Reproducibility of MRI-derived liver surface nodularity score: analysis of patients with repeated MRI in various scanners

Deok Jin Bae; Eun Sung Yang; Woo Sung Park; Hyun Kyung Lee; Ji Soo Song; Tae-Hoon Kim; Kwon-Ha Yoon

doi:10.1007/s00261-022-03744-6

Reproducibility of MRI-derived liver surface nodularity score: analysis of patients with repeated MRI in various scanners

Abdom Radiol (NY). 2023 Feb;48(2):590-600. doi: 10.1007/s00261-022-03744-6. Epub 2022 Nov 23.

Authors

Deok Jin Bae^#¹, Eun Sung Yang^#¹, Woo Sung Park¹, Hyun Kyung Lee^{2

3

4}, Ji Soo Song^{5

6

7}, Tae-Hoon Kim⁸, Kwon-Ha Yoon^{8

9}

Affiliations

¹ Jeonbuk National University Medical School, Jeonju, South Korea.
² Department of Radiology, Jeonbuk National University Medical School and Hospital, 20 Geonji-Ro, Deokjin-Gu, Jeonju, 54907, Jeonbuk, Korea.
³ Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, South Korea.
⁴ Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea.
⁵ Department of Radiology, Jeonbuk National University Medical School and Hospital, 20 Geonji-Ro, Deokjin-Gu, Jeonju, 54907, Jeonbuk, Korea. pichgo@gmail.com.
⁶ Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, South Korea. pichgo@gmail.com.
⁷ Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea. pichgo@gmail.com.
⁸ Medical Convergence Research Center, Wonkwang University, Iksan, South Korea.
⁹ Department of Radiology, Wonkwang University School of Medicine, Iksan, South Korea.

^# Contributed equally.

PMID: 36416904
DOI: 10.1007/s00261-022-03744-6

Abstract

Purpose: To assess trans-regional differences, reproducibility across different MRI scanners, and interobserver agreement of liver surface nodularity (LSN) score from routine liver MRI and to evaluate the correlation between LSN score and liver stiffness (LS) value on MR elastography.

Materials and methods: Ninety patients who underwent gadoxetic acid-enhanced liver MRI twice using different MRI scanners within a year were evaluated. On axial hepatobiliary phase images, right anterior (LSN_{RT_ANT}), right posterior (LSN_{RT_POST}), and left anterior hepatic surface (LSN_LT) were chosen for the quantification of LSN score. Repeated-measures ANOVA, paired t test, Pearson's correlation coefficient analysis, and intraclass correlation coefficient (ICC) were used for statistical analysis.

Results: LSN scores from high to low were LSN_{RT_POST}, LSN_{RT_ANT}, and LSN_LT, representing trans-regional differences (p < 0.001). Reproducibility of LSN measurement across different MRI scanners was high to excellent (ICC = 0.838-0.921). The mean difference between first and second examinations in LSN_{RT_ANT}, LSN_{RT_POST}, and LSN_LT were 0.032 (p = 0.013), 0.002 (p = 0.910), and 0.010 (p = 0.285) for reader 1 and 0.051 (p = 0.004), 0.061 (p = 0.002), and 0.023 (p = 0.005) for reader 2. The first and second examinations were highly correlated in all hepatic regions (r = 0.712-0.839, p < 0.001). There was a low to moderate correlation between LSN score and LS value (r = 0.364-0.592, p ≤ 0.001), which was higher in the chronic hepatitis B (CHB) group than in the non-CHB group in all hepatic regions.

Conclusions: In our study, LSN measurement on liver MRI showed trans-regional differences and excellent reproducibility across different MRI scanners. To use LSN score more widely, standardization of quantification software and selected hepatic regions is needed.

Keywords: Fibrosis; Liver cirrhosis; Magnetic resonance imaging; Reproducibility.

MeSH terms

Humans
Liver Cirrhosis* / pathology
Liver* / diagnostic imaging
Liver* / pathology
Magnetic Resonance Imaging / methods
Reproducibility of Results
Retrospective Studies