A novel magnetic resonance imaging segmentation technique for determining diffuse intrinsic pontine glioma tumor volume Journal Article


Authors: Singh, R.; Zhou, Z.; Tisnado, J.; Haque, S.; Peck, K. K.; Young, R. J.; Tsiouris, A. J.; Thakur, S. B.; Souweidane, M. M.
Article Title: A novel magnetic resonance imaging segmentation technique for determining diffuse intrinsic pontine glioma tumor volume
Abstract: OBJECTIVE Accurately determining diffuse intrinsic pontine glioma (DIPG) tumor volume is clinically important. The aims of the current study were to 1) measure DIPG volumes using methods that require different degrees of subjective judgment; and 2) evaluate interobserver agreement of measurements made using these methods. METHODS Eight patients from a Phase I clinical trial testing convection-enhanced delivery (CED) of a therapeutic antibody were included in the study. Pre-CED, post-radiation therapy axial T2-weighted images were analyzed using 2 methods requiring high degrees of subjective judgment (picture archiving and communication system [PACS] polygon and Volume Viewer auto-contour methods) and 1 method requiring a low degree of subjective judgment (k-means clustering segmentation) to determine tumor volumes. Lin's concordance correlation coefficients (CCCs) were calculated to assess interobserver agreement. RESULTS The CCCs of measurements made by 2 observers with the PACS polygon and the Volume Viewer auto-contour methods were 0.9465 (lower 1-sided 95% confidence limit 0.8472) and 0.7514 (lower 1-sided 95% confidence limit 0.3143), respectively. Both were considered poor agreement. The CCC of measurements made using k-means clustering segmentation was 0.9938 (lower 1-sided 95% confidence limit 0.9772), which was considered substantial strength of agreement. CONCLUSIONS The poor interobserver agreement of PACS polygon and Volume Viewer auto-contour methods highlighted the difficulty in consistently measuring DIPG tumor volumes using methods requiring high degrees of subjective judgment. k-means clustering segmentation, which requires a low degree of subjective judgment, showed better interobserver agreement and produced tumor volumes with delineated borders.
Keywords: child; preschool child; child, preschool; clinical trial; glioma; magnetic resonance imaging; animal; animals; tumor volume; diagnostic imaging; oncology; monoclonal antibody; tumor burden; phase 1 clinical trial; brain stem neoplasms; diffusion weighted imaging; diffusion magnetic resonance imaging; k-means clustering; procedures; antibodies, monoclonal, murine-derived; diffuse intrinsic pontine glioma; humans; human; male; female; tumor volume determination; ccc = concordance correlation coefficient; ced = convection-enhanced delivery; dipg = diffuse intrinsic pontine glioma; mskcc = memorial sloan kettering cancer center; pacs = picture archiving and communication system; roi = region of interest
Journal Title: Journal of Neurosurgery-Pediatrics
Volume: 18
Issue: 5
ISSN: 1933-0707
Publisher: American Association of Neurological Surgeons  
Date Published: 2016-11-01
Start Page: 565
End Page: 572
Language: English
PUBMED: 27391980
PROVIDER: scopus
DOI: 10.3171/2016.4.peds16132
PMCID: PMC5498312
DOI/URL:
Notes: Article -- Export Date: 2 March 2017 -- Source: Scopus
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MSK Authors
  1. Robert J Young
    228 Young
  2. Sofia S Haque
    148 Haque
  3. Kyung Peck
    116 Peck
  4. Sunitha Bai Thakur
    100 Thakur
  5. Jamie Tisnado
    16 Tisnado