Universität zu Köln

Lennartz, Simon, Zopfs, David, Nobis, Anne, Paquet, Stefanie, Hoyer, Ulrike Cornelia Isabel, Zaeske, Charlotte ORCID: 0000-0003-3746-8523, Goertz, Lukas, Kabbasch, Christoph, Laukamp, Kai Roman, Hokamp, Nils Grosse, Galldiks, Norbert ORCID: 0000-0002-2485-1796 and Borggrefe, Jan ORCID: 0000-0003-2908-7560 (2020). MRI Follow-up of Astrocytoma: Automated Coregistration and Color-Coding of FLAIR Sequences Improves Diagnostic Accuracy With Comparable Reading Time. J. Magn. Reson. Imaging, 52 (4). S. 1197 - 1207. HOBOKEN: WILEY. ISSN 1522-2586

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Abstract

Background MRI follow-up is widely used for longitudinal assessment of astrocytoma, yet reading can be tedious and error-prone, in particular when changes are subtle. Purpose/Hypothesis To determine the effect of automated, color-coded coregistration (AC) of fluid attenuated inversion recovery (FLAIR) sequences on diagnostic accuracy, certainty, and reading time compared to conventional follow-up MRI assessment of astrocytoma patients. Study Type Retrospective. Population In all, 41 patients with neuropathologically confirmed astrocytoma. Field Strength/Sequence 1.0-3.0T/FLAIR Assessment The presence or absence of tumor progression was determined based on FLAIR sequences, contrast-enhanced T-1 sequences, and clinical data. Three radiologists assessed 47 MRI study pairs in a conventional reading (CR) and in a second reading supported by AC after 6 weeks. Readers determined the presence/absence of tumor progression and indicated diagnostic certainty on a 5-point Likert scale. Reading time was recorded by an independent assessor. Statistical Tests The Wilcoxon test was used to assess reading time and diagnostic certainty. Differences in diagnostic accuracy, sensitivity, and specificity were analyzed with the McNemar mid-p test. Results Readers attained significantly higher overall sensitivity (0.86 vs. 0.75; P < 0.05) and diagnostic accuracy (0.84 vs. 0.73; P < 0.05) for detection of progressive nonenhancing tumor burden when using AC compared to CR. There was a strong trend towards higher specificity within the AC-augmented reading, yet without statistical significance (0.83 vs. 0.71; P = 0.08). Sensitivity for unequivocal disease progression was similarly high in both approaches (AC: 0.94, CR: 0.92), while for marginal disease progressions, it was significantly higher in AC (AC: 0.78, CR: 0.58; P < 0.05). Reading time including application loading time was comparable (AC: 38.1 +/- 16.8 sec, CR: 36.0 +/- 18.9 s; P = 0.25). Data Conclusion Compared to CR, AC improves comparison of FLAIR signal hyperintensity at MRI follow-up of astrocytoma patients, allowing for a significantly higher diagnostic accuracy, particularly for subtle disease progression at a comparable reading time. Evidence Level 3 Technical Efficacy Stage 6

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lennartz, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Zopfs, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Nobis, Anne UNSPECIFIED UNSPECIFIED UNSPECIFIED Paquet, Stefanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoyer, Ulrike Cornelia Isabel UNSPECIFIED UNSPECIFIED UNSPECIFIED Zaeske, Charlotte UNSPECIFIED orcid.org/0000-0003-3746-8523 UNSPECIFIED Goertz, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Kabbasch, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Laukamp, Kai Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Hokamp, Nils Grosse UNSPECIFIED UNSPECIFIED UNSPECIFIED Galldiks, Norbert UNSPECIFIED orcid.org/0000-0002-2485-1796 UNSPECIFIED Borggrefe, Jan UNSPECIFIED orcid.org/0000-0003-2908-7560 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-337586
DOI:	10.1002/jmri.27136
Journal or Publication Title:	J. Magn. Reson. Imaging
Volume:	52
Number:	4
Page Range:	S. 1197 - 1207
Date:	2020
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1522-2586
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PSEUDOPROGRESSION; PROGRESSION; THERAPY; GLIOMAS; ADULTS; BRAIN Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33758