Summary
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The TCGA Glioma Phenotype Research Group is part of the CIP TCGA Radiology Initiative. The group began as an ad hoc multi-institutional research team dedicated to discovering the value of applying controlled terminology to the MR imaging features of patients with gliomas. Research trials that incorporate imaging present unique challenges due to nonstandard use of terminologies, absence of uniform data collection and validation. These obstacles traditionally limit the impact of imaging as an effective biomarker in oncology. The purpose of this project was to assess reliability of tools and terminology developed by the Cancer Bioinformatics Grid (caBIG) initiative when performing a multireader simultaneous assessments of glioblastoma MR imaging features. |
A controlled terminology for describing the MR features of human gliomas was devised based upon prior work (VASARI / REMBRANDT project). This comprehensive featureset consists of 24 observations familiar to neuroradiologists to describe the morphology of brain tumors on routine contrast-enhanced MRI. The National Biomedical Imaging Archive (NBIA) was used to store the de-identified baseline MRI studies for 78 glioblastomas collected for The Cancer Genome Atlas (TCGA) initiative. Six neuroradiologists in three disparate geographic locations were recruited and trained in the use of the featureset using a visual guidebook. Training cases were employed to assess competency and to ensure agreement. A open-source PACS workstation (Clear Canvas) was customized for clinical imaging research evaluation and deployed at each of the three centers. Networking tools built into the workstation were used to securely download studies from NBIA (caGRID). As studies were evaluated, scores were simultaneously uplinked to a single remote AIM (Annotation and Image Markup) repository for QC checks and interim analysis. Case assignments were deliberately staged in a staggered fashion to ensure that a minimum of three evaluations were efficiently obtained. Administrative tools were employed by coordinators in a fourth location. Qualitative assessments included: (1) effectiveness of training, (2) ease of deployment & functionality of the informatics solutions and (3) efficiency of the process. Inter-observer variation for each feature was assessed with the generalized kappa statistic of Berry&Miekle.
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