Repeatability and reproducibility of multiparametric magnetic resonance imaging of the liver

Velicia Bachtiar, Matthew D Kelly, Henry R Wilman, Jaco Jacobs, Rexford Newbould, Catherine J Kelly, Michael L Gyngell, Katherine E Groves, Andy McKay, Amy H Herlihy, Carolina C Fernandes, Mark Halberstadt, Marion Maguire, Naomi Jayaratne, Sophia Linden, Stefan Neubauer, Rajarshi Banerjee, Velicia Bachtiar, Matthew D Kelly, Henry R Wilman, Jaco Jacobs, Rexford Newbould, Catherine J Kelly, Michael L Gyngell, Katherine E Groves, Andy McKay, Amy H Herlihy, Carolina C Fernandes, Mark Halberstadt, Marion Maguire, Naomi Jayaratne, Sophia Linden, Stefan Neubauer, Rajarshi Banerjee

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).

Conflict of interest statement

Authors are employees of Perspectum Diagnostics. V.B., M.D.K., J.J., R.N., C.J.K., M.L.G., K.E.G., A.M., A.H.H., C.C.F., M.H., M.M., N.J., S.L., and R.B. are employees at Perspectum Diagnostics. V.B., M.D.K., H.R.W., J.J., R.N., C.J.K., M.L.G., A.H.H., C.C.F., M.M., S.L., S.N., and R.B. are shareholders of Perspectum Diagnostics. S.N. and R.B. are founders of Perspectum Diagnostics. This commercial affiliation does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1. Study design.
Fig 1. Study design.
Two manufacturers (Siemens and Philips) and a range of scanner models were used to systematically test the repeatability and reproducibility of multiparametric-MRI derived measurements in human participants and phantoms.
Fig 2. Phantom T1 Standardisation.
Fig 2. Phantom T1 Standardisation.
Bland-Altman plots demonstrating T1 measurements in phantoms before and after standardisation at (a) 1.5T and (b) 3T.
Fig 3. Repeatability and reproducibility of phantom…
Fig 3. Repeatability and reproducibility of phantom measurements.
Bland-Altman plots from phantom measurements across manufacturer and field strength for (a) T1, (b) T2*, and (c) PDFF.
Fig 4. Repeatability and reproducibility of human…
Fig 4. Repeatability and reproducibility of human multiparametric MRI measurements.
Bland-Altman plots from human measurements across manufacturer and field strength for (a) cT1, (b) T2*, and (c) PDFF.

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