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Article

Effect of Inter-Reader Variability on Diffusion-Weighted MRI Apparent Diffusion Coefficient Measurements and Prediction of Pathologic Complete Response for Breast Cancer

1
Department of Radiology & Biomedical Imaging, University of California, San Francisco, CA 94158, USA
2
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94158, USA
3
Department of Radiology, University of Washington, Seattle, WA 98195, USA
4
I-SPY 2 Advocacy Group, San Francisco, CA 94143, USA
5
Department of Surgery and Radiology, University of California, San Francisco, CA 94143, USA
*
Author to whom correspondence should be addressed.
Academic Editors: Chad Quarles, Lubomir Hadjiiski and Robert J. Nordstrom
Tomography 2022, 8(3), 1208-1220; https://doi.org/10.3390/tomography8030099
Received: 1 February 2022 / Revised: 13 April 2022 / Accepted: 15 April 2022 / Published: 22 April 2022
(This article belongs to the Special Issue Quantitative Imaging Network)
This study evaluated the inter-reader agreement of tumor apparent diffusion coefficient (ADC) measurements performed on breast diffusion-weighted imaging (DWI) for assessing treatment response in a multi-center clinical trial of neoadjuvant chemotherapy (NAC) for breast cancer. DWIs from 103 breast cancer patients (mean age: 46 ± 11 years) acquired at baseline and after 3 weeks of treatment were evaluated independently by two readers. Three types of tumor regions of interests (ROIs) were delineated: multiple-slice restricted, single-slice restricted and single-slice tumor ROIs. Compared to tumor ROIs, restricted ROIs were limited to low ADC areas of enhancing tumor only. We found excellent agreement (intraclass correlation coefficient [ICC] ranged from 0.94 to 0.98) for mean ADC. Higher ICCs were observed in multiple-slice restricted ROIs (range: 0.97 to 0.98) than in other two ROI types (both in the range of 0.94 to 0.98). Among the three ROI types, the highest area under the receiver operating characteristic curves (AUCs) were observed for mean ADC of multiple-slice restricted ROIs (0.65, 95% confidence interval [CI]: 0.52–0.79 and 0.67, 95% CI: 0.53–0.81 for Reader 1 and Reader 2, respectively). In conclusion, mean ADC values of multiple-slice restricted ROI showed excellent agreement and similar predictive performance for pathologic complete response between the two readers. View Full-Text
Keywords: reader variability; diffusion-weighted imaging; breast cancer; treatment response; neoadjuvant therapy reader variability; diffusion-weighted imaging; breast cancer; treatment response; neoadjuvant therapy
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MDPI and ACS Style

Le, N.N.; Li, W.; Onishi, N.; Newitt, D.C.; Gibbs, J.E.; Wilmes, L.J.; Kornak, J.; Partridge, S.C.; LeStage, B.; Price, E.R.; Joe, B.N.; Esserman, L.J.; Hylton, N.M. Effect of Inter-Reader Variability on Diffusion-Weighted MRI Apparent Diffusion Coefficient Measurements and Prediction of Pathologic Complete Response for Breast Cancer. Tomography 2022, 8, 1208-1220. https://doi.org/10.3390/tomography8030099

AMA Style

Le NN, Li W, Onishi N, Newitt DC, Gibbs JE, Wilmes LJ, Kornak J, Partridge SC, LeStage B, Price ER, Joe BN, Esserman LJ, Hylton NM. Effect of Inter-Reader Variability on Diffusion-Weighted MRI Apparent Diffusion Coefficient Measurements and Prediction of Pathologic Complete Response for Breast Cancer. Tomography. 2022; 8(3):1208-1220. https://doi.org/10.3390/tomography8030099

Chicago/Turabian Style

Le, Nu N., Wen Li, Natsuko Onishi, David C. Newitt, Jessica E. Gibbs, Lisa J. Wilmes, John Kornak, Savannah C. Partridge, Barbara LeStage, Elissa R. Price, Bonnie N. Joe, Laura J. Esserman, and Nola M. Hylton. 2022. "Effect of Inter-Reader Variability on Diffusion-Weighted MRI Apparent Diffusion Coefficient Measurements and Prediction of Pathologic Complete Response for Breast Cancer" Tomography 8, no. 3: 1208-1220. https://doi.org/10.3390/tomography8030099

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