LGG are known to show constant slow growth ( 1), until-in adults-they inevitably transform to a more malignant type. Magnetic resonance (MR) imaging plays a key role in the management of low-grade glioma (LGG) as a method for measuring treatment response and for regular surveillance during periods of watchful waiting. This first cautious introduction of EASE in our clinic is a valuable step in the translation of automatic segmentation methods to clinical practice. In all cases the volume-based diagnosis was in line with the conventional visual diagnosis.

In its first 3 months of usage, it was applied to a total of 55 patients, and in 36 of those the radiologist was able to make a volume-based diagnosis using three successful consecutive measurements from EASE. Upon the introduction of EASE into clinical practice, we evaluated the individual segmentation success rate and impact on diagnosis. Additionally, to ensure patient safety and quality of care, protocols were established for the usage of volume measurements in clinical diagnosis and for future updates to the algorithm. The visual quality control of segmentations by the radiologist is an important step in this process, as errors in the segmentation are still possible. Recent advances in automated tumor segmentation have made such a volume quantification possible, and this work describes the clinical implementation of automated volume quantification in an application named EASE: Erasmus Automated SEgmentation. Volumetric assessment could provide a reliable quantification of tumor growth, but is only feasible if fully automated. The growth rate of non-enhancing low-grade glioma has prognostic value for both malignant progression and survival, but quantification of growth is difficult due to the irregular shape of the tumor. 2Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands.1Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, Netherlands.van der Voort 1, Adriaan Versteeg 1, Marcel Koek 1, Andrea Gutierrez 1, Marcel van Straten 1, Mart Rentmeester 1, Stefan Klein 1 and Marion Smits 1,2,3 *

Prototype 3 dr shaffeld