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Article

Semi-Automated Segmentation of Bone Metastases from Whole-Body MRI: Reproducibility of Apparent Diffusion Coefficient Measurements

1
Division of Radiology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
2
Postgraduate School in Radiodiagnostics, University of Milan, 20122 Milan, Italy
3
Radiology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy
4
Division of Radiotherapy, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
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Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
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MR Applications Pre-Development, Siemens Healthcare, 91052 Erlangen, Germany
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Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood HA6 2RN, UK
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Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Evangelos Terpos
Diagnostics 2021, 11(3), 499; https://doi.org/10.3390/diagnostics11030499
Received: 16 February 2021 / Revised: 5 March 2021 / Accepted: 9 March 2021 / Published: 11 March 2021
(This article belongs to the Special Issue Whole Body MRI: Major Advances and Future Perspective)
Using semi-automated software simplifies quantitative analysis of the visible burden of disease on whole-body MRI diffusion-weighted images. To establish the intra- and inter-observer reproducibility of apparent diffusion coefficient (ADC) measures, we retrospectively analyzed data from 20 patients with bone metastases from breast (BCa; n = 10; aged 62.3 ± 14.8) or prostate cancer (PCa; n = 10; aged 67.4 ± 9.0) who had undergone examinations at two timepoints, before and after hormone-therapy. Four independent observers processed all images twice, first segmenting the entire skeleton on diffusion-weighted images, and then isolating bone metastases via ADC histogram thresholding (ADC: 650–1400 µm2/s). Dice Similarity, Bland-Altman method, and Intraclass Correlation Coefficient were used to assess reproducibility. Inter-observer Dice similarity was moderate (0.71) for women with BCa and poor (0.40) for men with PCa. Nonetheless, the limits of agreement of the mean ADC were just ±6% for women with BCa and ±10% for men with PCa (mean ADCs: 941 and 999 µm2/s, respectively). Inter-observer Intraclass Correlation Coefficients of the ADC histogram parameters were consistently greater in women with BCa than in men with PCa. While scope remains for improving consistency of the volume segmented, the observer-dependent variability measured in this study was appropriate to distinguish the clinically meaningful changes of ADC observed in patients responding to therapy, as changes of at least 25% are of interest. View Full-Text
Keywords: WB-MRI; DWI; ADC; quantitative analysis; bone metastases; reproducibility WB-MRI; DWI; ADC; quantitative analysis; bone metastases; reproducibility
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MDPI and ACS Style

Colombo, A.; Saia, G.; Azzena, A.A.; Rossi, A.; Zugni, F.; Pricolo, P.; Summers, P.E.; Marvaso, G.; Grimm, R.; Bellomi, M.; Jereczek-Fossa, B.A.; Padhani, A.R.; Petralia, G. Semi-Automated Segmentation of Bone Metastases from Whole-Body MRI: Reproducibility of Apparent Diffusion Coefficient Measurements. Diagnostics 2021, 11, 499. https://doi.org/10.3390/diagnostics11030499

AMA Style

Colombo A, Saia G, Azzena AA, Rossi A, Zugni F, Pricolo P, Summers PE, Marvaso G, Grimm R, Bellomi M, Jereczek-Fossa BA, Padhani AR, Petralia G. Semi-Automated Segmentation of Bone Metastases from Whole-Body MRI: Reproducibility of Apparent Diffusion Coefficient Measurements. Diagnostics. 2021; 11(3):499. https://doi.org/10.3390/diagnostics11030499

Chicago/Turabian Style

Colombo, Alberto, Giulia Saia, Alcide A. Azzena, Alice Rossi, Fabio Zugni, Paola Pricolo, Paul E. Summers, Giulia Marvaso, Robert Grimm, Massimo Bellomi, Barbara A. Jereczek-Fossa, Anwar R. Padhani, and Giuseppe Petralia. 2021. "Semi-Automated Segmentation of Bone Metastases from Whole-Body MRI: Reproducibility of Apparent Diffusion Coefficient Measurements" Diagnostics 11, no. 3: 499. https://doi.org/10.3390/diagnostics11030499

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