Tumour subregion analysis of colorectal liver metastases using semi-automated clustering based on DCE-MRI: Comparison with histological subregions and impact on pharmacokinetic parameter analysis.

PURPOSE: To use a novel segmentation methodology based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to define tumour subregions of liver metastases from colorectal cancer (CRC), to compare these with histology, and to use these to compare extracted pharmacokinetic (PK) parameters between tumour subregions. MATERIALS AND METHODS: This ethically-approved prospective study recruited patients with CRC and ≥1 hepatic metastases scheduled for hepatic resection. Patients underwent DCE-MRI pre-metastasectomy. Histological sections of resection specimens were spatially matched to DCE-MRI acquisitions and used to define histological subregions of viable and non-viable tumour. A semi-automated voxel-wise image segmentation algorithm based on the DCE-MRI contrast-uptake curves was used to define imaging subregions of viable and non-viable tumour. Overlap of histologically-defined and imaging subregions was compared using the Dice similarity coefficient (DSC). DCE-MRI PK parameters were compared for the whole tumour and histology-defined and imaging-derived subregions. RESULTS: Fourteen patients were included in the analysis. Direct histological comparison with imaging was possible in nine patients. Mean DSC for viable tumour subregions defined by imaging and histology was 0.738 (range 0.540-0.930). There were significant differences between Ktrans and kep for viable and non-viable subregions (p < 0.001) and between whole lesions and viable subregions (p < 0.001). CONCLUSION: We demonstrate good concordance of viable tumour segmentation based on pre-operative DCE-MRI with a post-operative histological gold-standard. This can be used to extract viable tumour-specific values from quantitative image analysis, and could improve treatment response assessment in clinical practice

Visual analytics for the exploration of tumor tissue characterization

Tumors are heterogeneous tissues consisting of multiple regions with distinct characteristics. Characterization of these intra-tumor regions can improve patient diagnosis and enable a better targeted treatment. Ideally, tissue characterization could be performed non-invasively, using medical imaging data, to derive per voxel a number of features, indicative of tissue properties. However, the high dimensionality and complexity of this imaging-derived feature space is prohibiting for easy exploration and analysis - especially when clinical researchers require to associate observations from the feature space to other reference data, e.g., features derived from histopathological data. Currently, the exploratory approach used in clinical research consists of juxtaposing these data, visually comparing them and mentally reconstructing their relationships. This is a time consuming and tedious process, from which it is difficult to obtain the required insight. We propose a visual tool for: (1) easy exploration and visual analysis of the feature space of imaging-derived tissue characteristics and (2) knowledge discovery and hypothesis generation and confirmation, with respect to reference data used in clinical research. We employ, as central view, a 2D embedding of the imaging-derived features. Multiple linked interactive views provide functionality for the exploration and analysis of the local structure of the feature space, enabling linking to patient anatomy and clinical reference data. We performed an initial evaluation with ten clinical researchers. All participants agreed that, unlike current practice, the proposed visual tool enables them to identify, explore and analyze heterogeneous intra-tumor regions and particularly, to generate and confirm hypotheses, with respect to clinical reference data

Layered Formulation for the Robust Vehicle Routing Problem with Time Windows

Abstract. This paper studies the vehicle routing problem with time windows where travel times are uncertain and belong to a predetermined polytope. The objective of the problem is to find a set of routes that services all nodes of the graph and that are feasible for all values of the travel times in the uncertainty polytope. The problem is motivated by maritime transportation where delays are frequent and must be taken into account. We present an extended formulation for the vehicle routing problem with time windows that allows us to apply the classical (static) robust programming approach to the problem. The formulation is based on a layered representation of the graph, which enables to track the position of each arc in its route. We test our formulation on a test bed composed of maritime transportation instances

Phantom-based quality assurance for multicenter quantitative MRI in locally advanced cervical cancer

Background and purpose: A wide variation of MRI systems is a challenge in multicenter imaging biomarker studies as it adds variation in quantitative MRI values. The aim of this study was to design and test a quality assurance (QA) framework based on phantom measurements, for the quantitative MRI protocols of a multicenter imaging biomarker trial of locally advanced cervical cancer. Materials and methods: Fifteen institutes participated (five 1.5 T and ten 3 T scanners). Each institute optimized protocols for T2, diffusion-weighted imaging, T1, and dynamic contrast-enhanced (DCE–)MRI according to system possibilities, institutional preferences and study-specific constraints. Calibration phantoms with known values were used for validation. Benchmark protocols, similar on all systems, were used to investigate whether differences resulted from variations in institutional protocols or from system variations. Bias, repeatability (%RC), and reproducibility (%RDC) were determined. Ratios were used for T2 and T1 values. Results: The institutional protocols showed a range in bias of 0.88–0.98 for T2 (median %RC = 1%; %RDC = 12%), −0.007 to 0.029 × 10−3 mm2/s for the apparent diffusion coefficient (median %RC = 3%; %RDC = 18%), and 0.39–1.29 for T1 (median %RC = 1%; %RDC = 33%). For DCE a nonlinear vendor-specific relation was observed between measured and true concentrations with magnitude data, whereas the relation was linear when phase data was used. Conclusion: We designed a QA framework for quantitative MRI protocols and demonstrated for a multicenter trial for cervical cancer that measurement of consistent T2 and apparent diffusion coefficient values is feasible despite protocol differences. For DCE–MRI and T1 mapping with the variable flip angle method, this was more challenging