title: Development of a decision support system for diagnosis and grading of brain tumours using in vivo magnetic resonance single voxel spectra.
abstract: A computer-based decision support system to assist radiologists in diagnosing and grading brain tumours has been developed by the multi-centre INTERPRET project. Spectra from a database of 1H single-voxel spectra of different types of brain tumours, acquired in vivo from 334 patients at four different centres, are clustered according to their pathology, using automated pattern recognition techniques and the results are presented as a two-dimensional scatterplot using an intuitive graphical user interface (GUI). Formal quality control procedures were performed to standardize the performance of the instruments and check each spectrum, and teams of expert neuroradiologists, neurosurgeons, neurologists and neuropathologists clinically validated each case. The prototype decision support system (DSS) successfully classified 89% of the cases in an independent test set of 91 cases of the most frequent tumour types (meningiomas, low-grade gliomas and high-grade malignant tumours--glioblastomas and metastases). It also helps to resolve diagnostic difficulty in borderline cases. When the prototype was tested by radiologists and other clinicians it was favourably received. Results of the preliminary clinical analysis of the added value of using the DSS for brain tumour diagnosis with MRS showed a small but significant improvement over MRI used alone. In the comparison of individual pathologies, PNETs were significantly better diagnosed with the DSS than with MRI alone.
authors.affiliation: St George's, University of London, Cranmer Terrace, London SW17 0RE, UK.
authors.forename: Anne R
authors.initials: AR
authors.lastname: Tate
authors.forename: Joshua
authors.initials: J
authors.lastname: Underwood
authors.forename: Dionisio M
authors.initials: DM
authors.lastname: Acosta
authors.forename: Margarida
authors.initials: M
authors.lastname: Julià-Sapé
authors.forename: Carles
authors.initials: C
authors.lastname: Majós
authors.forename: Angel
authors.initials: A
authors.lastname: Moreno-Torres
authors.forename: Franklyn A
authors.initials: FA
authors.lastname: Howe
authors.forename: Marinette
authors.initials: M
authors.lastname: van der Graaf
authors.forename: Virginie
authors.initials: V
authors.lastname: Lefournier
authors.forename: Mary M
authors.initials: MM
authors.lastname: Murphy
authors.forename: Alison
authors.initials: A
authors.lastname: Loosemore
authors.forename: Christophe
authors.initials: C
authors.lastname: Ladroue
authors.forename: Pieter
authors.initials: P
authors.lastname: Wesseling
authors.forename: Jean
authors.initials: J
authors.lastname: Luc Bosson
authors.forename: Miquel E
authors.initials: ME
authors.lastname: Cabañas
authors.forename: Arjan W
authors.initials: AW
authors.lastname: Simonetti
authors.forename: Witold
authors.initials: W
authors.lastname: Gajewicz
authors.forename: Jorge
authors.initials: J
authors.lastname: Calvar
authors.forename: Antoni
authors.initials: A
authors.lastname: Capdevila
authors.forename: Peter R
authors.initials: PR
authors.lastname: Wilkins
authors.forename: B Anthony
authors.initials: BA
authors.lastname: Bell
authors.forename: Chantal
authors.initials: C
authors.lastname: Rémy
authors.forename: Arend
authors.initials: A
authors.lastname: Heerschap
authors.forename: Des
authors.initials: D
authors.lastname: Watson
authors.forename: John R
authors.initials: JR
authors.lastname: Griffiths
authors.forename: Carles
authors.initials: C
authors.lastname: Arús
mesh_terms: D000465:Algorithms; D001932:Brain Neoplasms / Q000175:diagnosis*; D016208:Databases, Factual; D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005103:Expert Systems; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D010363:Pattern Recognition, Automated / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity