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TOMOGRAPHY, March 2019, Volume 5, Issue 1:110-117
DOI: 10.18383/j.tom.2018.00041

Evaluating Multisite rCBV Consistency from DSC-MRI Imaging Protocols and Postprocessing Software Across the NCI Quantitative Imaging Network Sites Using a Digital Reference Object (DRO)

Laura C. Bell1, Natenael Semmineh1, Hongyu An2, Cihat Eldeniz2, Richard Wahl2, Kathleen M. Schmainda3, Melissa A. Prah3, Bradley J. Erickson4, Panagiotis Korfiatis4, Chengyue Wu5, Anna G. Sorace5, Thomas E. Yankeelov5, Neal Rutledge5, Thomas L. Chenevert6, Dariya Malyarenko6, Yichu Liu7, Andrew Brenner7, Leland S. Hu8, Yuxiang Zhou8, Jerrold L. Boxerman9, Yi-Fen Yen11, Jayashree Kalpathy-Cramer11, Andrew L. Beers11, Mark Muzi12, Ananth J. Madhuranthakam13, Marco Pinho13, Brian Johnson13, C. Chad Quarles1

1Division of Neuroimaging Research, Barrow Neurological Institute, Phoenix, AZ;2Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO;3Departments of Radiology and Biophysics, Medical College of Wisconsin, Wauwatosa, WI;4Department of Radiology, Mayo Clinic, Rochester, MN;5Department of Diagnostic Medicine, University of Texas at Austin, Austin, TX;6Department of Radiology, University of Michigan, Ann Arbor, MI;7UT Health San Antonio, San Antonio, TX;8Department of Radiology, Mayo Clinic, Scottsdale, AZ;9Department of Diagnostic Imaging, Rhode Island Hospital, Providence, RI;10Alpert Medical School of Brown University, Providence, RI;11Department of Radiology, Massachusetts General Hospital, Boston, MA;12Department of Radiology, University of Washington, Seattle, Washington;13UT Southwestern Medical Center, Dallas, TX; and14Philips Healthcare, Gainesville, FL

Abstract

The use of rCBV as a response metric in clinical trials has been hampered, in part, due to variations in the biomarker consistency and associated interpretation across sites, stemming from differences in image acquisition and post-processing methods. This study leveraged a dynamic susceptibility contrast magnetic resonance imaging digital reference object to characterize rCBV consistency across 12 sites participating in the Quantitative Imaging Network (QIN), specifically focusing on differences in site-specific imaging protocols (IPs; n = 17), and PMs (n = 19) and differences due to site-specific IPs and PMs (n = 25). Thus, high agreement across sites occurs when 1 managing center processes rCBV despite slight variations in the IP. This result is most likely supported by current initiatives to standardize IPs. However, marked intersite disagreement was observed when site-specific software was applied for rCBV measurements. This study's results have important implications for comparing rCBV values across sites and trials, where variability in PMs could confound the comparison of therapeutic effectiveness and/or any attempts to establish thresholds for categorical response to therapy. To overcome these challenges and ensure the successful use of rCBV as a clinical trial biomarker, we recommend the establishment of qualifying and validating site- and trial-specific criteria for scanners and acquisition methods (eg, using a validated phantom) and the software tools used for dynamic susceptibility contrast magnetic resonance imaging analysis (eg, using a digital reference object where the ground truth is known).

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