TY  - JOUR
AU  - Lennartz, Simon
AU  - Zopfs, David
AU  - Nobis, Anne
AU  - Paquet, Stefanie
AU  - Hoyer, Ulrike Cornelia Isabel
AU  - Zäske, Charlotte
AU  - Goertz, Lukas
AU  - Kabbasch, Christoph
AU  - Laukamp, Kai Roman
AU  - Große Hokamp, Nils
AU  - Galldiks, Norbert
AU  - Borggrefe, Jan
TI  - MRI Follow-up of Astrocytoma: Automated Coregistration and Color-Coding of FLAIR Sequences Improves Diagnostic Accuracy With Comparable Reading Time
JO  - Journal of magnetic resonance imaging
VL  - 52
IS  - 4
SN  - 1053-1807
CY  - New York, NY
PB  - Wiley-Liss
M1  - FZJ-2020-01690
SP  -  1197-1206
PY  - 2020
AB  - BackgroundMRI follow‐up is widely used for longitudinal assessment of astrocytoma, yet reading can be tedious and error‐prone, in particular when changes are subtle.Purpose/HypothesisTo determine the effect of automated, color‐coded coregistration (AC) of fluid attenuated inversion recovery (FLAIR) sequences on diagnostic accuracy, certainty, and reading time compared to conventional follow‐up MRI assessment of astrocytoma patients.Study TypeRetrospective.PopulationIn all, 41 patients with neuropathologically confirmed astrocytoma.Field Strength/Sequence1.0–3.0T/FLAIRAssessmentThe presence or absence of tumor progression was determined based on FLAIR sequences, contrast‐enhanced T1 sequences, and clinical data. Three radiologists assessed 47 MRI study pairs in a conventional reading (CR) and in a second reading supported by AC after 6 weeks. Readers determined the presence/absence of tumor progression and indicated diagnostic certainty on a 5‐point Likert scale. Reading time was recorded by an independent assessor.Statistical TestsThe Wilcoxon test was used to assess reading time and diagnostic certainty. Differences in diagnostic accuracy, sensitivity, and specificity were analyzed with the McNemar mid‐p test.ResultsReaders attained significantly higher overall sensitivity (0.86 vs. 0.75; P < 0.05) and diagnostic accuracy (0.84 vs. 0.73; P < 0.05) for detection of progressive nonenhancing tumor burden when using AC compared to CR. There was a strong trend towards higher specificity within the AC‐augmented reading, yet without statistical significance (0.83 vs. 0.71; P = 0.08). Sensitivity for unequivocal disease progression was similarly high in both approaches (AC: 0.94, CR: 0.92), while for marginal disease progressions, it was significantly higher in AC (AC: 0.78, CR: 0.58; P < 0.05). Reading time including application loading time was comparable (AC: 38.1 ± 16.8 sec, CR: 36.0 ± 18.9 s; P = 0.25).Data ConclusionCompared to CR, AC improves comparison of FLAIR signal hyperintensity at MRI follow‐up of astrocytoma patients, allowing for a significantly higher diagnostic accuracy, particularly for subtle disease progression at a comparable reading time.
LB  - PUB:(DE-HGF)16
C6  - pmid:32246803
UR  - <Go to ISI:>//WOS:000523255700001
DO  - DOI:10.1002/jmri.27136
UR  - https://juser.fz-juelich.de/record/874902
ER  -