Department of Radiology, University Hospital Cologne, Cologne, Germany.
Department of Radiology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.
PLoS One. 2022 Mar 8;17(3):e0265056. doi: 10.1371/journal.pone.0265056. eCollection 2022.
Dynamic contrast enhanced MRI (DCE-MRI) is a useful method to monitor therapy assessment in malignancies but must be reliable and comparable for successful clinical use. The aim of this study was to evaluate the inter- and intrarater reproducibility of DCE-MRI in lung cancer. At this IRB approved single centre study 40 patients with lung cancer underwent up to 5 sequential DCE-MRI examinations. DCE-MRI were performed using a 3.0T system. The volume transfer constant Ktrans was assessed by three readers using the two-compartment Tofts model. Inter- and intrarater reliability and agreement was calculated by wCV, ICC and their 95% confident intervals. DCE-MRI allowed a quantitative measurement of Ktrans in 107 tumors where 91 were primary carcinomas or intrapulmonary metastases and 16 were extrapulmonary metastases. Ktrans showed moderate to good interrater reliability in overall measurements (ICC 0.716-0.841; wCV 30.3-38.4%). Ktrans in pulmonary lesions ≥ 3 cm showed a good to excellent reliability (ICC 0.773-0.907; wCV 23.0-29.4%) compared to pulmonary lesions < 3 cm showing a moderate to good reliability (ICC 0.710-0.889; wCV 31.6-48.7%). Ktrans in intrapulmonary lesions showed a good reliability (ICC 0.761-0.873; wCV 28.9-37.5%) compared to extrapulmonary lesions with a poor to moderate reliability (ICC 0.018-0.680; wCV 28.1-51.8%). The overall intrarater agreement was moderate to good (ICC 0.607-0.795; wCV 24.6-30.4%). With Ktrans, DCE MRI offers a reliable quantitative biomarker for early non-invasive therapy assessment in lung cancer patients, but with a coefficient of variation of up to 48.7% in smaller lung lesions.
动态对比增强磁共振成像（DCE-MRI）是一种用于监测恶性肿瘤治疗评估的有用方法，但为了成功临床应用，必须是可靠且可比较的。本研究的目的是评估肺癌中 DCE-MRI 的观察者间和观察者内可重复性。在这项经过机构审查委员会批准的单中心研究中，40 名肺癌患者接受了多达 5 次连续的 DCE-MRI 检查。DCE-MRI 采用 3.0T 系统进行。通过三位读者使用双室 Tofts 模型评估容积转移常数 Ktrans。通过 wCV、ICC 及其 95%置信区间计算观察者间和观察者内的可靠性和一致性。DCE-MRI 允许对 107 个肿瘤进行定量测量 Ktrans，其中 91 个为原发性癌或肺内转移，16 个为肺外转移。Ktrans 在整体测量中具有中度至高度的观察者间可靠性（ICC 0.716-0.841；wCV 30.3-38.4%）。直径≥3cm 的肺部病变的 Ktrans 具有良好到极好的可靠性（ICC 0.773-0.907；wCV 23.0-29.4%），而直径<3cm 的肺部病变具有中度到高度的可靠性（ICC 0.710-0.889；wCV 31.6-48.7%）。肺内病变的 Ktrans 具有良好的可靠性（ICC 0.761-0.873；wCV 28.9-37.5%），而肺外病变的可靠性较差到中度（ICC 0.018-0.680；wCV 28.1-51.8%）。总体观察者内一致性为中度到高度（ICC 0.607-0.795；wCV 24.6-30.4%）。对于 Ktrans，DCE-MRI 为肺癌患者的早期非侵入性治疗评估提供了一种可靠的定量生物标志物，但在较小的肺部病变中，变异系数高达 48.7%。
