RT Journal Article
SR Electronic
T1 Semiautomated Volumetric Measurement on Postcontrast MR Imaging for Analysis of Recurrent and Residual Disease in Glioblastoma Multiforme
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A3724
A1 D.S. Chow
A1 J. Qi
A1 X. Guo
A1 V.Z. Miloushev
A1 F.M. Iwamoto
A1 J.N. Bruce
A1 A.B. Lassman
A1 L.H. Schwartz
A1 A. Lignelli
A1 B. Zhao
A1 C.G. Filippi
YR 2013
UL http://www.ajnr.org/content/early/2013/08/29/ajnr.A3724.abstract
AB BACKGROUND AND PURPOSE: A limitation in postoperative monitoring of patients with glioblastoma is the lack of objective measures to quantify residual and recurrent disease. Automated computer-assisted volumetric analysis of contrast-enhancing tissue represents a potential tool to aid the radiologist in following these patients. In this study, we hypothesize that computer-assisted volumetry will show increased precision and speed over conventional 1D and 2D techniques in assessing residual and/or recurrent tumor. MATERIALS AND METHODS: This retrospective study included patients with native glioblastomas with MR imaging performed at 24–48 hours following resection and 2–4 months postoperatively. 1D and 2D measurements were performed by 2 neuroradiologists with Certificates of Added Qualification. Volumetry was performed by using manual segmentation and computer-assisted volumetry, which combines region-based active contours and a level set approach. Tumor response was assessed by using established 1D, 2D, and volumetric standards. Manual and computer-assisted volumetry segmentation times were compared. Interobserver correlation was determined among 1D, 2D, and volumetric techniques. RESULTS: Twenty-nine patients were analyzed. Discrepancy in disease status between 1D and 2D compared with computer-assisted volumetry was 10.3% (3/29) and 17.2% (5/29), respectively. The mean time for segmentation between manual and computer-assisted volumetry techniques was 9.7 minutes and <1 minute, respectively (P < .01). Interobserver correlation was highest for volumetric measurements (0.995; 95% CI, 0.990–0.997) compared with 1D (0.826; 95% CI, 0.695–0.904) and 2D (0.905; 95% CI, 0.828–0.948) measurements. CONCLUSIONS: Computer-assisted volumetry provides a reproducible and faster volumetric assessment of enhancing tumor burden, which has implications for monitoring disease progression and quantification of tumor burden in treatment trials. Abbreviations CAVcomputer-assisted volumetryGBMglioblastoma multiformeRANOResponse Assessment in Neuro-Oncology