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Clinical Trial
. 2009 Sep;4(5):457-62.
doi: 10.1007/s11548-009-0356-4. Epub 2009 Jun 4.

Comparison of diagnostic quality and accuracy in color-coded versus gray-scale DCE-MR imaging display

A Mehndiratta  1 , M V Knopp, C M Zechmann, M Owsijewitsch, H von Tengg-Kobligk, P Zamecnik, H U Kauczor, P L Choyke, F L Giesel
Affiliations
Clinical Trial

Comparison of diagnostic quality and accuracy in color-coded versus gray-scale DCE-MR imaging display

A Mehndiratta et al. Int J Comput Assist Radiol Surg. 2009 Sep.

Abstract

Purpose: The purpose of this study was to evaluate the diagnostic value and tumor-vascular display properties (microcirculation) of two different functional MRI post-processing and display (color and gray-scale display) techniques used in oncology.

Materials and methods: The study protocol was approved by the IRB and written informed consent was obtained from all patients. 38 dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) data sets of patients with malignant pleural-mesothelioma were acquired and post-processed. DCE-MRI was performed at 1.5 tesla with a T1-weighted 2D gradient-echo-sequence (TR 7.0 ms, TE 3.9 ms, 15 axial slices, 22 sequential repetitions), prior and during chemotherapy. Subtracting first image of contrast-enhanced-dynamic series from the last, produced gray-scale images. Color images were produced using a pharmacokinetic two-compartment model. Eight raters, blinded to diagnosis, by visual assessment of post-processed images evaluated both diagnostic quality of the images and vasculature of the tumor using a rating scale ranging from -5 to +5. The scores for vasculature were assessed by correlating with the maximum amplitude of the total-tumor-ROI for accuracy.

Results: Color coded images were rated as significantly higher in diagnostic quality and tumor vascular score than gray-scale images (p < 0.001, 0.005). ROI signal amplitude analysis and vascular ratings on color coded images were better correlated compared to gray-scale images rating (p < 0.05).

Conclusion: Color coded images were shown to have higher diagnostic quality and accuracy with respect to tumor vasculature in DCE-MRI, therefore their implementation in clinical assessment and follow-up should be considered for wider application.

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Figures

Fig. 1
Fig. 1
Subtraction images (a) presenting a patient with malignant pleural mesothelioma adjacent to the right chest wall. The high masculinity of the tumor can be already appreciated to most of the tumor tissue. Color code display (b) presents the same tumor vasculature as in a, but on the basis of a post processed dynamic contrast enhanced MRI. Tumor vasculature is better visualized and hyper- and hypo-vascular areas can be well differentiated
Fig. 2
Fig. 2
Spearman’s rank correlation coefficients for tumor vascularity with signal drop amplitude for the eight rates
Fig. 3
Fig. 3
ROC analysis for tumor vascularity with gray scale and color coded images for eight raters
See this image and copyright information in PMC

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