Prah M A, Stufflebeam S M, Paulson E S, Kalpathy-Cramer J, Gerstner E R, Batchelor T T, Barboriak D P, Rosen B R, Schmainda K M
From the Departments of Radiology (M.A.P., K.M.S., E.S.P.).
Department of Radiology (S.M.S., J.K.-C., E.R.G., T.T.B., B.R.R.), Massachusetts General Hospital, Boston, Massachusetts.
AJNR Am J Neuroradiol. 2015 Sep;36(9):1654-61. doi: 10.3174/ajnr.A4374. Epub 2015 Jun 11.
BACKGROUND AND PURPOSE: For more widespread clinical use advanced imaging methods such as relative cerebral blood volume must be both accurate and repeatable. The aim of this study was to determine the repeatability of relative CBV measurements in newly diagnosed glioblastoma multiforme by using several of the most commonly published estimation techniques. MATERIALS AND METHODS: The relative CBV estimates were calculated from dynamic susceptibility contrast MR imaging in double-baseline examinations for 33 patients with treatment-naïve and pathologically proved glioblastoma multiforme (men = 20; mean age = 55 years). Normalized and standardized relative CBV were calculated by using 6 common postprocessing methods. The repeatability of both normalized and standardized relative CBV, in both tumor and contralateral brain, was examined for each method with metrics of repeatability, including the repeatability coefficient and within-subject coefficient of variation. The minimum sample size required to detect a parameter change of 10% or 20% was also determined for both normalized relative CBV and standardized relative CBV for each estimation method. RESULTS: When ordered by the repeatability coefficient, methods using postprocessing leakage correction and ΔR2*(t) techniques offered superior repeatability. Across processing techniques, the standardized relative CBV repeatability in normal-appearing brain was comparable with that in tumor (P = .31), yet inferior in tumor for normalized relative CBV (P = .03). On the basis of the within-subject coefficient of variation, tumor standardized relative CBV estimates were less variable (13%-20%) than normalized relative CBV estimates (24%-67%). The minimum number of participants needed to detect a change of 10% or 20% is 118-643 or 30-161 for normalized relative CBV and 109-215 or 28-54 for standardized relative CBV. CONCLUSIONS: The ΔR2* estimation methods that incorporate leakage correction offer the best repeatability for relative CBV, with standardized relative CBV being less variable and requiring fewer participants to detect a change compared with normalized relative CBV.
背景与目的：为实现更广泛的临床应用，诸如相对脑血容量等先进成像方法必须兼具准确性和可重复性。本研究旨在通过使用几种最常用的已发表估算技术，确定新诊断的多形性胶质母细胞瘤中相对脑血容量测量的可重复性。 材料与方法：对33例未经治疗且经病理证实为多形性胶质母细胞瘤的患者（男性20例；平均年龄55岁）进行双基线检查，通过动态磁敏感对比磁共振成像计算相对脑血容量估计值。使用6种常见的后处理方法计算归一化和标准化相对脑血容量。采用包括重复性系数和受试者内变异系数在内的重复性指标，对每种方法在肿瘤和对侧脑内的归一化和标准化相对脑血容量的可重复性进行检测。还针对每种估算方法，确定检测归一化相对脑血容量和标准化相对脑血容量中10%或20%参数变化所需的最小样本量。 结果：按重复性系数排序时，使用后处理泄漏校正和ΔR2*(t)技术的方法具有更好的可重复性。在各种处理技术中，正常脑区的标准化相对脑血容量可重复性与肿瘤中的相当（P = 0.31），但在肿瘤中归一化相对脑血容量的可重复性较差（P = 0.03）。基于受试者内变异系数，肿瘤标准化相对脑血容量估计值的变异性（13% - 20%）低于归一化相对脑血容量估计值（24% - 67%）。检测归一化相对脑血容量中10%或20%变化所需的最少参与者数量分别为118 - 643或30 - 161，而检测标准化相对脑血容量中10%或20%变化所需的最少参与者数量分别为109 - 215或28 - 54。 结论：采用泄漏校正的ΔR2*估算方法在相对脑血容量方面具有最佳可重复性，与归一化相对脑血容量相比，标准化相对脑血容量变异性更小，检测变化所需的参与者更少。
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