Phantom-based quality assurance for multicenter quantitative MRI in locally advanced cervical cancer

Radiotherapy and Oncology, vol. 153, pp. 114–121

Abstract

BACKGROUND AND PURPOSE: A wide variation of MRI systems is a challenge in multicenter imaging biomarker studies as it adds variation in quantitative MRI values. The aim of this study was to design and test a quality assurance (QA) framework based on phantom measurements, for the quantitative MRI protocols of a multicenter imaging biomarker trial of locally advanced cervical cancer. MATERIALS AND METHODS: Fifteen institutes participated (five 1.5 T and ten 3 T scanners). Each institute optimized protocols for T2, diffusion-weighted imaging, T1, and dynamic contrast-enhanced (DCE-)MRI according to system possibilities, institutional preferences and study-specific constraints. Calibration phantoms with known values were used for validation. Benchmark protocols, similar on all systems, were used to investigate whether differences resulted from variations in institutional protocols or from system variations. Bias, repeatability (%RC), and reproducibility (%RDC) were determined. Ratios were used for T2 and T1 values. RESULTS: /s for the apparent diffusion coefficient (median %RC = 3%; %RDC = 18%), and 0.39-1.29 for T1 (median %RC = 1%; %RDC = 33%). For DCE a nonlinear vendor-specific relation was observed between measured and true concentrations with magnitude data, whereas the relation was linear when phase data was used. CONCLUSION: We designed a QA framework for quantitative MRI protocols and demonstrated for a multicenter trial for cervical cancer that measurement of consistent T2 and apparent diffusion coefficient values is feasible despite protocol differences. For DCE-MRI and T1 mapping with the variable flip angle method, this was more challenging.

Authors 17

1. Petra J. van Houdt corresponding

   The Netherlands Cancer Institute

   Affiliation as printed

   Department of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam, the Netherlands. Electronic address: p.v.houdt@nki.nl

   Department of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam, the Netherlands

2. Jesper Folsted Kallehauge
   Affiliation as printed

   Danish Centre for Particle Therapy, Aarhus, Denmark

3. Kari Tanderup

   Aarhus University Hospital

   Affiliation as printed

   Department of Clinical Medicine, Aarhus University Hospital, Denmark

4. Remi A. Nout Aachen Department of Radiation Oncology

   Leiden University Medical Center

   Affiliation as printed

   Department of Radiation Oncology, Leiden University Medical Center, the Netherlands

5. Marko Zaletelj

   Institute of Oncology Ljubljana

   Affiliation as printed

   Department of Radiotherapy, Institute of Oncology Ljubljana, Slovenia

6. Tony Tadic

   Princess Margaret Cancer Centre

   Affiliation as printed

   Radiation Medicine Program, Princess Margaret Cancer Center, Toronto, Canada

7. Z. van Kesteren

   Amsterdam University Medical Centers

   Affiliation as printed

   Department of Radiation Oncology, Amsterdam University Medical Center, the Netherlands

8. Cornelius A.T. van den Berg

   University Medical Center Utrecht

   Affiliation as printed

   Department of Radiotherapy, University Medical Center Utrecht, the Netherlands

9. Dietmar Georg

   Medical University of Vienna

   Affiliation as printed

   Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University Of Vienna, Austria

10. Jean-Charles Côté

    Centre Hospitalier de l’Université de Montréal

    Affiliation as printed

    Department of Radiation Oncology, Centre Hospitalier de l'Universite de Montreal, Canada

11. Ives R. Levesque

    McGill University

    Affiliation as printed

    Medical Physics Unit and Gerald Bronfman Department of Oncology, McGill University, Montreal, Canada

12. Jamema Swamidas

    Tata Memorial Hospital

    Affiliation as printed

    Department of Radiation Oncology, Tata Memorial Centre, Mumbai, India

13. Eirik Malinen

    Oslo University Hospital

    Affiliation as printed

    Department of Medical Physics, Oslo University Hospital, Norway

14. Sven Telliskivi

    North Estonia Medical Centre

    Affiliation as printed

    Department of Radiation Oncology, North-Estonia Medical Centre, Tallinn, Estonia

15. Patrik Brynolfsson

    Skåne University Hospital

    Affiliation as printed

    Department of Translational Sciences, Skåne University Hospital, Lund, Sweden

16. Faisal Mahmood

    University of Southern Denmark · Odense University Hospital

    Affiliation as printed

    Department of Oncology, Odense University Hospital, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark

    Department of Clinical Research, University of Southern Denmark, Odense, Denmark

    Department of Oncology, Odense University Hospital, Denmark

17. Uulke A. van der Heide

    The Netherlands Cancer Institute

    Affiliation as printed

    Department of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam, the Netherlands