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<meta name="HW.identifier" content="/ajnr/early/2021/04/29/ajnr.A7132.atom" />
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<meta name="DC.Title" content="Comparison of Measurement Techniques and Response Criteria for MR Imaging Follow-up in Adult Primary Central Nervous System Lymphoma" />
<meta name="DC.Identifier" content="10.3174/ajnr.A7132" />
<meta name="DC.Date" content="2021-04-29" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2021 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Current guidelines proposed for the measurement of primary central nervous system lymphoma in 2005 have indicated that unidimensional and bidimensional measurements may be used, using the same threshold for response categorization, because no clinical study has evaluated the agreement among the measurement techniques. Hence, our study assessed the agreement among different measurements.

MATERIALS AND METHODS: In this retrospective study, primary central nervous system lymphoma lesions were measured with different techniques (longest 1D, axial 1D, 2D, 3D, and the Response Evaluation Criteria in Solid Tumor) on consecutive MR images. Intra- and interobserver correlations were calculated with intraclass correlation coefficients. Correlations between raw measurements and variations in size compared with baseline were evaluated with the Spearman rank correlation, and agreement among response categories was evaluated.

RESULTS: A total of 304 examinations obtained in 40 patients was assessed. The intraobserver intraclass correlation coefficient for 3D, 2D, and longest 1D were ≥0.993. The interobserver intraclass correlation coefficient was ≥0.967. The correlations in raw measurements and size variation in comparison with 3D were respectively; 0.99 and 0.98 for 2D; 0.94 and 0.92 for longest 1D; 0.94 and 0.83 for axial 1D; and 0.90 and 0.79 for Response Evaluation Criteria in Solid Tumor. With 20%–30% and 25%–50% thresholds for unidimensional techniques, response categorizations were 95% and 95% for 2D, 92.5% and 90% for the longest 1D, 87.5% and 82.5% for axial 1D, and 90% and 85% for the Response Evaluation Criteria in Solid Tumor.

CONCLUSIONS: Both longest 1D and 2D demonstrated excellent correlations with 3D measurements. The longest 1D could be used for the follow-up of primary central nervous system lymphoma. If unidimensional measurements were used, 20% and 30% cutoffs should be used for defining response categorization instead of the current guidelines.

CNS
:   central nervous system
CR
:   complete response
ICC
:   intraclass correlation coefficient
PCNSL
:   primary central nervous system lymphoma
PD
:   progressive disease
PR
:   partial response
RECIST
:   Response Evaluation Criteria in Solid Tumor
SD
:   stable disease
WBRT
:   whole brain radiotherapy" />
<meta name="DC.Contributor" content="K. Massicotte-Tisluck" />
<meta name="DC.Contributor" content="D. Vanderweyen" />
<meta name="DC.Contributor" content="J.-F. Vendrell" />
<meta name="DC.Contributor" content="D. Fortin" />
<meta name="DC.Contributor" content="G. Gahide" />
<meta name="article:published_time" content="2021-04-29" />
<meta name="article:section" content="ADULT BRAIN" />
<meta name="citation_title" content="Comparison of Measurement Techniques and Response Criteria for MR Imaging Follow-up in Adult Primary Central Nervous System Lymphoma" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Current guidelines proposed for the measurement of primary central nervous system lymphoma in 2005 have indicated that unidimensional and bidimensional measurements may be used, using the same threshold for response categorization, because no clinical study has evaluated the agreement among the measurement techniques. Hence, our study assessed the agreement among different measurements.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;In this retrospective study, primary central nervous system lymphoma lesions were measured with different techniques (longest 1D, axial 1D, 2D, 3D, and the Response Evaluation Criteria in Solid Tumor) on consecutive MR images. Intra- and interobserver correlations were calculated with intraclass correlation coefficients. Correlations between raw measurements and variations in size compared with baseline were evaluated with the Spearman rank correlation, and agreement among response categories was evaluated.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;A total of 304 examinations obtained in 40 patients was assessed. The intraobserver intraclass correlation coefficient for 3D, 2D, and longest 1D were ≥0.993. The interobserver intraclass correlation coefficient was ≥0.967. The correlations in raw measurements and size variation in comparison with 3D were respectively; 0.99 and 0.98 for 2D; 0.94 and 0.92 for longest 1D; 0.94 and 0.83 for axial 1D; and 0.90 and 0.79 for Response Evaluation Criteria in Solid Tumor. With 20%–30% and 25%–50% thresholds for unidimensional techniques, response categorizations were 95% and 95% for 2D, 92.5% and 90% for the longest 1D, 87.5% and 82.5% for axial 1D, and 90% and 85% for the Response Evaluation Criteria in Solid Tumor.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Both longest 1D and 2D demonstrated excellent correlations with 3D measurements. The longest 1D could be used for the follow-up of primary central nervous system lymphoma. If unidimensional measurements were used, 20% and 30% cutoffs should be used for defining response categorization instead of the current guidelines.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2021/04/29" />
<meta name="citation_mjid" content="ajnr;ajnr.A7132v1" />
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<meta name="citation_doi" content="10.3174/ajnr.A7132" />
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<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="ADULT BRAIN" />
<meta name="citation_author" content="K. Massicotte-Tisluck" />
<meta name="citation_author_institution" content="aFrom the Département d’Imagerie Médicale, (K.M.-T., D.V., G.G.)" />
<meta name="citation_author_institution" content="dFaculté de Médecine et des Sciences de la Santé (K.M.-T., D.V.), Université de Sherbrooke, Sherbrooke, Québec, Canada" />
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<meta name="citation_author" content="D. Vanderweyen" />
<meta name="citation_author_institution" content="aFrom the Département d’Imagerie Médicale, (K.M.-T., D.V., G.G.)" />
<meta name="citation_author_institution" content="dFaculté de Médecine et des Sciences de la Santé (K.M.-T., D.V.), Université de Sherbrooke, Sherbrooke, Québec, Canada" />
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<meta name="citation_author" content="J.-F. Vendrell" />
<meta name="citation_author_institution" content="eDepartments of Neuroradiology (J.-F.V.), Institut de cancérologie de Montpellier, Clinique de val d Aurelle, Montpellier, France" />
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<meta name="citation_author" content="D. Fortin" />
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<meta name="twitter:title" content="Comparison of Measurement Techniques and Response Criteria for MR Imaging Follow-up in Adult Primary Central Nervous System Lymphoma" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Current guidelines proposed for the measurement of primary central nervous system lymphoma in 2005 have indicated that unidimensional and bidimensional measurements may be used, using the same threshold for response categorization, because no clinical study has evaluated the agreement among the measurement techniques. Hence, our study assessed the agreement among different measurements.

MATERIALS AND METHODS: In this retrospective study, primary central nervous system lymphoma lesions were measured with different techniques (longest 1D, axial 1D, 2D, 3D, and the Response Evaluation Criteria in Solid Tumor) on consecutive MR images. Intra- and interobserver correlations were calculated with intraclass correlation coefficients. Correlations between raw measurements and variations in size compared with baseline were evaluated with the Spearman rank correlation, and agreement among response categories was evaluated.

RESULTS: A total of 304 examinations obtained in 40 patients was assessed. The intraobserver intraclass correlation coefficient for 3D, 2D, and longest 1D were ≥0.993. The interobserver intraclass correlation coefficient was ≥0.967. The correlations in raw measurements and size variation in comparison with 3D were respectively; 0.99 and 0.98 for 2D; 0.94 and 0.92 for longest 1D; 0.94 and 0.83 for axial 1D; and 0.90 and 0.79 for Response Evaluation Criteria in Solid Tumor. With 20%–30% and 25%–50% thresholds for unidimensional techniques, response categorizations were 95% and 95% for 2D, 92.5% and 90% for the longest 1D, 87.5% and 82.5% for axial 1D, and 90% and 85% for the Response Evaluation Criteria in Solid Tumor.

CONCLUSIONS: Both longest 1D and 2D demonstrated excellent correlations with 3D measurements. The longest 1D could be used for the follow-up of primary central nervous system lymphoma. If unidimensional measurements were used, 20% and 30% cutoffs should be used for defining response categorization instead of the current guidelines.

CNS
:   central nervous system
CR
:   complete response
ICC
:   intraclass correlation coefficient
PCNSL
:   primary central nervous system lymphoma
PD
:   progressive disease
PR
:   partial response
RECIST
:   Response Evaluation Criteria in Solid Tumor
SD
:   stable disease
WBRT
:   whole brain radiotherapy" />
<meta name="og-title" property="og:title" content="Comparison of Measurement Techniques and Response Criteria for MR Imaging Follow-up in Adult Primary Central Nervous System Lymphoma" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2021/04/29/ajnr.A7132" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Current guidelines proposed for the measurement of primary central nervous system lymphoma in 2005 have indicated that unidimensional and bidimensional measurements may be used, using the same threshold for response categorization, because no clinical study has evaluated the agreement among the measurement techniques. Hence, our study assessed the agreement among different measurements.

MATERIALS AND METHODS: In this retrospective study, primary central nervous system lymphoma lesions were measured with different techniques (longest 1D, axial 1D, 2D, 3D, and the Response Evaluation Criteria in Solid Tumor) on consecutive MR images. Intra- and interobserver correlations were calculated with intraclass correlation coefficients. Correlations between raw measurements and variations in size compared with baseline were evaluated with the Spearman rank correlation, and agreement among response categories was evaluated.

RESULTS: A total of 304 examinations obtained in 40 patients was assessed. The intraobserver intraclass correlation coefficient for 3D, 2D, and longest 1D were ≥0.993. The interobserver intraclass correlation coefficient was ≥0.967. The correlations in raw measurements and size variation in comparison with 3D were respectively; 0.99 and 0.98 for 2D; 0.94 and 0.92 for longest 1D; 0.94 and 0.83 for axial 1D; and 0.90 and 0.79 for Response Evaluation Criteria in Solid Tumor. With 20%–30% and 25%–50% thresholds for unidimensional techniques, response categorizations were 95% and 95% for 2D, 92.5% and 90% for the longest 1D, 87.5% and 82.5% for axial 1D, and 90% and 85% for the Response Evaluation Criteria in Solid Tumor.

CONCLUSIONS: Both longest 1D and 2D demonstrated excellent correlations with 3D measurements. The longest 1D could be used for the follow-up of primary central nervous system lymphoma. If unidimensional measurements were used, 20% and 30% cutoffs should be used for defining response categorization instead of the current guidelines.

CNS
:   central nervous system
CR
:   complete response
ICC
:   intraclass correlation coefficient
PCNSL
:   primary central nervous system lymphoma
PD
:   progressive disease
PR
:   partial response
RECIST
:   Response Evaluation Criteria in Solid Tumor
SD
:   stable disease
WBRT
:   whole brain radiotherapy" />
<meta name="og-type" property="og:type" content="article" />
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      <h1 class="highwire-cite-title" id="page-title">Comparison of Measurement Techniques and Response Criteria for MR Imaging Follow-up in Adult Primary Central Nervous System Lymphoma</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">K. Massicotte-Tisluck</span>, <span class="highwire-citation-author" data-delta="1">D. Vanderweyen</span>, <span class="highwire-citation-author" data-delta="2">J.-F. Vendrell</span>, <span class="highwire-citation-author" data-delta="3">D. Fortin</span> and <span class="highwire-citation-author" data-delta="4">G. Gahide</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">April 2021,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A7132 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-90804--61475157016" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">K. Massicotte-Tisluck </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Département d’Imagerie Médicale, (K.M.-T., D.V., G.G.)</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Faculté de Médecine et des Sciences de la Santé (K.M.-T., D.V.), Université de Sherbrooke, Sherbrooke, Québec, Canada</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.%2BMassicotte-Tisluck%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Massicotte-Tisluck%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AK.%2BMassicotte-Tisluck%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-8279-9447" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for K. Massicotte-Tisluck</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">D. Vanderweyen </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Département d’Imagerie Médicale, (K.M.-T., D.V., G.G.)</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Faculté de Médecine et des Sciences de la Santé (K.M.-T., D.V.), Université de Sherbrooke, Sherbrooke, Québec, Canada</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.%2BVanderweyen%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Vanderweyen%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.%2BVanderweyen%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-8723-631X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D. Vanderweyen</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">J.-F. Vendrell </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Departments of Neuroradiology (J.-F.V.), Institut de cancérologie de Montpellier, Clinique de val d Aurelle, Montpellier, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.-F.%2BVendrell%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Vendrell%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.-F.%2BVendrell%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-0351-2696" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.-F. Vendrell</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">D. Fortin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Service de Neurochirurgie, Département de Chirurgie (D.F.), Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Etienne Le Bel (D.F., G.G.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.%2BFortin%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Fortin%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.%2BFortin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-3283-9260" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D. Fortin</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">G. Gahide </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Département d’Imagerie Médicale, (K.M.-T., D.V., G.G.)</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Etienne Le Bel (D.F., G.G.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.%2BGahide%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Gahide%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AG.%2BGahide%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1153-1179" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for G. 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