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A novel, reproducible, and objective method for volumetric magnetic resonance imaging assessment of enhancing glioblastoma.

Publication ,  Journal Article
Kanaly, CW; Mehta, AI; Ding, D; Hoang, JK; Kranz, PG; Herndon, JE; Coan, A; Crocker, I; Waller, AF; Friedman, AH; Reardon, DA; Sampson, JH
Published in: J Neurosurg
September 2014

OBJECT: Robust methodology that allows objective, automated, and observer-independent measurements of brain tumor volume, especially after resection, is lacking. Thus, determination of tumor response and progression in neurooncology is unreliable. The objective of this study was to determine if a semi-automated volumetric method for quantifying enhancing tissue would perform with high reproducibility and low interobserver variability. METHODS: Fifty-seven MR images from 13 patients with glioblastoma were assessed using our method, by 2 neuroradiologists, 1 neurosurgeon, 1 neurosurgical resident, 1 nurse practitioner, and 1 medical student. The 2 neuroradiologists also performed traditional 1-dimensional (1D) and 2-dimensional (2D) measurements. Intraclass correlation coefficients (ICCs) assessed interobserver variability between measurements. Radiological response was determined using Response Evaluation Criteria In Solid Tumors (RECIST) guidelines and Macdonald criteria. Kappa statistics described interobserver variability of volumetric radiological response determinations. RESULTS: There was strong agreement for 1D (RECIST) and 2D (Macdonald) measurements between neuroradiologists (ICC = 0.42 and 0.61, respectively), but the agreement using the authors' novel automated approach was significantly stronger (ICC = 0.97). The volumetric method had the strongest agreement with regard to radiological response (κ = 0.96) when compared with 2D (κ = 0.54) or 1D (κ = 0.46) methods. Despite diverse levels of experience of the users of the volumetric method, measurements using the volumetric program remained remarkably consistent in all users (0.94). CONCLUSIONS: Interobserver variability using this new semi-automated method is less than the variability with traditional methods of tumor measurement. This new method is objective, quick, and highly reproducible among operators with varying levels of expertise. This approach should be further evaluated as a potential standard for response assessment based on contrast enhancement in brain tumors.

Duke Scholars

Published In

J Neurosurg

DOI

EISSN

1933-0693

Publication Date

September 2014

Volume

121

Issue

3

Start / End Page

536 / 542

Location

United States

Related Subject Headings

  • Tumor Burden
  • Reproducibility of Results
  • Observer Variation
  • Neurology & Neurosurgery
  • Middle Aged
  • Magnetic Resonance Imaging
  • Humans
  • Glioblastoma
  • Disease Progression
  • Brain Neoplasms
 

Citation

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Kanaly, C. W., Mehta, A. I., Ding, D., Hoang, J. K., Kranz, P. G., Herndon, J. E., … Sampson, J. H. (2014). A novel, reproducible, and objective method for volumetric magnetic resonance imaging assessment of enhancing glioblastoma. J Neurosurg, 121(3), 536–542. https://doi.org/10.3171/2014.4.JNS121952
Kanaly, Charles W., Ankit I. Mehta, Dale Ding, Jenny K. Hoang, Peter G. Kranz, James E. Herndon, April Coan, et al. “A novel, reproducible, and objective method for volumetric magnetic resonance imaging assessment of enhancing glioblastoma.J Neurosurg 121, no. 3 (September 2014): 536–42. https://doi.org/10.3171/2014.4.JNS121952.
Kanaly CW, Mehta AI, Ding D, Hoang JK, Kranz PG, Herndon JE, et al. A novel, reproducible, and objective method for volumetric magnetic resonance imaging assessment of enhancing glioblastoma. J Neurosurg. 2014 Sep;121(3):536–42.
Kanaly, Charles W., et al. “A novel, reproducible, and objective method for volumetric magnetic resonance imaging assessment of enhancing glioblastoma.J Neurosurg, vol. 121, no. 3, Sept. 2014, pp. 536–42. Pubmed, doi:10.3171/2014.4.JNS121952.
Kanaly CW, Mehta AI, Ding D, Hoang JK, Kranz PG, Herndon JE, Coan A, Crocker I, Waller AF, Friedman AH, Reardon DA, Sampson JH. A novel, reproducible, and objective method for volumetric magnetic resonance imaging assessment of enhancing glioblastoma. J Neurosurg. 2014 Sep;121(3):536–542.

Published In

J Neurosurg

DOI

EISSN

1933-0693

Publication Date

September 2014

Volume

121

Issue

3

Start / End Page

536 / 542

Location

United States

Related Subject Headings

  • Tumor Burden
  • Reproducibility of Results
  • Observer Variation
  • Neurology & Neurosurgery
  • Middle Aged
  • Magnetic Resonance Imaging
  • Humans
  • Glioblastoma
  • Disease Progression
  • Brain Neoplasms