RT Journal Article
SR Electronic
T1 Optimal Presentation Modes for Detecting Brain Tumor Progression
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1652
OP 1657
DO 10.3174/ajnr.A2596
VO 32
IS 9
A1 B.J. Erickson
A1 C.P. Wood
A1 T.J. Kaufmann
A1 J.W. Patriarche
A1 J. Mandrekar
YR 2011
UL http://www.ajnr.org/content/32/9/1652.abstract
AB BACKGROUND AND PURPOSE: A common task in radiology interpretation is visual comparison of images. The purpose of this study was to compare traditional side-by-side and in-place (flicker) image presentation modes with advanced methods for detecting primary brain tumors on MR imaging. MATERIALS AND METHODS: We identified 66 patients with gliomas and 3 consecutive brain MR imaging examinations (a “triplet”). A display application that presented images in side-by-side mode with or without flicker display as well as display of image subtraction or automated change detection information (also with and without flicker display) was used by 3 board-certified neuroradiologists. They identified regions of brain tumor progression by using this display application. Each case was reviewed using all modes (side-by-side presentation with and without flicker, subtraction with and without flicker, and change detection with and without flicker), with results compared via a panel rating. RESULTS: Automated change detection with or without flicker (P < .0027) as well as subtraction with or without flicker (P < .0027) were more sensitive to tumor progression than side-by-side presentation in cases where all 3 raters agreed. Change detection afforded the highest interrater agreement, followed by subtraction. Clinically determined time to progression was longer for cases rated as nonprogressing by using subtraction images and change-detection images both with and without flicker display mode compared with side-by-side presentation. CONCLUSIONS: Automated change detection and image subtraction, with and without flicker display mode, are superior to side-by-side image comparison. AAanaplastic astrocytomaAUCarea under the receiver operating characteristic curveBxbiopsy onlyCchange detection images presented side-by-side onlyC+Fchange detection with flickerCFchange detection images also allowing flicker display modeFLAIRfluid-attenuated inversion recoveryFNfalse-negativeFPfalse-positiveGBMglioblastoma multiformeGTRgross total resectionLCLlower confidence intervalLGGlow-grade gliomaNnormal side-by-side display onlyN+Fside-by-side plus flickerNFnormal side-by-side mode with flickerRECISTresponse evaluation criteria in solid tumorsSsubtraction images with side-by-side displaySFsubtraction images with flicker display modeSTRsubtotal resectionTNtrue-negativeTPtrue-positiveTTPtime to progressionUCLupper confidence interval