Real-Time Quantitative Assessment of Accuracy and Precision of Blood Volume Derived from DCE-MRI in Individual Patients During a Clinical Trial.
Accuracy and precision of quantitative imaging (QI) metrics should be assessed in real time in each patient during a clinical trial to support QI-based decision-making. We developed a framework for real-time quantitative assessment of QI metrics and evaluated accuracy and precision of dynamic contrast-enhanced (DCE)-magnetic resonance imaging (MRI)-derived blood volume (BV) in a clinical trial for head and neck cancers. Patients underwent DCE-MRI before and after 2 weeks of radiation therapy (2wkRT). A mean as a reference value and a repeatability coefficient (RC) of BV values established from n patients in cerebellum volumes of interest (VOIs), which were normal and affected little by therapy, served as accuracy and precision measurements. The BV maps of a new patient were called accurate and precise if the values in cerebellum VOIs and the difference between the 2 scans agreed with the respective mean and RC with 95% confidence. The new data could be used to update reference values. Otherwise, the data were flagged for further evaluation before use in the trial. BV maps from 62 patients enrolled on the trial were evaluated. Mean BV values were 2.21 (±0.14) mL/100 g pre-RT and 2.22 (±0.17) mL/100 g at 2wkRT; relative RC was 15.9%. The BV maps from 3 patients were identified to be inaccurate and imprecise before use in the clinical trial. Our framework of real-time quantitative assessment of QI metrics during a clinical trial can be translated to different QI metrics and organ-sites for supporting QI-based decision-making that warrants success of a clinical trial.
['Aryal|Madhava P|MP|', 'Lee|Choonik|C|', 'Hawkins|Peter G|PG|', 'Chapman|Christina|C|', 'Eisbruch|Avraham|A|', 'Mierzwa|Michelle|M|', 'Cao|Yue|Y|']
D000368:Aged D002531:Cerebellum D000071937:Cerebral Blood Volume D003287:Contrast Media D003658:Decision Making, Computer-Assisted D005260:Female D006258:Head and Neck Neoplasms D006801:Humans D007090:Image Interpretation, Computer-Assisted D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D009367:Neoplasm Staging D011379:Prognosis D015203:Reproducibility of Results
blood volume quantitative imaging head and neck cancer repeatability dynamic contrast enhanced MRI real-time assessment