Repeatability and reproducibility of multiparametric magnetic resonance imaging of the liver

Abstract

As the burden of liver disease reaches epidemic levels, there is a high unmet medical need to develop robust, accurate and reproducible non-invasive methods to quantify liver tissue characteristics for use in clinical development and ultimately in clinical practice. This prospective cross-sectional study systematically examines the repeatability and reproducibility of iron-corrected T1 (cT1), T2*, and hepatic proton density fat fraction (PDFF) quantification with multiparametric MRI across different field strengths, scanner manufacturers and models. 61 adult participants with mixed liver disease aetiology and those without any history of liver disease underwent multiparametric MRI on combinations of 5 scanner models from two manufacturers (Siemens and Philips) at different field strengths (1.5T and 3T). We report high repeatability and reproducibility across different field strengths, manufacturers, and scanner models in standardized cT1 (repeatability CoV 1.7%, bias -7.5ms, 95% LoA of -53.6 ms to 38.5 ms; reproducibility CoV 3.3%, bias 6.5 ms, 95% LoA of -76.3 to 89.2 ms) and T2* (repeatability CoV 5.5%, bias -0.18 ms, 95% LoA -5.41 to 5.05 ms; reproducibility CoV 6.6%, bias -1.7 ms, 95% LoA -6.61 to 3.15 ms) in human measurements. PDFF repeatability (0.8%) and reproducibility (0.75%) coefficients showed high precision of this metric. Similar precision was observed in phantom measurements. Inspection of the ICC model indicated that most of the variance in cT1 could be accounted for by study participants (ICC = 0.91), with minimal contribution from technical differences. We demonstrate that multiparametric MRI is a non-invasive, repeatable and reproducible method for quantifying liver tissue characteristics across manufacturers (Philips and Siemens) and field strengths (1.5T and 3T).

A composite biomarker using multiparametric magnetic resonance imaging and blood analytes accurately identifies patients with non-alcoholic steatohepatitis and significant fibrosis

“…The utility of cT1 in distinguishing between these groups derives from the significantly higher cT1 in the progressive NASH group. To put the 79.8 ms difference in context, the reported standard deviation for cT1 reproducibility (same patient scanned across different MRI scanners) is 41.4 ms 37 and 31.9 ms for a longitudinal test–retest study over 16 weeks 43 . Although the data reported in this study is not longitudinal, the magnitude of the difference between the two risk groups, relative to the reported repeatability and reproducibility, supports the utility of cT1 as a sensitive biomarker for monitoring changes in disease state 44 .…”

“…The Liver MultiScan MRI scanning protocol was installed, calibrated and phantom tested on all the MR systems in these trials in a standard way 37 . Patients underwent their MRI (SIEMENS MAGNETOM TrioTim, Magnetic Field Strength 3 T) having fasted for at least 4 h. The average scan time for this protocol was 10 min.…”

Multiparametric MR mapping in clinical decision-making for diffuse liver disease

“…Multiparametric MRI refers to use of multiple quantitative (parametric) MRI features or measures with several possibilities for combinations [34][35][36][40][41][42][43][44][45]. Therefore, these combinations could be used to evaluate two or more specific characteristics of chronic liver disease and diffuse liver processes, to include derivation of composite metrics [44,46].…”

Mechanisms, screening modalities and treatment options for individuals with non‐alcoholic fatty liver disease and type 2 diabetes

“…It is now increasingly adopted in NASH clinical trials due to low measurement failure rates, high repeatability and reproducibility (Fig. 4) [29,30].…”