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Operator dependency of arterial input function in dynamic contrast-enhanced MRI |
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| Authors: | Kleppestø Magne Bjørnerud Atle Groote Inge Rasmus Kim Minjae Vardal Jonas Larsson Christopher |
| Affiliation: | 1.Division of Radiology and Nuclear Medicine, Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway ;2.Faculty of Medicine, University of Oslo, Oslo, Norway ;3.Unit for Computational Radiology and Artificial Intelligence, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway ;4.Department of Physics, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway ;5.Department of Psychology, Faculty for Social Sciences, University of Oslo, Oslo, Norway ;6.Department of Radiology, Vestfold Hospital Trust, Tønsberg, Norway ;7.Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea ;8.Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea ;9.Department of Radiology, Vestre Viken Hospital Trust, Drammen, Norway ;10.Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway ; |
| Abstract: | Objective To investigate the effect of inter-operator variability in arterial input function (AIF) definition on kinetic parameter estimates (KPEs) from dynamic contrast-enhanced (DCE) MRI in patients with high-grade gliomas. MethodsThe study included 118 DCE series from 23 patients. AIFs were measured by three domain experts (DEs), and a population AIF (pop-AIF) was constructed from the measured AIFs. The DE-AIFs, pop-AIF and AUC-normalized DE-AIFs were used for pharmacokinetic analysis with the extended Tofts model. AIF-dependence of KPEs was assessed by intraclass correlation coefficient (ICC) analysis, and the impact on relative longitudinal change in Ktrans was assessed by Fleiss’ kappa (κ). ResultsThere was a moderate to substantial agreement (ICC 0.51–0.76) between KPEs when using DE-AIFs, while AUC-normalized AIFs yielded ICC 0.77–0.95 for Ktrans, kep and ve and ICC 0.70 for vp. Inclusion of the pop-AIF did not reduce agreement. Agreement in relative longitudinal change in Ktrans was moderate (κ?=?0.591) using DE-AIFs, while AUC-normalized AIFs gave substantial (κ?=?0.809) agreement. DiscussionAUC-normalized AIFs can reduce the variation in kinetic parameter results originating from operator input. The pop-AIF presented in this work may be applied in absence of a satisfactory measurement. |
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