Oliver Lukas Sedlaczek1,2,3, Jens Kleesiek4, Ferdia A Gallagher5, Jacob Murray4, Sebastian Prinz4, Raquel Perez-Lopez6, Evia Sala7, Caroline Caramella8, Sebastian Diffetock8, Nathalie Lassau8, Andrew N Priest5,9, Chikako Suzuki10, Roberto Vargas11, Tommaso Giandini12, Marta Vaiani13, Antonella Messina13, Lennart K Blomqvist10, Regina G H Beets-Tan14, Petra Oberrauch15, Heinz-Peter Schlemmer4,15, Michael Bach4. 1. Department of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany. O.Sedlaczek@nct-heidelberg.de. 2. Division of Translational Medical Oncology, National Center for Tumor Diseases Heidelberg (NCT) and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 460, 69120, Heidelberg, Germany. O.Sedlaczek@nct-heidelberg.de. 3. Department of Radiology, University Hospital Heidelberg, Heidelberg, Germany. O.Sedlaczek@nct-heidelberg.de. 4. Department of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany. 5. Department of Radiology, University of Cambridge, Cambridge, UK. 6. Department of Radiology, Vall d'Hebron University Hospital, Barcelona, Spain. 7. Department of Radiology, University of Cambridge and Cancer Research UK Cambridge Centre, Cambridge, UK. 8. Imaging Department, Gustave Roussy, BIOMAPS, UMR1281, INSERM, CEA, CNRS, Université Paris Saclay, Villejuif, Paris, France. 9. Department of Radiology, Addenbrooke's Hospital, Cambridge, UK. 10. Department of Radiation Physics and Nuclear Medicine, Karolinska University Hospital and Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden. 11. Department of Radiology, Karolinska University Hospital and Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden. 12. Medical Physics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 13. Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 14. Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 15. Division of Translational Medical Oncology, National Center for Tumor Diseases Heidelberg (NCT) and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 460, 69120, Heidelberg, Germany.
Abstract
OBJECTIVES: In the Cancer Core Europe Consortium (CCE), standardized biomarkers are required for therapy monitoring oncologic multicenter clinical trials. Multiparametric functional MRI and particularly diffusion-weighted MRI offer evident advantages for noninvasive characterization of tumor viability compared to CT and RECIST. A quantification of the inter- and intraindividual variation occurring in this setting using different hardware is missing. In this study, the MRI protocol including DWI was standardized and the residual variability of measurement parameters quantified. METHODS: Phantom and volunteer measurements (single-shot T2w and DW-EPI) were performed at the seven CCE sites using the MR hardware produced by three different vendors. Repeated measurements were performed at the sites and across the sites including a traveling volunteer, comparing qualitative and quantitative ROI-based results including an explorative radiomics analysis. RESULTS: For DWI/ADC phantom measurements using a central post-processing algorithm, the maximum deviation could be decreased to 2%. However, there is no significant difference compared to a decentralized ADC value calculation at the respective MRI devices. In volunteers, the measurement variation in 2 repeated scans did not exceed 11% for ADC and is below 20% for single-shot T2w in systematic liver ROIs. The measurement variation between sites amounted to 20% for ADC and < 25% for single-shot T2w. Explorative radiomics classification experiments yield better results for ADC than for single-shot T2w. CONCLUSION: Harmonization of MR acquisition and post-processing parameters results in acceptable standard deviations for MR/DW imaging. MRI could be the tool in oncologic multicenter trials to overcome the limitations of RECIST-based response evaluation. KEY POINTS: • Harmonizing acquisition parameters and post-processing homogenization, standardized protocols result in acceptable standard deviations for multicenter MR-DWI studies. • Total measurement variation does not to exceed 11% for ADC in repeated measurements in repeated MR acquisitions, and below 20% for an identical volunteer travelling between sites. • Radiomic classification experiments were able to identify stable features allowing for reliable discrimination of different physiological tissue samples, even when using heterogeneous imaging data.
OBJECTIVES: In the Cancer Core Europe Consortium (CCE), standardized biomarkers are required for therapy monitoring oncologic multicenter clinical trials. Multiparametric functional MRI and particularly diffusion-weighted MRI offer evident advantages for noninvasive characterization of tumor viability compared to CT and RECIST. A quantification of the inter- and intraindividual variation occurring in this setting using different hardware is missing. In this study, the MRI protocol including DWI was standardized and the residual variability of measurement parameters quantified. METHODS: Phantom and volunteer measurements (single-shot T2w and DW-EPI) were performed at the seven CCE sites using the MR hardware produced by three different vendors. Repeated measurements were performed at the sites and across the sites including a traveling volunteer, comparing qualitative and quantitative ROI-based results including an explorative radiomics analysis. RESULTS: For DWI/ADC phantom measurements using a central post-processing algorithm, the maximum deviation could be decreased to 2%. However, there is no significant difference compared to a decentralized ADC value calculation at the respective MRI devices. In volunteers, the measurement variation in 2 repeated scans did not exceed 11% for ADC and is below 20% for single-shot T2w in systematic liver ROIs. The measurement variation between sites amounted to 20% for ADC and < 25% for single-shot T2w. Explorative radiomics classification experiments yield better results for ADC than for single-shot T2w. CONCLUSION: Harmonization of MR acquisition and post-processing parameters results in acceptable standard deviations for MR/DW imaging. MRI could be the tool in oncologic multicenter trials to overcome the limitations of RECIST-based response evaluation. KEY POINTS: • Harmonizing acquisition parameters and post-processing homogenization, standardized protocols result in acceptable standard deviations for multicenter MR-DWI studies. • Total measurement variation does not to exceed 11% for ADC in repeated measurements in repeated MR acquisitions, and below 20% for an identical volunteer travelling between sites. • Radiomic classification experiments were able to identify stable features allowing for reliable discrimination of different physiological tissue samples, even when using heterogeneous imaging data.