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Tomography
Volume 6
Issue 2
10.18383/j.tom.2020.00008
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Tomography is published by MDPI from Volume 7 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Grapho, LLC.
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Article

Repeatability and Reproducibility of ADC Histogram Metrics from the ACRIN 6698 Breast Cancer Therapy Response Trial

by
David C. Newitt
1,*,
Ghoncheh Amouzandeh
2,
Savannah C. Partridge
3,
Helga S. Marques
4,
Benjamin A. Herman
4,
Brian D. Ross
2,
Nola M. Hylton
1,
Thomas L. Chenevert
2 and
Dariya I. Malyarenko
2
1
Department of Radiology and Biomedical Imaging, UCSF/Mt. Zion Hospital, 1600 Divisadero St., Room C254, San Francisco, CA 94115, USA
2
Department of Radiology, University of Michigan, Ann Arbor, MI, USA
3
Department of Radiology, University of Washington, Seattle, WA, USA
4
Brown University—Center for Statistical Sciences, ECOG-ACRIN Biostatistics Center, Providence, RI, USA
*
Author to whom correspondence should be addressed.
Tomography 2020, 6(2), 177-185; https://doi.org/10.18383/j.tom.2020.00008
Submission received: 10 March 2020 / Revised: 11 April 2020 / Accepted: 12 May 2020 / Published: 1 June 2020
Versions Notes

Abstract

Mean tumor apparent diffusion coefficient (ADC) of breast cancer showed excellent repeatability but only moderate predictive power for breast cancer therapy response in the ACRIN 6698 multicenter imaging trial. Previous single-center studies have shown improved predictive performance for alternative ADC histogram metrics related to low ADC dense tumor volume. Using test/retest (TT/RT) 4 b-value diffusion-weighted imaging acquisitions from pretreatment or early-treatment time-points on 71 ACRIN 6698 patients, we evaluated repeatability for ADC histogram metrics to establish confidence intervals and inform predictive models for future therapy response analysis. Histograms were generated using regions of interest (ROIs) defined separately for TT and RT diffusion-weighted imaging. TT/RT repeatability and intra- and inter-reader reproducibility (on a 20-patient subset) were evaluated using wCV and Bland–Altman limits of agreement for histogram percentiles, low-ADC dense tumor volumes, and fractional volumes (normalized to total histogram volume). Pearson correlation was used to reveal connections between metrics and ROI variability across the sample cohort. Low percentiles (15th and 25th) were highly repeatable and reproducible, wCV < 8.1%, comparable to mean ADC values previously reported. Volumetric metrics had higher wCV values in all cases, with fractional volumes somewhat better but at least 3 times higher than percentile wCVs. These metrics appear most sensitive to ADC changes around a threshold of 1.2 μm2/ms. Volumetric results were moderately to strongly correlated with ROI size. In conclusion, Lower histogram percentiles have comparable repeatability to mean ADC, while ADC-thresholded volumetric measures currently have poor repeatability but may benefit from improvements in ROI techniques.
Keywords: clinical imaging trials; breast cancer therapy response; apparent diffusion coefficient; ADC repeatability; ADC histogram analysis clinical imaging trials; breast cancer therapy response; apparent diffusion coefficient; ADC repeatability; ADC histogram analysis

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MDPI and ACS Style

Newitt, D.C.; Amouzandeh, G.; Partridge, S.C.; Marques, H.S.; Herman, B.A.; Ross, B.D.; Hylton, N.M.; Chenevert, T.L.; Malyarenko, D.I. Repeatability and Reproducibility of ADC Histogram Metrics from the ACRIN 6698 Breast Cancer Therapy Response Trial. Tomography 2020, 6, 177-185. https://doi.org/10.18383/j.tom.2020.00008

AMA Style

Newitt DC, Amouzandeh G, Partridge SC, Marques HS, Herman BA, Ross BD, Hylton NM, Chenevert TL, Malyarenko DI. Repeatability and Reproducibility of ADC Histogram Metrics from the ACRIN 6698 Breast Cancer Therapy Response Trial. Tomography. 2020; 6(2):177-185. https://doi.org/10.18383/j.tom.2020.00008

Chicago/Turabian Style

Newitt, David C., Ghoncheh Amouzandeh, Savannah C. Partridge, Helga S. Marques, Benjamin A. Herman, Brian D. Ross, Nola M. Hylton, Thomas L. Chenevert, and Dariya I. Malyarenko. 2020. "Repeatability and Reproducibility of ADC Histogram Metrics from the ACRIN 6698 Breast Cancer Therapy Response Trial" Tomography 6, no. 2: 177-185. https://doi.org/10.18383/j.tom.2020.00008

APA Style

Newitt, D. C., Amouzandeh, G., Partridge, S. C., Marques, H. S., Herman, B. A., Ross, B. D., Hylton, N. M., Chenevert, T. L., & Malyarenko, D. I. (2020). Repeatability and Reproducibility of ADC Histogram Metrics from the ACRIN 6698 Breast Cancer Therapy Response Trial. Tomography, 6(2), 177-185. https://doi.org/10.18383/j.tom.2020.00008

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