Recommendations for improved reproducibility of ADC derivation on behalf of the Elekta MRI-linac consortium image analysis working group Journal Article


Authors: Bisgaard, A. L. H.; Keesman, R.; van Lier, A. L. H. M. W.; Coolens, C.; van Houdt, P. J.; Tree, A.; Wetscherek, A.; Romesser, P. B.; Tyagi, N.; Lo Russo, M.; Habrich, J.; Vesprini, D.; Lau, A. Z.; Mook, S.; Chung, P.; Kerkmeijer, L. G. W.; Gouw, Z. A. R.; Lorenzen, E. L.; van der Heide, U. A.; Schytte, T.; Brink, C.; Mahmood, F.
Article Title: Recommendations for improved reproducibility of ADC derivation on behalf of the Elekta MRI-linac consortium image analysis working group
Abstract: Background and purpose: The apparent diffusion coefficient (ADC), a potential imaging biomarker for radiotherapy response, needs to be reproducible before translation into clinical use. The aim of this study was to evaluate the multi-centre delineation- and calculation-related ADC variation and give recommendations to minimize it. Materials and methods: Nine centres received identical diffusion-weighted and anatomical magnetic resonance images of different cancerous tumours (adrenal gland, pelvic oligo metastasis, pancreas, and prostate). All centres delineated the gross tumour volume (GTV), clinical target volume (CTV), and viable tumour volume (VTV), and calculated ADCs using both their local calculation methods and each of the following calculation conditions: b-values 0–500 vs. 150–500 s/mm2, region-of-interest (ROI)-based vs. voxel-based calculation, and mean vs. median. ADC variation was assessed using the mean coefficient of variation across delineations (CVD) and calculation methods (CVC). Absolute ADC differences between calculation conditions were evaluated using Friedman's test. Recommendations for ADC calculation were formulated based on observations and discussions within the Elekta MRI-linac consortium image analysis working group. Results: The median (range) CVD and CVC were 0.06 (0.02–0.32) and 0.17 (0.08–0.26), respectively. The ADC estimates differed 18% between b-value sets and 4% between ROI/voxel-based calculation (p-values < 0.01). No significant difference was observed between mean and median (p = 0.64). Aligning calculation conditions between centres reduced CVC to 0.04 (0.01–0.16). CVD was comparable between ROI types. Conclusion: Overall, calculation methods had a larger impact on ADC reproducibility compared to delineation. Based on the results, significant sources of variation were identified, which should be considered when initiating new studies, in particular multi-centre investigations. © 2023 The Author(s)
Keywords: adult; clinical article; controlled study; aged; middle aged; pancreas cancer; nuclear magnetic resonance imaging; magnetic resonance imaging; neoplasm; neoplasms; reproducibility; reproducibility of results; metastasis; image analysis; tumor volume; prostate cancer; multicenter study; image processing, computer-assisted; image processing; diffusion weighted imaging; diffusion magnetic resonance imaging; nuclear magnetic resonance; gross tumor volume; clinical target volume; prostate volume; procedures; apparent diffusion coefficient; adrenal cancer; diffusion-weighted magnetic resonance imaging; humans; human; male; female; article; mri-linac; t2 weighted imaging; adaptive radiotheray; adc reproducibility; mri biomarkers; seminal vesicle cancer
Journal Title: Radiotherapy and Oncology
Volume: 186
ISSN: 0167-8140
Publisher: Elsevier Inc.  
Date Published: 2023-09-01
Start Page: 109803
Language: English
DOI: 10.1016/j.radonc.2023.109803
PUBMED: 37437609
PROVIDER: scopus
PMCID: PMC11197850
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Paul Bernard Romesser
    189 Romesser
  2. Neelam Tyagi
    151 Tyagi