Safa Hoodeshenas1, Christopher L Welle1, Patrick J Navin1, Bogdan Dzyubak1, John E Eaton2, Richard L Ehman1, Sudhakar K Venkatesh3. 1. Department of Radiology, Mayo Clinic College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. 2. Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota. 3. Department of Radiology, Mayo Clinic College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. Electronic address: venkatesh.sudhakar@mayo.edu.
Abstract
RATIONALE AND OBJECTIVE: Primary sclerosing cholangitis, a chronic liver disease causes heterogeneous parenchymal changes and fibrosis. Liver stiffness measurement (LSM) with magnetic resonance Elastography (MRE) may be affected by this heterogeneous distribution. We evaluated interobserver agreement of LSM in primary sclerosing cholangitis (PSC) with manual and automated methods to study the influence of heterogeneous changes. MATERIALS AND METHODS: A total of 79 consecutive patients with PSC who had a liver MRI and MRE formed the study group. Three readers with 1-3 years' experience in MRE and a MRE expert (11 years' experience) independently performed LSM. Each reader manually drew free hand (fROI) and average (aROI) on stiffness maps. Automatic liver elasticity calculation (ALEC) was used to generate automated LSM. The expert fROI was the reference standard. Correlation analysis and absolute intra-class correlation coefficient (ICC) analysis was performed. RESULTS: LSM data of 79 livers and 315 sections were evaluated. There was excellent ICC between expert and reader fROIs (0.989, 95% confidence interval, and 0.985-0.993) and aROIs (0.971, 95% confidence interval, and 0.953-0.983) and ALEC (0.972, 0.957-0.982) with fROI performing better. The areas measured with fROIs and ALEC had moderate ICC with Expert fROI (0.64 and 0.56, respectively) whereas aROI area had a poor ICC of 0.12. Comparison of multiple methods showed significant differences in LSM between expert fROI and aROI of two readers and no significant differences for fROIs of all three readers. CONCLUSION: LSM with MRE in PSC patients shows excellent interobserver agreement with both fROI and aROI methods with better performance with fROI. fROI may therefore be preferred for LSM measurements in PSC.
RATIONALE AND OBJECTIVE:Primary sclerosing cholangitis, a chronic liver disease causes heterogeneous parenchymal changes and fibrosis. Liver stiffness measurement (LSM) with magnetic resonance Elastography (MRE) may be affected by this heterogeneous distribution. We evaluated interobserver agreement of LSM in primary sclerosing cholangitis (PSC) with manual and automated methods to study the influence of heterogeneous changes. MATERIALS AND METHODS: A total of 79 consecutive patients with PSC who had a liver MRI and MRE formed the study group. Three readers with 1-3 years' experience in MRE and a MRE expert (11 years' experience) independently performed LSM. Each reader manually drew free hand (fROI) and average (aROI) on stiffness maps. Automatic liver elasticity calculation (ALEC) was used to generate automated LSM. The expert fROI was the reference standard. Correlation analysis and absolute intra-class correlation coefficient (ICC) analysis was performed. RESULTS: LSM data of 79 livers and 315 sections were evaluated. There was excellent ICC between expert and reader fROIs (0.989, 95% confidence interval, and 0.985-0.993) and aROIs (0.971, 95% confidence interval, and 0.953-0.983) and ALEC (0.972, 0.957-0.982) with fROI performing better. The areas measured with fROIs and ALEC had moderate ICC with Expert fROI (0.64 and 0.56, respectively) whereas aROI area had a poor ICC of 0.12. Comparison of multiple methods showed significant differences in LSM between expert fROI and aROI of two readers and no significant differences for fROIs of all three readers. CONCLUSION: LSM with MRE in PSC patients shows excellent interobserver agreement with both fROI and aROI methods with better performance with fROI. fROI may therefore be preferred for LSM measurements in PSC.
Authors: Deep B Gandhi; Amol Pednekar; Adebayo B Braimah; Jonathan Dudley; Jean A Tkach; Andrew T Trout; Alexander G Miethke; Marnix D Franck; Jeremiah A Heilman; Bogdan Dzyubak; David S Lake; Jonathan R Dillman Journal: Abdom Radiol (NY) Date: 2021-04-02
Authors: Christopher L Welle; Michael C Olson; Scott B Reeder; Sudhakar K Venkatesh Journal: Radiol Clin North Am Date: 2022-07-15 Impact factor: 1.947
Authors: Narine Mesropyan; Patrick Kupczyk; Guido M Kukuk; Leona Dold; Tobias Weismueller; Christoph Endler; Alexander Isaak; Anton Faron; Alois M Sprinkart; Claus C Pieper; Daniel Kuetting; Christian P Strassburg; Ulrike I Attenberger; Julian A Luetkens Journal: BMC Med Imaging Date: 2021-04-07 Impact factor: 1.930