title: Quantitative analysis of focal masses at MR imaging: a plea for standardization.
abstract: OBJECTIVE
  To assess the effects of changing analytic method variables on the signal intensity (SI) difference-to-noise ratios (SDNRs) for the contrast between lesions and background organs depicted on magnetic resonance (MR) images and to propose a standardized analytic method for the quantitative analysis of focal masses seen at MR imaging.
  
  
  METHODS
  The SIs of 48 liver metastases (originating from colorectal cancer) in 20 patients, the surrounding liver parenchyma, and the background noise were measured on T2-weighted MR images. All 2000 and 2001 issues of the American Journal of Roentgenology, the Journal of Magnetic Resonance Imaging, Magnetic Resonance Imaging, and Radiology were searched for articles describing quantitative analyses. SDNRs were calculated by using formulas from these articles and various region-of-interest (ROI) locations to measure metastasis and background noise SIs. The Wilcoxon signed rank test was used to compare the various SDNR calculations.
  
  
  RESULTS
  In 34 articles in which quantitative analyses of focal masses are described, the reported SDNRs were calculated with four different formulas. The SDNRs for our study material calculated with the four formulas reported in the literature differed grossly in both number and unit. The SDNRs for ROIs encompassing the entire metastasis differed significantly (P =.034) from the SDNRs for ROIs in a homogeneous area of the metastasis margin. Differences in SDNRs between various noise ROI locations were significant (P <.022).
  
  
  CONCLUSIONS
  Slight changes in the variables of quantitative analysis of focal masses had marked effects on reported SDNRs. To overcome these effects, the use of a standardized method involving one formula, a lesion ROI in a homogeneous area at the metastasis margin, and a background noise ROI along the phase-encoding axis in the air (including systematic noise) is proposed for the quantitative analysis of findings on magnitude MR images.
authors.affiliation: Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands. m.e.j.pijl@lumc.nl
authors.forename: Milan E J
authors.initials: ME
authors.lastname: Pijl
authors.forename: Joost
authors.initials: J
authors.lastname: Doornbos
authors.forename: Martin N J M
authors.initials: MN
authors.lastname: Wasser
authors.forename: Hans C
authors.initials: HC
authors.lastname: van Houwelingen
authors.forename: Rob A E M
authors.initials: RA
authors.lastname: Tollenaar
authors.forename: Johan L
authors.initials: JL
authors.lastname: Bloem
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008297:Male; D008875:Middle Aged; D012015:Reference Standards