TY - JOUR
T1 - Phantom-based quality assurance for multicenter quantitative MRI in locally advanced cervical cancer
AU - van Houdt, Petra J.
AU - Kallehauge, Jesper F.
AU - Tanderup, Kari
AU - Nout, Remi
AU - Zaletelj, Marko
AU - Tadic, Tony
AU - van Kesteren, Zdenko J.
AU - van den Berg, Cornelius A.T.
AU - Georg, Dietmar
AU - Côté, Jean Charles
AU - Levesque, Ives R.
AU - Swamidas, Jamema
AU - Malinen, Eirik
AU - Telliskivi, Sven
AU - Brynolfsson, Patrik
AU - Mahmood, Faisal
AU - van der Heide, Uulke A.
N1 - Funding Information:
We thank the following people for their assistance with phantom measurements and/or protocol optimization: Robert Hudej, PhD (Dept. of Radiotherapy, Institute of Oncology Ljubljana), Michaela Daniel (Dept. of Radiation Oncology, Medical University of Vienna), Pascal A. Baltzer, MD (Dept. of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna), Supriya Chopra, MD PhD (ACTREC, Tata Memorial Centre), Kelly McPhee, PhD and Warren Foltz, PhD (Radiation Medicine Program, Princess Margaret Cancer Center) and Djordje Kovacevic (Oslo University Hospital). We thank Iris Walraven, PhD (Dept. of Radiation Oncology, the Netherlands Cancer Institute) for consultation on statistical analysis. This work was funded by a research grant from Varian Medical Systems received by Kari Tanderup, PhD and Uulke van der Heide, PhD.
Funding Information:
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: This work was funded by a grant from Varian Medical Systems received by Kari Tanderup and Uulke van der Heide. Relevant financial activities outside the submitted work are reported for the following authors: Uulke van der Heide receives research funding from Philips Healthcare and Elekta AB. Remi Nout receives research funding from Elekta AB, Varian Medical Systems, and Accuray. Cornelius van den Berg receives research funding from Philips Healthcare.
Publisher Copyright:
© 2020 The Authors
PY - 2020/12
Y1 - 2020/12
N2 - Background and purpose: A wide variation of MRI systems is a challenge in multicenter imaging biomarker studies as it adds variation in quantitative MRI values. The aim of this study was to design and test a quality assurance (QA) framework based on phantom measurements, for the quantitative MRI protocols of a multicenter imaging biomarker trial of locally advanced cervical cancer. Materials and methods: Fifteen institutes participated (five 1.5 T and ten 3 T scanners). Each institute optimized protocols for T2, diffusion-weighted imaging, T1, and dynamic contrast-enhanced (DCE–)MRI according to system possibilities, institutional preferences and study-specific constraints. Calibration phantoms with known values were used for validation. Benchmark protocols, similar on all systems, were used to investigate whether differences resulted from variations in institutional protocols or from system variations. Bias, repeatability (%RC), and reproducibility (%RDC) were determined. Ratios were used for T2 and T1 values. Results: The institutional protocols showed a range in bias of 0.88–0.98 for T2 (median %RC = 1%; %RDC = 12%), −0.007 to 0.029 × 10−3 mm2/s for the apparent diffusion coefficient (median %RC = 3%; %RDC = 18%), and 0.39–1.29 for T1 (median %RC = 1%; %RDC = 33%). For DCE a nonlinear vendor-specific relation was observed between measured and true concentrations with magnitude data, whereas the relation was linear when phase data was used. Conclusion: We designed a QA framework for quantitative MRI protocols and demonstrated for a multicenter trial for cervical cancer that measurement of consistent T2 and apparent diffusion coefficient values is feasible despite protocol differences. For DCE–MRI and T1 mapping with the variable flip angle method, this was more challenging.
AB - Background and purpose: A wide variation of MRI systems is a challenge in multicenter imaging biomarker studies as it adds variation in quantitative MRI values. The aim of this study was to design and test a quality assurance (QA) framework based on phantom measurements, for the quantitative MRI protocols of a multicenter imaging biomarker trial of locally advanced cervical cancer. Materials and methods: Fifteen institutes participated (five 1.5 T and ten 3 T scanners). Each institute optimized protocols for T2, diffusion-weighted imaging, T1, and dynamic contrast-enhanced (DCE–)MRI according to system possibilities, institutional preferences and study-specific constraints. Calibration phantoms with known values were used for validation. Benchmark protocols, similar on all systems, were used to investigate whether differences resulted from variations in institutional protocols or from system variations. Bias, repeatability (%RC), and reproducibility (%RDC) were determined. Ratios were used for T2 and T1 values. Results: The institutional protocols showed a range in bias of 0.88–0.98 for T2 (median %RC = 1%; %RDC = 12%), −0.007 to 0.029 × 10−3 mm2/s for the apparent diffusion coefficient (median %RC = 3%; %RDC = 18%), and 0.39–1.29 for T1 (median %RC = 1%; %RDC = 33%). For DCE a nonlinear vendor-specific relation was observed between measured and true concentrations with magnitude data, whereas the relation was linear when phase data was used. Conclusion: We designed a QA framework for quantitative MRI protocols and demonstrated for a multicenter trial for cervical cancer that measurement of consistent T2 and apparent diffusion coefficient values is feasible despite protocol differences. For DCE–MRI and T1 mapping with the variable flip angle method, this was more challenging.
KW - Magnetic resonance imaging
KW - Radiotherapy
KW - Uterine cervical neoplasms
UR - http://www.scopus.com/inward/record.url?scp=85091713431&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2020.09.013
DO - 10.1016/j.radonc.2020.09.013
M3 - Article
C2 - 32931890
AN - SCOPUS:85091713431
SN - 0167-8140
VL - 153
SP - 114
EP - 121
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
ER -