Camilo A Campo1, Diego Hernando1,2, Tilman Schubert1,3, Candice A Bookwalter1,4, Andrew J Van Pay1, Scott B Reeder1,2,5,6,7. 1. 1 Department of Radiology, Wisconsin Institutes for Medical Research, University of Wisconsin-Madison, 1111 Highland Ave, Madison, WI 53705. 2. 2 Department of Medical Physics, University of Wisconsin-Madison, Madison, WI. 3. 3 Clinic of Radiology and Nuclear Medicine, Basel University Hospital, Basel, Switzerland. 4. 4 Department of Radiology, Mayo Clinic, Rochester, MN. 5. 5 Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI. 6. 6 Department of Medicine, University of Wisconsin-Madison, Madison, WI. 7. 7 Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI.
Abstract
OBJECTIVE: The purpose of this study was to evaluate the reproducibility (interreviewer agreement) and repeatability (intrareviewer agreement) of ROI sampling strategies to measure chemical shift-encoded (CSE) MRI-based liver proton density fat fraction (PDFF) and R2* (1 / T2*). A secondary purpose was to standardize ROI-based liver PDFF and R2* measurements by providing a compromise between measurement reproducibility and repeatability and time burden for image analysts. MATERIALS AND METHODS: CSE data from two cohorts were retrospectively analyzed. Cohort A included 53 patients referred for abdominal MRI and healthy subjects recruited for a comparison study of CT and MRI. Cohort B included 37 patients with suspected liver iron overload. Three reviewers measured liver PDFF and R2* using previously reported ROI sampling strategies. Inter- and intrareviewer agreement of liver PDFF and R2* were evaluated using Bland-Altman analysis. RESULTS: Averaging largest-fit ROIs over the nine Couinaud segments resulted in the narrowest limits of agreement (LOA) for liver PDFF and R2* measurements in both cohorts. For PDFF, interreviewer agreement had mean LOA of ± 0.8% for cohort A and ± 1.7% for cohort B. Intrareviewer agreement was ± 0.5% for cohort A and ± 0.9% for cohort B. For R2* interre-viewer agreement had mean LOA of ± 3.0 s-1 for cohort A and ± 17.9 s-1 for cohort B. Intrare-viewer agreement was ± 2.6 s-1 for cohort A and ± 14.6 s-1 for cohort B. This approach was the most time-burdensome, requiring a mean ± SD of 149.7 ± 8.6 s per dataset. CONCLUSION: For improved reproducibility and repeatability of liver PDFF and R2* measurements, clinicians and researchers should sample as much area of the liver as possible using multiple large ROIs.
OBJECTIVE: The purpose of this study was to evaluate the reproducibility (interreviewer agreement) and repeatability (intrareviewer agreement) of ROI sampling strategies to measure chemical shift-encoded (CSE) MRI-based liver proton density fat fraction (PDFF) and R2* (1 / T2*). A secondary purpose was to standardize ROI-based liver PDFF and R2* measurements by providing a compromise between measurement reproducibility and repeatability and time burden for image analysts. MATERIALS AND METHODS: CSE data from two cohorts were retrospectively analyzed. Cohort A included 53 patients referred for abdominal MRI and healthy subjects recruited for a comparison study of CT and MRI. Cohort B included 37 patients with suspected liver iron overload. Three reviewers measured liver PDFF and R2* using previously reported ROI sampling strategies. Inter- and intrareviewer agreement of liver PDFF and R2* were evaluated using Bland-Altman analysis. RESULTS: Averaging largest-fit ROIs over the nine Couinaud segments resulted in the narrowest limits of agreement (LOA) for liver PDFF and R2* measurements in both cohorts. For PDFF, interreviewer agreement had mean LOA of ± 0.8% for cohort A and ± 1.7% for cohort B. Intrareviewer agreement was ± 0.5% for cohort A and ± 0.9% for cohort B. For R2* interre-viewer agreement had mean LOA of ± 3.0 s-1 for cohort A and ± 17.9 s-1 for cohort B. Intrare-viewer agreement was ± 2.6 s-1 for cohort A and ± 14.6 s-1 for cohort B. This approach was the most time-burdensome, requiring a mean ± SD of 149.7 ± 8.6 s per dataset. CONCLUSION: For improved reproducibility and repeatability of liver PDFF and R2* measurements, clinicians and researchers should sample as much area of the liver as possible using multiple large ROIs.
Entities:
Keywords:
MRI; R2*; ROI; liver disease; proton density fat fraction
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