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Related Experiment Videos

Diffusion-weighted (DW) MRI in lung cancers: ADC test-retest repeatability.

Alex Weller1, Marianthi Vasiliki Papoutsaki2, John C Waterton3

  • 1CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Downs Road, Surrey, SM2 5PT, UK. alex.weller@icr.ac.uk.

European Radiology
|April 12, 2017
PubMed
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Free-breathing Diffusion-Weighted MRI (DW-MRI) shows good test-retest repeatability for lung cancer. Apparent Diffusion Coefficient (ADC) measurements are reliable across institutions and software, supporting multi-center trials.

Area of Science:

  • Radiology
  • Oncology
  • Medical Imaging

Background:

  • Diffusion-Weighted MRI (DW-MRI) is increasingly used for lung cancer assessment.
  • Standardization of Apparent Diffusion Coefficient (ADC) measurements is crucial for multi-center trials and clinical decision-making.

Purpose of the Study:

  • To evaluate the test-retest repeatability of whole-tumour ADC measurements in malignant lung lesions.
  • To assess the impact of different MRI institutions, vendors, and post-processing software on ADC measurement precision.
  • To determine the reliability of a free-breathing DW-MRI protocol for lung cancer imaging.

Main Methods:

  • Thirty malignant lung lesions (>2 cm) from 23 patients were scanned twice using echo-planar DW-MRI (b=100, 500, 800 s/mm²).
  • Scans were performed across 4 institutions and 3 MRI vendors.
Keywords:
Apparent Diffusion Coefficient (ADC)Diffusion-weighted MRILung CancerRepeatabilityReproducibility

Related Experiment Videos

  • Whole-tumour volumes-of-interest were transferred between visits and post-processing platforms to assess repeatability and reproducibility.

    • Main Results:

    • Within-patient coefficient of variation (wCV) for ADC was 7.1% (95% CI 5.7-9.6%), with limits-of-agreement (LoA) of -18.0% to 21.9%.
    • Improved repeatability was observed for lesions >3 cm (wCV 3.9%, LoA -10.2% to 11.4%), with 2.46 times higher variability for smaller lesions.
    • Excellent ADC reproducibility was found across different post-processing platforms (Pearson's R²=0.99, CoV 2.8%, LoA -7.4% to 8.0%).

    Conclusions:

    • A free-breathing DW-MRI protocol provides satisfactory within-patient repeatability for malignant lung tumours.
    • The protocol is robust to variations in post-processing software, making it suitable for multi-center trials.
    • A change in ADC exceeding 21.9% is recommended to indicate treatment-related changes in individual patients.