Comparison of diagnostic quality and accuracy in color-coded versus gray-scale DCE-MR imaging display

Indian Institute of Technology (IIT) School of Medical Science and Technology Kharagpur India
International Journal of Computer Assisted Radiology and Surgery (Impact Factor: 1.66). 09/2009; 4(5):457-462. DOI: 10.1007/s11548-009-0356-4
Source: PubMed

ABSTRACT PurposeThe purpose of this study was to evaluate the diagnostic value and tumor-vascular display properties (microcirculation) of
two different functional MRI post-processing and display (color and gray-scale display) techniques used in oncology.

Materials and methodsThe study protocol was approved by the IRB and written informed consent was obtained from all patients. 38 dynamic contrast
enhanced magnetic resonance imaging (DCE-MRI) data sets of patients with malignant pleural-mesothelioma were acquired and
post-processed. DCE-MRI was performed at 1.5tesla with a T1-weighted 2D gradient-echo-sequence (TR 7.0ms, TE 3.9ms, 15
axial slices, 22 sequential repetitions), prior and during chemotherapy. Subtracting first image of contrast-enhanced-dynamic
series from the last, produced gray-scale images. Color images were produced using a pharmacokinetic two-compartment model.
Eight raters, blinded to diagnosis, by visual assessment of post-processed images evaluated both diagnostic quality of the
images and vasculature of the tumor using a rating scale ranging from −5 to +5. The scores for vasculature were assessed by
correlating with the maximum amplitude of the total-tumor-ROI for accuracy.

ResultsColor coded images were rated as significantly higher in diagnostic quality and tumor vascular score than gray-scale images
(p < 0.001, 0.005). ROI signal amplitude analysis and vascular ratings on color coded images were better correlated compared
to gray-scale images rating (p < 0.05).

ConclusionColor coded images were shown to have higher diagnostic quality and accuracy with respect to tumor vasculature in DCE-MRI,
therefore their implementation in clinical assessment and follow-up should be considered for wider application.