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Repeatability and accuracy of various region-of-interest sampling strategies for hepatic MRI proton density fat fraction quantification

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Abstract

Purpose

To evaluate repeatability of ROI-sampling strategies for quantifying hepatic proton density fat fraction (PDFF) and to assess error relative to the 9-ROI PDFF.

Methods

This was a secondary analysis in subjects with known or suspected nonalcoholic fatty liver disease who underwent MRI for magnitude-based hepatic PDFF quantification. Each subject underwent three exams, each including three acquisitions (nine acquisitions total). An ROI was placed in each hepatic segment on the first acquisition of the first exam and propagated to other acquisitions. PDFF was calculated for each of 511 sampling strategies using every combination of 1, 2, …, all 9 ROIs. Intra- and inter-exam intra-class correlation coefficients (ICCs) and repeatability coefficients (RCs) were estimated for each sampling strategy. Mean absolute error (MAE) was estimated relative to the 9-ROI PDFF. Strategies that sampled both lobes evenly (“balanced”) were compared with those that did not (“unbalanced”) using two-sample t tests.

Results

The 29 enrolled subjects (23 male, mean age 24 years) had mean 9-ROI PDFF 11.8% (1.1–36.3%). With more ROIs, ICCs increased, RCs decreased, and MAE decreased. Of the 60 balanced strategies with 4 ROIs, all (100%) achieved inter- and intra-exam ICCs > 0.998, 55 (92%) achieved intra-exam RC < 1%, 50 (83%) achieved inter-exam RC < 1%, and all (100%) achieved MAE < 1%. Balanced sampling strategies had higher ICCs and lower RCs, and lower MAEs than unbalanced strategies in aggregate (p < 0.001 for comparisons between balanced vs. unbalanced strategies).

Conclusion

Repeatability improves and error diminishes with more ROIs. Balanced 4-ROI strategies provide high repeatability and low error.

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Acknowledgements

The authors would like to acknowledge grant support from the National Institutes of Health T32 EB005970-09 and R01 DK106419-02. We also acknowledge Gilead Sciences and GE Healthcare which provide research support to UCSD.

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Authors and Affiliations

  1. Department of Radiology, University of California San Diego, 200 W. Arbor Drive #8756, San Diego, CA, 92103-8756, USA

    Cheng William Hong, Jennifer Y. Cui, Danielle Batakis, Yang Xu, Alexandra N. Schlein, Lindsey M. Negrete, Michael S. Middleton, Gavin Hamilton & Kathryn J. Fowler

  2. School of Medicine, Wayne State University, Detroit, MI, USA

    Jennifer Y. Cui

  3. Computational and Applied Statistics Laboratory, University of California San Diego, San Diego, CA, USA

    Tanya Wolfson & Anthony C. Gamst

  4. Division of Gastroenterology, Department of Medicine, University of California San Diego, San Diego, USA

    Rohit Loomba

  5. Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA, USA

    Jeffrey B. Schwimmer

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

    Jeffrey B. Schwimmer

  7. Department of Radiology, University of California San Diego, 9500 Gilman Drive #0888, La Jolla, CA, 92093-0888, USA

    Claude B. Sirlin

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  1. Cheng William Hong
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Correspondence to Cheng William Hong or Claude B. Sirlin.

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Hong, C.W., Cui, J.Y., Batakis, D. et al. Repeatability and accuracy of various region-of-interest sampling strategies for hepatic MRI proton density fat fraction quantification. Abdom Radiol 46, 3105–3116 (2021). https://doi.org/10.1007/s00261-021-02965-5

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