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Accuracy and precision of proton density fat fraction measurement across field strengths and scan intervals: A phantom and human study

Authors
Kim, HJ  | Cho, HJ  | Kim, B  | You, MW | Lee, JH  | Huh, J  | Kim, JK
Citation
Journal of magnetic resonance imaging : JMRI, 50(1). : 305-314, 2019
Journal Title
Journal of magnetic resonance imaging : JMRI
ISSN
1053-18071522-2586
Abstract
BACKGROUND: Complex-based chemical shift imaging-based magnetic resonance imaging (CSE-MRI) is emerging as a preferred method for noninvasively quantifying proton density fat fraction (PDFF), a promising quantitative imaging biomarker (QIB) for longitudinal hepatic steatosis measurement.
PURPOSE: To determine linearity, bias, repeatability, and reproducibility of the PDFF measurement using CSE-MRI (CSE-PDFF) across scan intervals, MR field strengths, and readers in phantom and nonalcoholic fatty liver disease (NAFLD) patients.
STUDY TYPE: Institutional Review Board (IRB)-approved prospective.
SUBJECTS: Fat-water phantom and 20 adult patients.
FIELD STRENGTH/SEQUENCE: 1.5 T and 3.0 T MR systems and a commercially available CSE-MRI sequence (IDEAL-IQ).
ASSESSMENT: Two independent readers measured CSE-PDFF of fat-water phantom and NAFLD patients across two field strengths and scan intervals (same-day and 2-week) each and in a combination of both. MR spectroscopy-based PDFF (MRS-PDFF) was used as the reference standard for phantom PDFF.
STATISTICAL TESTS: Linearity and bias of measurement were evaluated by linear regression analysis and Bland-Altman plots, respectively. Repeatability and reproducibility were assessed by coefficient of variance and repeatability / reproducibility coefficients (RC). The intraclass correlation coefficient was used to validate intra- and interobserver agreements.
RESULTS: CSE-PDFF showed high linearity and small bias (-0.6-0.4 PDFF%) with 95% limits of agreement within +/-2.9 PDFF% across field strengths, 2-week interscan period, and readers in the clinical scans. CSE-PDFF was highly repeatable and reproducible both in phantom and clinical scans, with the largest observed RC across field strengths and 2-week interscan period being 3 PDFF%.
DATA CONCLUSION: CSE-PDFF is a robust QIB with high linearity, small bias, and excellent repeatability/reproducibility. A change of more than 3 PDFF% across field strengths within 2 weeks of scan interval likely reflects a true change, which is well within the clinically acceptable range.
LEVEL OF EVIDENCE: 3
TECHNICAL EFFICACY: Stage 2.
Keywords
DOI
10.1002/jmri.26575
PMID
30430684
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
Ajou Authors
김, 보현  |  김, 재근  |  김, 혜진  |  이, 제희  |  조, 효정  |  허, 지미
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