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Volumetric segmentation of glioblastoma progression compared to bidimensional products and clinical radiological reports

  • Original Article - Tumor - Glioma
  • Published:
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Abstract

Background

Detection of progression is clinically important for the management of glioblastoma. We sought to assess the accuracy of clinical radiological reporting and measured bidimensional products to identify radiological glioblastoma progression. The two were compared to volumetric segmentation.

Methods

In this retrospective study, we included 106 patients with histopathologically verified glioblastomas and two separate MRI scans obtained before surgery. Bidimensional products based on measurements on the axial slice with the largest tumor area were calculated, and growth estimations from the clinical radiological reports were retrieved. The two growth estimations were compared to manual volumetric segmentations. Inter-observer agreement using the bidimensional product was assessed using Kappa-statistics and by calculating the difference between two neuroradiologist in percentage change of the bidimensional product for each tumor.

Results

Clinical radiological reports and bidimensional products showed fairly equal accuracy when compared to volumetric segmentation with an accuracy of 67% and 66–68%, respectively. There was a difference in median volume increase of 6.9 mL (2.4 vs 9.3 mL, p < 0.001) between tumors evaluated as stable and progressed based on the clinical radiological reports. This difference was 8.1 mL (2.0 vs 10.1 ml, p < 0.001) when using the bidimensional products. The bidimensional product reached a moderate inter-observer agreement with a Kappa value of 0.689. For 32% of the tumors, the two neuroradiologists calculated a difference of more than 25% using bidimensional products.

Conclusions

Clinical radiological reporting and the bidimensional product exhibit similar accuracy. The bidimensional product has moderate inter-observer agreement and is prone to underestimating tumor progression, as an average glioblastoma had to grow 10 mL in order to be classified as progressed. These findings underline the assumption that one should try to move towards volumetric assessment of glioblastoma growth in the future.

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Authors and Affiliations

  1. Department of Radiology and Nuclear Medicine, St. Olavs University Hospital, Olav Kyrres Gate, 7006, Trondheim, Norway

    Erik Magnus Berntsen, Pål Christensen & Viggo Andreas Moholdt

  2. Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491, Trondheim, Norway

    Erik Magnus Berntsen, Anne Line Stensjøen, Maren Staurset Langlo & Solveig Quam Simonsen

  3. Department of Neurosurgery, St. Olavs University Hospital, Olav Kyrres Gate, 7006, Trondheim, Norway

    Ole Solheim

  4. National Competence Centre for Ultrasound and Image Guided Therapy, St. Olavs University Hospital, 7006, Trondheim, Norway

    Ole Solheim

  5. Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, 7491, Trondheim, Norway

    Ole Solheim

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  1. Erik Magnus Berntsen
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  2. Anne Line Stensjøen
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  3. Maren Staurset Langlo
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  7. Ole Solheim
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Corresponding author

Correspondence to Erik Magnus Berntsen.

Ethics declarations

The study was approved by the regional ethics committee and adhered to the 1964 Helsinki Declaration. The current study was a retrospective study where no formal consent was required.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Berntsen, E.M., Stensjøen, A.L., Langlo, M.S. et al. Volumetric segmentation of glioblastoma progression compared to bidimensional products and clinical radiological reports. Acta Neurochir 162, 379–387 (2020). https://doi.org/10.1007/s00701-019-04110-0

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  • DOI: https://doi.org/10.1007/s00701-019-04110-0

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