Cerebral blood volume analysis in glioblastomas using dynamic susceptibility contrast-enhanced perfusion MRI: a comparison of manual and semiautomatic segmentation methods.
OBJECTIVE
To compare the reproducibilities of manual and semiautomatic segmentation method for the measurement of normalized cerebral blood volume (nCBV) using dynamic susceptibility contrast-enhanced (DSC) perfusion MR imaging in glioblastomas.


METHODS
Twenty-two patients (11 male, 11 female; 27 tumors) with histologically confirmed glioblastoma (WHO grade IV) were examined with conventional MR imaging and DSC imaging at 3T before surgery or biopsy. Then nCBV (means and standard deviations) in each mass was measured using two DSC MR perfusion analysis methods including manual and semiautomatic segmentation method, in which contrast-enhanced (CE)-T1WI and T2WI were used as structural imaging. Intraobserver and interobserver reproducibility were assessed according to each perfusion analysis method or each structural imaging. Interclass correlation coefficient (ICC), Bland-Altman plot, and coefficient of variation (CV) were used to evaluate reproducibility.


RESULTS
Intraobserver reproducibilities on CE-T1WI and T2WI were ICC of 0.74-0.89 and CV of 20.39-36.83% in manual segmentation method, and ICC of 0.95-0.99 and CV of 8.53-16.19% in semiautomatic segmentation method, repectively. Interobserver reproducibilites on CE-T1WI and T2WI were ICC of 0.86-0.94 and CV of 19.67-35.15% in manual segmentation method, and ICC of 0.74-1.0 and CV of 5.48-49.38% in semiautomatic segmentation method, respectively. Bland-Altman plots showed a good correlation with ICC or CV in each method. The semiautomatic segmentation method showed higher intraobserver and interobserver reproducibilities at CE-T1WI-based study than other methods.


CONCLUSIONS
The best reproducibility was found using the semiautomatic segmentation method based on CE-T1WI for structural imaging in the measurement of the nCBV of glioblastomas.
Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
Seung Chai
SC
Jung
Seung Hong
SH
Choi
Jeong A
JA
Yeom
Ji-Hoon
JH
Kim
Inseon
I
Ryoo
Soo Chin
SC
Kim
Hwaseon
H
Shin
A Leum
AL
Lee
Tae Jin
TJ
Yun
Chul-Kee
CK
Park
Chul-Ho
CH
Sohn
Sung-Hye
SH
Park
D000328:Adult; D000368:Aged; D001810:Blood Volume; D001921:Brain / Q000098:blood supply* / Q000473:pathology / Q000503:physiopathology*; D001932:Brain Neoplasms / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology*; D003287:Contrast Media; D005260:Female; D005909:Glioblastoma / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D055815:Young Adult
D003287:Contrast Media