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Intra- and inter-examination repeatability of magnetic resonance spectroscopy, magnitude-based MRI, and complex-based MRI for estimation of hepatic proton density fat fraction in overweight and obese children and adults

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Abstract

Purpose

Determine intra- and inter-examination repeatability of magnitude-based magnetic resonance imaging (MRI-M), complex-based magnetic resonance imaging (MRI-C), and magnetic resonance spectroscopy (MRS) at 3T for estimating hepatic proton density fat fraction (PDFF), and using MRS as a reference, confirm MRI-M and MRI-C accuracy.

Methods

Twenty-nine overweight and obese pediatric (n = 20) and adult (n = 9) subjects (23 male, 6 female) underwent three same-day 3T MR examinations. In each examination MRI-M, MRI-C, and single-voxel MRS were acquired three times. For each MRI acquisition, hepatic PDFF was estimated at the MRS voxel location. Intra- and inter-examination repeatability were assessed by computing standard deviations (SDs) and intra-class correlation coefficients (ICCs). Aggregate SD was computed for each method as the square root of the average of first repeat variances. MRI-M and MRI-C PDFF estimation accuracy was assessed using linear regression with MRS as a reference.

Results

For MRI-M, MRI-C, and MRS acquisitions, respectively, mean intra-examination SDs were 0.25%, 0.42%, and 0.49%; mean intra-examination ICCs were 0.999, 0.997, and 0.995; mean inter-examination SDs were 0.42%, 0.45%, and 0.46%; and inter-examination ICCs were 0.995, 0.992, and 0.990. Aggregate SD for each method was <0.9%. Using MRS as a reference, regression slope, intercept, average bias, and R 2, respectively, for MRI-M were 0.99%, 1.73%, 1.61%, and 0.986, and for MRI-C were 0.96%, 0.43%, 0.40%, and 0.991.

Conclusion

MRI-M, MRI-C, and MRS showed high intra- and inter-examination hepatic PDFF estimation repeatability in overweight and obese subjects. Longitudinal hepatic PDFF change >1.8% (twice the maximum aggregate SD) may represent real change rather than measurement imprecision. Further research is needed to assess whether examinations performed on different days or with different MR technologists affect repeatability of MRS voxel placement and MRS-based PDFF measurements.

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Acknowledgments

Contract grant sponsor: National Institutes of Health; Contract grant numbers: NIDDK R01 DK075128, NIDDK R01 DK088925, NCMHD EXPORT P60 MD00220, NIH T32 EB005970, UL1TR000100.

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Authors and Affiliations

  1. Liver Imaging Group, MR3T Bydder Laboratory, Department of Radiology, University of California at San Diego, 408 Dickinson Street MC 8226, San Diego, CA, 92103-8226, USA

    Avishkar Tyagi, Omid Yeganeh, Yakir Levin, Jonathan C. Hooker, Gavin C. Hamilton, Amir K. Zand, Elhamy Heba, Jeffrey Schwimmer, Michael S. Middleton & Claude B. Sirlin

  2. Computational and Applied Statistics Laboratory (CASL), SDSC - University of California, San Diego, La Jolla, CA, USA

    Tanya Wolfson & Anthony Gamst

  3. Division of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, CA, USA

    Rohit Loomba

  4. Division of Epidemiology, Department of Family Medicine and Preventive Medicine, University of California at San Diego, La Jolla, CA, USA

    Rohit Loomba

  5. Division of Pediatric Gastroenterology, Department of Pediatrics, Hepatology, and Nutrition, University of California at San Diego, San Diego, CA, USA

    Jeffrey Schwimmer

  6. Department of Gastroenterology, Rady Children’s Hospital, San Diego, CA, USA

    Jeffrey Schwimmer

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  1. Avishkar Tyagi
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Correspondence to Avishkar Tyagi.

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Tyagi, A., Yeganeh, O., Levin, Y. et al. Intra- and inter-examination repeatability of magnetic resonance spectroscopy, magnitude-based MRI, and complex-based MRI for estimation of hepatic proton density fat fraction in overweight and obese children and adults. Abdom Imaging 40, 3070–3077 (2015). https://doi.org/10.1007/s00261-015-0542-5

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  • DOI: https://doi.org/10.1007/s00261-015-0542-5

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