Implementing diffusion-weighted MRI for body imaging in prospective multicentre trials: current considerations and future perspectives.
Abstract
For body imaging, diffusion-weighted MRI may be used for tumour detection, staging,
prognostic information, assessing response and follow-up. Disease detection and staging
involve qualitative, subjective assessment of images, whereas for prognosis, progression
or response, quantitative evaluation of the apparent diffusion coefficient (ADC) is
required. Validation and qualification of ADC in multicentre trials involves examination
of i) technical performance to determine biomarker bias and reproducibility and ii)
biological performance to interrogate a specific aspect of biology or to forecast
outcome. Unfortunately, the variety of acquisition and analysis methodologies employed
at different centres make ADC values non-comparable between them. This invalidates
implementation in multicentre trials and limits utility of ADC as a biomarker. This
article reviews the factors contributing to ADC variability in terms of data acquisition
and analysis. Hardware and software considerations are discussed when implementing
standardised protocols across multi-vendor platforms together with methods for quality
assurance and quality control. Processes of data collection, archiving, curation,
analysis, central reading and handling incidental findings are considered in the conduct
of multicentre trials. Data protection and good clinical practice are essential prerequisites.
Developing international consensus of procedures is critical to successful validation
if ADC is to become a useful biomarker in oncology.• Standardised acquisition/analysis
allows quantification of imaging biomarkers in multicentre trials. • Establishing
"precision" of the measurement in the multicentre context is essential. • A repository
with traceable data of known provenance promotes further research.
Type
Journal articleSubject
HumansNeoplasms
Disease Progression
Diffusion Magnetic Resonance Imaging
Prognosis
Prospective Studies
Reproducibility of Results
Software
Quality Assurance, Health Care
Multicenter Studies as Topic
Healthy Volunteers
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https://hdl.handle.net/10161/18008Published Version (Please cite this version)
10.1007/s00330-017-4972-zPublication Info
deSouza, NM; Winfield, JM; Waterton, JC; Weller, A; Papoutsaki, M-V; Doran, SJ; ...
Liu, Y (2018). Implementing diffusion-weighted MRI for body imaging in prospective multicentre trials:
current considerations and future perspectives. European radiology, 28(3). pp. 1118-1131. 10.1007/s00330-017-4972-z. Retrieved from https://hdl.handle.net/10161/18008.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Daniel Carl Sullivan
Professor Emeritus of Radiology
Research interests are in oncologic imaging, especially the clinical evaluation and
validation of imaging biomarkers for therapeutic response assessment.

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