and QA procedure. Improvements to DWI image quality could reduce loss of data in clinical trials. Level of Evidence: 2. Technical Efficacy: Stage 1. J. Magn. Reson. Imaging 2018.

Original languageEnglish (US)
JournalJournal of Magnetic Resonance Imaging
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Breast
Confidence Intervals
Breast Neoplasms
Clinical Trials
Moving and Lifting Patients
Neoplasms
Diffusion Magnetic Resonance Imaging
Signal-To-Noise Ratio
Artifacts
Biomarkers
Fats
Prospective Studies
Drug Therapy
Therapeutics

Keywords

  • breast cancer
  • breast MRI
  • diffusion
  • reproducibility
  • treatment response

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Test–retest repeatability and reproducibility of ADC measures by breast DWI : Results from the ACRIN 6698 trial. / for the ACRIN Trial Team and I-SPY 2 TRIAL Investigators.

In: Journal of Magnetic Resonance Imaging, 01.01.2018.

Research output: Contribution to journalArticle

@article{d0aea96a64e1425e84e60a60071d0d9b,
title = "Test–retest repeatability and reproducibility of ADC measures by breast DWI: Results from the ACRIN 6698 trial",
abstract = "Background: Quantitative diffusion-weighted imaging (DWI) MRI is a promising technique for cancer characterization and treatment monitoring. Knowledge of the reproducibility of DWI metrics in breast tumors is necessary to apply DWI as a clinical biomarker. Purpose: To evaluate the repeatability and reproducibility of breast tumor apparent diffusion coefficient (ADC) in a multi-institution clinical trial setting, using standardized DWI protocols and quality assurance (QA) procedures. Study Type: Prospective. Subjects: In all, 89 women from nine institutions undergoing neoadjuvant chemotherapy for invasive breast cancer. Field Strength/Sequence: DWI was acquired before and after patient repositioning using a four b-value, single-shot echo-planar sequence at 1.5T or 3.0T. Assessment: A QA procedure by trained operators assessed artifacts, fat suppression, and signal-to-noise ratio, and determine study analyzability. Mean tumor ADC was measured via manual segmentation of the multislice tumor region referencing DWI and contrast-enhanced images. Twenty cases were evaluated multiple times to assess intra- and interoperator variability. Segmentation similarity was assessed via the S{\o}renson–Dice similarity coefficient. Statistical Tests: Repeatability and reproducibility were evaluated using within-subject coefficient of variation (wCV), intraclass correlation coefficient (ICC), agreement index (AI), and repeatability coefficient (RC). Correlations were measured by Pearson's correlation coefficients. Results: In all, 71 cases (80{\%}) passed QA evaluation: 44 at 1.5T, 27 at 3.0T; 60 pretreatment, 11 after 3 weeks of taxane-based treatment. ADC repeatability was excellent: wCV = 4.8{\%} (95{\%} confidence interval [CI] 4.0, 5.7{\%}), ICC = 0.97 (95{\%} CI 0.95, 0.98), AI = 0.83 (95{\%} CI 0.76, 0.87), and RC = 0.16 * 10−3 mm2/sec (95{\%} CI 0.13, 0.19). The results were similar across field strengths and timepoint subgroups. Reproducibility was excellent: interreader ICC = 0.92 (95{\%} CI 0.80, 0.97) and intrareader ICC = 0.91 (95{\%} CI 0.78, 0.96). Data Conclusion: Breast tumor ADC can be measured with excellent repeatability and reproducibility in a multi-institution setting using a standardized protocol and QA procedure. Improvements to DWI image quality could reduce loss of data in clinical trials. Level of Evidence: 2. Technical Efficacy: Stage 1. J. Magn. Reson. Imaging 2018.",
keywords = "breast cancer, breast MRI, diffusion, reproducibility, treatment response",
author = "{for the ACRIN Trial Team and I-SPY 2 TRIAL Investigators} and Newitt, {David C.} and Zheng Zhang and Gibbs, {Jessica E.} and Partridge, {Savannah C.} and Chenevert, {Thomas L.} and Rosen, {Mark A.} and Bolan, {Patrick J.} and Marques, {Helga S.} and Sheye Aliu and Wen Li and Lisa Cimino and Joe, {Bonnie N.} and Heidi Umphrey and Haydee Ojeda-Fournier and Basak Dogan and Karen Oh and Hiroyuki Abe and Jennifer Drukteinis and Esserman, {Laura J.} and Hylton, {Nola M.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1002/jmri.26539",
language = "English (US)",
journal = "Journal of Magnetic Resonance Imaging",
issn = "1053-1807",
publisher = "John Wiley and Sons Inc.",

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TY - JOUR

T1 - Test–retest repeatability and reproducibility of ADC measures by breast DWI

T2 - Results from the ACRIN 6698 trial

AU - for the ACRIN Trial Team and I-SPY 2 TRIAL Investigators

AU - Newitt, David C.

AU - Zhang, Zheng

AU - Gibbs, Jessica E.

AU - Partridge, Savannah C.

AU - Chenevert, Thomas L.

AU - Rosen, Mark A.

AU - Bolan, Patrick J.

AU - Marques, Helga S.

AU - Aliu, Sheye

AU - Li, Wen

AU - Cimino, Lisa

AU - Joe, Bonnie N.

AU - Umphrey, Heidi

AU - Ojeda-Fournier, Haydee

AU - Dogan, Basak

AU - Oh, Karen

AU - Abe, Hiroyuki

AU - Drukteinis, Jennifer

AU - Esserman, Laura J.

AU - Hylton, Nola M.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Quantitative diffusion-weighted imaging (DWI) MRI is a promising technique for cancer characterization and treatment monitoring. Knowledge of the reproducibility of DWI metrics in breast tumors is necessary to apply DWI as a clinical biomarker. Purpose: To evaluate the repeatability and reproducibility of breast tumor apparent diffusion coefficient (ADC) in a multi-institution clinical trial setting, using standardized DWI protocols and quality assurance (QA) procedures. Study Type: Prospective. Subjects: In all, 89 women from nine institutions undergoing neoadjuvant chemotherapy for invasive breast cancer. Field Strength/Sequence: DWI was acquired before and after patient repositioning using a four b-value, single-shot echo-planar sequence at 1.5T or 3.0T. Assessment: A QA procedure by trained operators assessed artifacts, fat suppression, and signal-to-noise ratio, and determine study analyzability. Mean tumor ADC was measured via manual segmentation of the multislice tumor region referencing DWI and contrast-enhanced images. Twenty cases were evaluated multiple times to assess intra- and interoperator variability. Segmentation similarity was assessed via the Sørenson–Dice similarity coefficient. Statistical Tests: Repeatability and reproducibility were evaluated using within-subject coefficient of variation (wCV), intraclass correlation coefficient (ICC), agreement index (AI), and repeatability coefficient (RC). Correlations were measured by Pearson's correlation coefficients. Results: In all, 71 cases (80%) passed QA evaluation: 44 at 1.5T, 27 at 3.0T; 60 pretreatment, 11 after 3 weeks of taxane-based treatment. ADC repeatability was excellent: wCV = 4.8% (95% confidence interval [CI] 4.0, 5.7%), ICC = 0.97 (95% CI 0.95, 0.98), AI = 0.83 (95% CI 0.76, 0.87), and RC = 0.16 * 10−3 mm2/sec (95% CI 0.13, 0.19). The results were similar across field strengths and timepoint subgroups. Reproducibility was excellent: interreader ICC = 0.92 (95% CI 0.80, 0.97) and intrareader ICC = 0.91 (95% CI 0.78, 0.96). Data Conclusion: Breast tumor ADC can be measured with excellent repeatability and reproducibility in a multi-institution setting using a standardized protocol and QA procedure. Improvements to DWI image quality could reduce loss of data in clinical trials. Level of Evidence: 2. Technical Efficacy: Stage 1. J. Magn. Reson. Imaging 2018.

AB - Background: Quantitative diffusion-weighted imaging (DWI) MRI is a promising technique for cancer characterization and treatment monitoring. Knowledge of the reproducibility of DWI metrics in breast tumors is necessary to apply DWI as a clinical biomarker. Purpose: To evaluate the repeatability and reproducibility of breast tumor apparent diffusion coefficient (ADC) in a multi-institution clinical trial setting, using standardized DWI protocols and quality assurance (QA) procedures. Study Type: Prospective. Subjects: In all, 89 women from nine institutions undergoing neoadjuvant chemotherapy for invasive breast cancer. Field Strength/Sequence: DWI was acquired before and after patient repositioning using a four b-value, single-shot echo-planar sequence at 1.5T or 3.0T. Assessment: A QA procedure by trained operators assessed artifacts, fat suppression, and signal-to-noise ratio, and determine study analyzability. Mean tumor ADC was measured via manual segmentation of the multislice tumor region referencing DWI and contrast-enhanced images. Twenty cases were evaluated multiple times to assess intra- and interoperator variability. Segmentation similarity was assessed via the Sørenson–Dice similarity coefficient. Statistical Tests: Repeatability and reproducibility were evaluated using within-subject coefficient of variation (wCV), intraclass correlation coefficient (ICC), agreement index (AI), and repeatability coefficient (RC). Correlations were measured by Pearson's correlation coefficients. Results: In all, 71 cases (80%) passed QA evaluation: 44 at 1.5T, 27 at 3.0T; 60 pretreatment, 11 after 3 weeks of taxane-based treatment. ADC repeatability was excellent: wCV = 4.8% (95% confidence interval [CI] 4.0, 5.7%), ICC = 0.97 (95% CI 0.95, 0.98), AI = 0.83 (95% CI 0.76, 0.87), and RC = 0.16 * 10−3 mm2/sec (95% CI 0.13, 0.19). The results were similar across field strengths and timepoint subgroups. Reproducibility was excellent: interreader ICC = 0.92 (95% CI 0.80, 0.97) and intrareader ICC = 0.91 (95% CI 0.78, 0.96). Data Conclusion: Breast tumor ADC can be measured with excellent repeatability and reproducibility in a multi-institution setting using a standardized protocol and QA procedure. Improvements to DWI image quality could reduce loss of data in clinical trials. Level of Evidence: 2. Technical Efficacy: Stage 1. J. Magn. Reson. Imaging 2018.

KW - breast cancer

KW - breast MRI

KW - diffusion

KW - reproducibility

KW - treatment response

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DO - 10.1002/jmri.26539

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JO - Journal of Magnetic Resonance Imaging

JF - Journal of Magnetic Resonance Imaging

SN - 1053-1807

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