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European Radiology
Published in: European Radiology 12/2011

Open Access 01-12-2011 | Gastrointestinal

Tumour ADC measurements in rectal cancer: effect of ROI methods on ADC values and interobserver variability

Authors: Doenja M. J. Lambregts, Geerard L. Beets, Monique Maas, Luís Curvo-Semedo, Alfons G. H. Kessels, Thomas Thywissen, Regina G. H. Beets-Tan

Published in: European Radiology | Issue 12/2011

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Abstract

Objectives

To assess the influence of region of interest (ROI) size and positioning on tumour ADC measurements and interobserver variability in patients with locally advanced rectal cancer (LARC).

Methods

Forty-six LARC patients were retrospectively included. Patients underwent MRI including DWI (b0,500,1000) before and 6–8 weeks after chemoradiation (CRT). Two readers measured mean tumour ADCs (pre- and post-CRT) according to three ROI protocols: whole-volume, single-slice or small solid samples. The three protocols were compared for differences in ADC, SD and interobserver variability (measured as the intraclass correlation coefficient; ICC).

Results

ICC for the whole-volume ROIs was excellent (0.91) pre-CRT versus good (0.66) post-CRT. ICCs were 0.53 and 0.42 for the single-slice ROIs versus 0.60 and 0.65 for the sample ROIs. Pre-CRT ADCs for the sample ROIs were significantly lower than for the whole-volume or single-slice ROIs. Post-CRT there were no significant differences between the whole-volume ROIs and the single-slice or sample ROIs, respectively. The SDs for the whole-volume and single-slice ROIs were significantly larger than for the sample ROIs.

Conclusions

ROI size and positioning have a considerable influence on tumour ADC values and interobserver variability. Interobserver variability is worse after CRT. ADCs obtained from the whole tumour volume provide the most reproducible results.
Key Points
• ROI size and positioning influence tumour ADC measurements in rectal cancer
• ROI size and positioning influence interobserver variability of tumour ADC measurements
• ADC measurements of the whole tumour volume provide the most reproducible results
• Tumour ADC measurements are more reproducible before, rather than after, chemoradiation treatment
• Variations caused by ROI size and positioning should be taken into account when using ADC as a biomarker for tumour response
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Metadata
Title
Tumour ADC measurements in rectal cancer: effect of ROI methods on ADC values and interobserver variability
Authors
Doenja M. J. Lambregts
Geerard L. Beets
Monique Maas
Luís Curvo-Semedo
Alfons G. H. Kessels
Thomas Thywissen
Regina G. H. Beets-Tan
Publication date
01-12-2011
Publisher
Springer-Verlag
Published in
European Radiology / Issue 12/2011
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-011-2220-5

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