• Hao Chen, Yaoyao He, Cecheng Zhao, Lili Zheng, Ning Pan, Jianfeng Qiu, Zhaoxi Zhang, Xiaohui Niu, and Zilong Yuan.
• Department of Radiology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China.
• Acta Radiol. 2021 May 1; 62 (5): 679-686.

BackgroundThe reproducibility of intravoxel incoherent motion (IVIM)-based radiomics studies in humans has not been reported.PurposeTo determine the inter- and intra-observer variability on the reproducibility of IVIM-based radiomics features in cervical cancer (CC).Material And MethodsThe IVIM images of 25 patients with CC were retrospectively collected. Based on the high-resolution T2-weighted images, the regions of interest (ROIs) were independently delineated twice in diffusion-weighted images at a b value of 1000 s/mm2 (interval time was one month) by two radiologists. This was done at the largest transversal cross-sections of the tumors. The ROI was subsequently used in apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) maps derived from IVIM images. In total, 105 radiomics features were then finally extracted from the IVIM-derived maps. The inter- and intra-observer reproducibility of IVIM-derived features was then evaluated using the intraclass correlation coefficient.ResultsInter- and intra-observer variability affected the reproducibility of radiomics features. D* map had 100% and 95% reproducible features, ADC map had 89% and 93%, D map had 97% and 86%, while f map had 54% and 62% reproducible features with good to excellent reliability in the intra-observer analysis. Similarly, D* map had 90% and 94%, ADC map had 85% and 70%, D map had 81% and 78%, while f map had 41% and 93% reproducible features with good to excellent reliability in the inter-observer analysis.ConclusionInter- and intra-observer variability can affect radiomics analysis. Cognizant to this, multicenter studies should pay more attention to intra- and inter-observer variability.

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