Abstract
PurposeTo compare the reproducibilities of manual and semiautomatic segmentation method for the measurement of normalized cerebral blood volume (nCBV) using dynamic susceptibility contrast-enhanced (DSC) perfusion MR imaging in glioblastomas.Materials and MethodsTwenty-two patients (11 male, 11 female; 27 tumors) with histologically confirmed glioblastoma (WHO grade IV) were examined with conventional MR imaging and DSC imaging at 3T before surgery or biopsy. Then nCBV (means and standard deviations) in each mass was measured using two DSC MR perfusion analysis methods including manual and semiautomatic segmentation method, in which contrast-enhanced (CE)-T1WI and T2WI were used as structural imaging. Intraobserver and interobserver reproducibility were assessed according to each perfusion analysis method or each structural imaging. Interclass correlation coefficient (ICC), Bland-Altman plot, and coefficient of variation (CV) were used to evaluate reproducibility.ResultsIntraobserver reproducibilities on CE-T1WI and T2WI were ICC of 0.74–0.89 and CV of 20.39–36.83% in manual segmentation method, and ICC of 0.95–0.99 and CV of 8.53–16.19% in semiautomatic segmentation method, repectively. Interobserver reproducibilites on CE-T1WI and T2WI were ICC of 0.86–0.94 and CV of 19.67–35.15% in manual segmentation method, and ICC of 0.74–1.0 and CV of 5.48–49.38% in semiautomatic segmentation method, respectively. Bland-Altman plots showed a good correlation with ICC or CV in each method. The semiautomatic segmentation method showed higher intraobserver and interobserver reproducibilities at CE-T1WI-based study than other methods.ConclusionThe best reproducibility was found using the semiautomatic segmentation method based on CE-T1WI for structural imaging in the measurement of the nCBV of glioblastomas.
Highlights
Perfusion magnetic resonance (MR) imaging has recently become one of the most important methods for the characterization of gliomas
Intraobserver reproducibilities on CE-T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI) were Interclass correlation coefficient (ICC) of 0.74–0.89 and coefficient of variation (CV) of 20.39–36.83% in manual segmentation method, and ICC of 0.95–0.99 and CV of 8.53–16.19% in semiautomatic segmentation method, repectively
Interobserver reproducibilites on CE-T1WI and T2WI were ICC of 0.86–0.94 and CV of 19.67–35.15% in manual segmentation method, and ICC of 0.74–1.0 and CV of 5.48–49.38% in semiautomatic segmentation method, respectively
Summary
Perfusion magnetic resonance (MR) imaging has recently become one of the most important methods for the characterization of gliomas. T2- or T2*-weighted echo-planar MR sequences have been used to demonstrate dynamic changes of signal intensity during the first passage of a bolus of paramagnetic intravascular contrast agents because of the excellent temporal resolution in the entire brain [2,3,4]. The relative cerebral blood volume (rCBV) map derived from DSC MR imaging has been used for the evaluation of gliomas. The rCBV values can be calculated from the measurement of dynamic changes in signal intensity on a pixel-by-pixel basis [2,3,4]. The rCBV values correlate with glioma grading and tumor microvascular degree. Various histogram analyses of brain tumors are possible because of the measurement of rCBV on a pixel-by-pixel basis in the entire brain [7,8,9]
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