PT - JOURNAL ARTICLE AU - Schmainda, K.M. AU - Prah, M.A. AU - Rand, S.D. AU - Liu, Y. AU - Logan, B. AU - Muzi, M. AU - Rane, S.D. AU - Da, X. AU - Yen, Y.-F. AU - Kalpathy-Cramer, J. AU - Chenevert, T.L. AU - Hoff, B. AU - Ross, B. AU - Cao, Y. AU - Aryal, M.P. AU - Erickson, B. AU - Korfiatis, P. AU - Dondlinger, T. AU - Bell, L. AU - Hu, L. AU - Kinahan, P.E. AU - Quarles, C.C. TI - Multisite Concordance of DSC-MRI Analysis for Brain Tumors: Results of a National Cancer Institute Quantitative Imaging Network Collaborative Project AID - 10.3174/ajnr.A5675 DP - 2018 Jun 01 TA - American Journal of Neuroradiology PG - 1008--1016 VI - 39 IP - 6 4099 - 4100 - SO - Am. J. Neuroradiol.2018 Jun 01; 39 AB - BACKGROUND AND PURPOSE: Standard assessment criteria for brain tumors that only include anatomic imaging continue to be insufficient. While numerous studies have demonstrated the value of DSC-MR imaging perfusion metrics for this purpose, they have not been incorporated due to a lack of confidence in the consistency of DSC-MR imaging metrics across sites and platforms. This study addresses this limitation with a comparison of multisite/multiplatform analyses of shared DSC-MR imaging datasets of patients with brain tumors.MATERIALS AND METHODS: DSC-MR imaging data were collected after a preload and during a bolus injection of gadolinium contrast agent using a gradient recalled-echo–EPI sequence (TE/TR = 30/1200 ms; flip angle = 72°). Forty-nine low-grade (n = 13) and high-grade (n = 36) glioma datasets were uploaded to The Cancer Imaging Archive. Datasets included a predetermined arterial input function, enhancing tumor ROIs, and ROIs necessary to create normalized relative CBV and CBF maps. Seven sites computed 20 different perfusion metrics. Pair-wise agreement among sites was assessed with the Lin concordance correlation coefficient. Distinction of low- from high-grade tumors was evaluated with the Wilcoxon rank sum test followed by receiver operating characteristic analysis to identify the optimal thresholds based on sensitivity and specificity.RESULTS: For normalized relative CBV and normalized CBF, 93% and 94% of entries showed good or excellent cross-site agreement (0.8 ≤ Lin concordance correlation coefficient ≤ 1.0). All metrics could distinguish low- from high-grade tumors. Optimum thresholds were determined for pooled data (normalized relative CBV = 1.4, sensitivity/specificity = 90%:77%; normalized CBF = 1.58, sensitivity/specificity = 86%:77%).CONCLUSIONS: By means of DSC-MR imaging data obtained after a preload of contrast agent, substantial consistency resulted across sites for brain tumor perfusion metrics with a common threshold discoverable for distinguishing low- from high-grade tumors.AIFarterial input functionHGGhigh-grade gliomaLCCCLin concordance correlation coefficientLGGlow-grade gliomaNAWMnormal-appearing white matternCBFnormalized cerebral blood flownRCBVnormalized relative cerebral blood volumerCBVrelative cerebral blood volumeSNsensitivity (in the context of receiver operating characteristic analysis)SPspecificity (in the context of receiver operating characteristic analysis)T1+Cpostcontrast T1WI