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Fuzzy Clustering Segmentation of Glioblastoma in T1-MRI Imaging for Clinical Trials

E Schreibmann

J S Cordova1,2, Eduard Schreibmann3, Constantinos G. Hadjipanayis4, Chad A. Holder1, Vivek Bansal1, Julio Sepulveda1, Hasan Danish3, Ying Guo5, Tim H. Fox3, Ian R. Crocker3, Hui-Kuo G. Shu3, Hyunsuk Shim1 1Dept. of Radiology, 2Medical Scientist Training Program, 3Department of Radiation Oncology and Winship Cancer Institute, 4Dept. of Neurosurgery, 5Dept. of Biostatistics, Emory University , Atlanta, GA 30322


SU-E-J-139 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

Purpose: Generating brain tumor volume measurements in a reproducible and efficient manner is a difficult, yet necessary, component of response assessment. The purpose of this study was to adapt and validate a multi-level Fuzzy C-means clustering algorithms for ROI tumor segmentation to allow consistent volumetric comparisons at multiple sites.

Methods: Preoperative contrast-enhanced T1W images from 37 glioblastoma cases were segmented using Fuzzy C-means clustering-based methods and compared to manually contoured volumes created by specialists. The same was done post-operatively, using subtracted images to eliminate intrinsically T1-hyperintense material (blood). Volume computations based on the MacDonald criteria were also used for comparison. Agreement and inter-rater variability between volumes produced with each method was assessed by determining the concordance correlation coefficient (CCC).

Results: The MacDonald criteria method had poor agreement (CCC=0.350-0.972) with manual contouring pre- and postoperatively, while the proposed semi-automated methods exhibited very high agreement (CCC=0.839-0.995) with manual contouring before and after resection. Fuzzy C-means clustering with three classes was the most robust semi-automated method, showing better inter-rater agreement than the MacDonald criteria method for both pre- (CCC of 0.990 and 0.975, respectively) and post-operative cases (CCC of 0.983 and 0.576, respectively). Post-operative inter-rater agreement was significantly different between these methods (p < 0.001).

Conclusion: The proposed semi-automated segmentation methods allow tumor volume measurements of MR images in a reliable and reproducible fashion necessary for measuring treatment response in glioblastoma patients in multicenter clinical trials.

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