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Inter-reader reliability of functional liver imaging score derived from gadoxetic acid-enhanced MRI: a meta-analysis

  • Hepatobiliary
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Abstract

Purpose

This study aimed to systematically determine the inter-reader reliability of the functional liver imaging score (FLIS) and explore the factors affecting it.

Methods

Original articles reporting the inter-reader reliability of FLIS derived from gadoxetic acid-enhanced magnetic resonance imaging (MRI) were systematically searched in the MEDLINE and EMBASE databases from January 2013 to June 2022. Data synthesis was performed to calculate the meta-analytic pooled estimates of the FLIS and its three subcategories, including enhancement quality score (EnQS), excretion quality score (ExQS), and portal vein sign quality score (PVsQS) using the DerSimonian-Laird random-effects model. To explore any cause of study heterogeneity, we conducted a meta-regression analysis.

Results

Six studies with data from 1419 patients were included. The meta-analytic pooled inter-reader reliability of FLIS was 0.93 (95% confidence interval [CI], 0.88–0.98). That of the three FLIS subcategories were 0.93 (95% CI, 0.85–1.00), 0.95 (95% CI, 0.91–1.00), and 0.90 (95% CI, 0.81–0.99) for EnQS, ExQS, and PVsQS, respectively. The pooled FLIS data was moderately heterogenous, but heterogeneity was not associated with the study methodology, MRI-related factors, and reader experience.

Conclusion

The FLIS and its three subcategories showed almost perfect inter-reader reliability. Therefore, FLIS may be a reliable imaging parameter that reflects liver function and outcomes in patients with chronic liver disease. Further studies should be conducted to confirm any factors affecting the inter-reader reliability of FLIS.

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Abbreviations

MRI:

Magnetic resonance imaging

FLIS:

Functional liver imaging score

EnQS:

Enhancement quality score

ExQS:

Excretion quality score

PVsQS:

Portal vein sign quality score

ICC:

Intraclass correlation coefficient

κ :

Kappa value

CI:

Confidence interval

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Funding

This work was supported by a research fund from Hanyang University (HY-202200000001418).

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea

    Nam Hee Kim

  2. Department of Radiology, Hanyang University College of Medicine, Hanyang University Guri Hospital, 153 Gyeongchun-Ro, Guri-Si, 11923, Gyeonggi-Do, Korea

    Ji Hun Kang

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  1. Nam Hee Kim
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Correspondence to Ji Hun Kang.

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Kim, N.H., Kang, J.H. Inter-reader reliability of functional liver imaging score derived from gadoxetic acid-enhanced MRI: a meta-analysis. Abdom Radiol 48, 886–894 (2023). https://doi.org/10.1007/s00261-022-03785-x

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