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. 2020 Oct;52(4):1197-1206.
doi: 10.1002/jmri.27136. Epub 2020 Apr 4.

MRI Follow-up of Astrocytoma: Automated Coregistration and Color-Coding of FLAIR Sequences Improves Diagnostic Accuracy With Comparable Reading Time

Simon Lennartz  1   2   3 , David Zopfs  1 , Anne Nobis  1 , Stefanie Paquet  1 , Ulrike Cornelia Isabel Hoyer  1 , Charlotte Zäske  1 , Lukas Goertz  4 , Christoph Kabbasch  1 , Kai Roman Laukamp  1 , Nils Große Hokamp  1 , Norbert Galldiks  5   6   7 , Jan Borggrefe  1
Affiliations

MRI Follow-up of Astrocytoma: Automated Coregistration and Color-Coding of FLAIR Sequences Improves Diagnostic Accuracy With Comparable Reading Time

Simon Lennartz et al. J Magn Reson Imaging. 2020 Oct.

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 T1 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 J. Magn. Reson. Imaging 2020;52:1197-1206.

Keywords: astrocytoma; central nervous system; coregistration; diagnosis; follow-up; magnetic resonance imaging.

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References

    1. Ostrom QT, Bauchet L, Davis FG, et al. The epidemiology of glioma in adults. A “state of the science” review. Neuro Oncol 2014;16:896-913.
    1. Forst DA, Nahed BV, Loeffler JS, Batchelor TT. Low-grade gliomas. Oncologist 2014;19:403-413.
    1. Hathout L, Pope WB, Lai A, Nghiemphu PL, Cloughesy TF, Ellingson BM. Radial expansion rates and tumor growth kinetics predict malignant transformation in contrast-enhancing low-grade diffuse astrocytoma. CNS Oncol 2015;4:247-256.
    1. Reuss DE, Sahm F, Schrimpf D, et al. ATRX and IDH1-R132H immunohistochemistry with subsequent copy number analysis and IDH sequencing as a basis for an "integrated" diagnostic approach for adult astrocytoma, oligodendroglioma and glioblastoma. Acta Neuropathol 2015;129:133-146.
    1. Louis DN, Perry A, Reifenberger G, et al. The World Health Organization classification of tumors of the central nervous system. A summary. Acta Neuropathol 2016;2016(131):803-820.

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