A Comparative Study of Three Systems for Liver Magnetic Resonance Elastography

Runke Wang; Yikun Wang; Suhao Qiu; Shengyuan Ma; Fuhua Yan; Guang-Zhong Yang; Ruokun Li; Yuan Feng

doi:10.1002/jmri.29335

A Comparative Study of Three Systems for Liver Magnetic Resonance Elastography

J Magn Reson Imaging. 2024 Mar 6. doi: 10.1002/jmri.29335. Online ahead of print.

Authors

Runke Wang^{1

2

3

4}, Yikun Wang^{1

5}, Suhao Qiu^{1

2

3

4}, Shengyuan Ma^{1

2

3

4}, Fuhua Yan^{1

5}, Guang-Zhong Yang^{2

3

4}, Ruokun Li^{1

5}, Yuan Feng^{1

2

3

4}

Affiliations

¹ Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
² School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
³ Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China.
⁴ National Engineering Research Center of Advanced Magnetic Resonance Technologies for Diagnosis and Therapy (NERC-AMRT), Shanghai Jiao Tong University, Shanghai, China.
⁵ Faculty of Medical Imaging Technology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

PMID: 38449389
DOI: 10.1002/jmri.29335

Abstract

Background: Different MR elastography (MRE) systems may produce different stiffness measurements, making direct comparison difficult in multi-center investigations.

Purpose: To assess the repeatability and reproducibility of liver stiffness measured by three typical MRE systems.

Study type: Prospective.

Population/phantoms: Thirty volunteers without liver disease history (20 males, aged 21-28)/5 gel phantoms.

Field strength/sequence: 3.0 T United Imaging Healthcare (UIH), 1.5 T Siemens Healthcare, 3.0 T General Electric Healthcare (GE)/Echo planar imaging-based MRE sequence.

Assessment: Wave images of volunteers and phantoms were acquired by three MRE systems. Tissue stiffness was evaluated by two observers, while phantom stiffness was assessed automatically by code. The reproducibility across three MRE systems was quantified based on the mean stiffness of each volunteer and phantom.

Statistical tests: Intraclass correlation coefficients (ICC), coefficients of variation (CV), and Bland-Altman analyses were used to assess the interobserver reproducibility, the interscan repeatability, and the intersystem reproducibility. Paired t-tests were performed to assess the interobserver and interscan variation. Friedman tests with Dunn's multiple comparison correction were performed to assess the intersystem variation. P values less than 0.05 indicated significant difference.

Results: The reproducibility of stiffness measured by the two observers demonstrated consistency with ICC > 0.92, CV < 4.32%, Mean bias < 2.23%, and P > 0.06. The repeatability of measurements obtained using the electromagnetic system for the liver revealed ICC > 0.96, CV < 3.86%, Mean bias < 0.19%, P > 0.90. When considering the range of reproducibility across the three systems for liver evaluations, results ranged with ICCs from 0.70 to 0.87, CVs from 6.46% to 10.99%, and Mean biases between 1.89% and 6.30%. Phantom studies showed similar results. The values of measured stiffness differed across all three systems significantly.

Data conclusion: Liver stiffness values measured from different MRE systems can be different, but the measurements across the three MRE systems produced consistent results with excellent reproducibility.

Evidence level: 1 TECHNICAL EFFICACY: Stage 2.

Keywords: liver; magnetic resonance elastography; repeatability; reproducibility; systems comparison; tissue stiffness.

Abstract

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