Optimal presentation modes for detecting brain tumor progression

Bradley J. Erickson, C. P. Wood, T. J. Kaufmann, J. W. Patriarche, J. Mandrekar

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


BACKGROUND AND PURPOSE: A common task in radiology interpretation is visual comparison of images. The purpose of this study was to compare traditional side-by-side and in-place (flicker) image presentation modes with advanced methods for detecting primary brain tumors on MR imaging. MATERIALS AND METHODS: We identified 66 patients with gliomas and 3 consecutive brain MR imaging examinations (a "triplet"). A display application that presented images in side-by-side mode with or without flicker display as well as display of image subtraction or automated change detection information (also with and without flicker display) was used by 3 board-certified neuroradiologists. They identified regions of brain tumor progression by using this display application. Each case was reviewed using all modes (side-by-side presentation with and without flicker, subtraction with and without flicker, and change detection with and without flicker), with results compared via a panel rating. RESULTS: Automated change detection with or without flicker (P < .0027) as well as subtraction with or without flicker (P < .0027) were more sensitive to tumor progression than side-by-side presentation in cases where all 3 raters agreed. Change detection afforded the highest interrater agreement, followed by subtraction. Clinically determined time to progression was longer for cases rated as nonprogressing by using subtraction images and change-detection images both with and without flicker display mode compared with side-by-side presentation. CONCLUSIONS: Automated change detection and image subtraction, with and without flicker display mode, are superior to side-by-side image comparison.

Original languageEnglish (US)
Pages (from-to)1652-1657
Number of pages6
JournalAmerican Journal of Neuroradiology
Issue number9
StatePublished - Oct 2011

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology


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