Multi-site concordance of diffusion-weighted imaging quantification for assessing prostate cancer aggressiveness Journal Article
| Authors: | McGarry, S. D.; Brehler, M.; Bukowy, J. D.; Lowman, A. K.; Bobholz, S. A.; Duenweg, S. R.; Banerjee, A.; Hurrell, S. L.; Malyarenko, D.; Chenevert, T. L.; Cao, Y.; Li, Y.; You, D.; Fedorov, A.; Bell, L. C.; Quarles, C. C.; Prah, M. A.; Schmainda, K. M.; Taouli, B.; LoCastro, E.; Mazaheri, Y.; Shukla-Dave, A.; Yankeelov, T. E.; Hormuth, D. A. 2nd; Madhuranthakam, A. J.; Hulsey, K.; Li, K.; Huang, W.; Huang, W.; Muzi, M.; Jacobs, M. A.; Solaiyappan, M.; Hectors, S.; Antic, T.; Paner, G. P.; Palangmonthip, W.; Jacobsohn, K.; Hohenwalter, M.; Duvnjak, P.; Griffin, M.; See, W.; Nevalainen, M. T.; Iczkowski, K. A.; LaViolette, P. S. |
| Article Title: | Multi-site concordance of diffusion-weighted imaging quantification for assessing prostate cancer aggressiveness |
| Abstract: | Background: Diffusion-weighted imaging (DWI) is commonly used to detect prostate cancer, and a major clinical challenge is differentiating aggressive from indolent disease. Purpose: To compare 14 site-specific parametric fitting implementations applied to the same dataset of whole-mount pathologically validated DWI to test the hypothesis that cancer differentiation varies with different fitting algorithms. Study Type: Prospective. Population: Thirty-three patients prospectively imaged prior to prostatectomy. Field Strength/Sequence: 3 T, field-of-view optimized and constrained undistorted single-shot DWI sequence. Assessment: Datasets, including a noise-free digital reference object (DRO), were distributed to the 14 teams, where locally implemented DWI parameter maps were calculated, including mono-exponential apparent diffusion coefficient (MEADC), kurtosis (K), diffusion kurtosis (DK), bi-exponential diffusion (BID), pseudo-diffusion (BID*), and perfusion fraction (F). The resulting parametric maps were centrally analyzed, where differentiation of benign from cancerous tissue was compared between DWI parameters and the fitting algorithms with a receiver operating characteristic area under the curve (ROC AUC). Statistical Test: Levene's test, P < 0.05 corrected for multiple comparisons was considered statistically significant. Results: The DRO results indicated minimal discordance between sites. Comparison across sites indicated that K, DK, and MEADC had significantly higher prostate cancer detection capability (AUC range = 0.72–0.76, 0.76–0.81, and 0.76–0.80 respectively) as compared to bi-exponential parameters (BID, BID*, F) which had lower AUC and greater between site variation (AUC range = 0.53–0.80, 0.51–0.81, and 0.52–0.80 respectively). Post-processing parameters also affected the resulting AUC, moving from, for example, 0.75 to 0.87 for MEADC varying cluster size. Data Conclusion: We found that conventional diffusion models had consistent performance at differentiating prostate cancer from benign tissue. Our results also indicated that post-processing decisions on DWI data can affect sensitivity and specificity when applied to radiological–pathological studies in prostate cancer. Level of Evidence: 1. Technical Efficacy: Stage 3. © 2021 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine. |
| Keywords: | retrospective studies; prospective study; sensitivity and specificity; prospective studies; diffusion; diagnostic imaging; retrospective study; prostatic neoplasms; prostate; prostate tumor; diffusion weighted imaging; diffusion magnetic resonance imaging; mri; roc curve; receiver operating characteristic; procedures; cancer; humans; human; male; multisite |modelling |
| Journal Title: | Journal of Magnetic Resonance Imaging |
| Volume: | 55 |
| Issue: | 6 |
| ISSN: | 1053-1807 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2022-06-01 |
| Start Page: | 1745 |
| End Page: | 1758 |
| Language: | English |
| DOI: | 10.1002/jmri.27983 |
| PUBMED: | 34767682 |
| PROVIDER: | scopus |
| PMCID: | PMC9095769 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 June 2022 -- Source: Scopus |
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