Inter‐ and intra‐rater reproducibility of quantitative dynamic contrast enhanced MRI using TWIST perfusion data in a uterine fibroid model. Issue 2 (12th December 2012)

• Record Type: Journal Article
• Authors: Davenport, Matthew S.; Heye, Tobias; Dale, Brian M.; Horvath, Jeffrey J.; Breault, Steven R.; Feuerlein, Sebastian; Bashir, Mustafa R.; Boll, Daniel T.; Merkle, Elmar M.
• Is Part Of: Journal of magnetic resonance imaging. Volume 38:Issue 2(2013)
• Page Start: 329
• Page End: 335
• Publication Date: 2012-12-12
• Subjects: Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.23974
• Languages: English
• ISSNs: 1053-1807

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jmri23974-sec-0001" sec-type="section"> <title>Purpose</title> <p>To determine the reproducibility of TWIST‐derived (Time‐Resolved Angiography with Interleaved Stochastic Trajectories) quantitative dynamic contrast enhanced (DCE) MRI in a uterine fibroid model.</p> </sec> <sec id="jmri23974-sec-0002" sec-type="section"> <title>Materials and Methods</title> <p>The institutional review board approved this retrospective study. Dynamic contrast‐enhanced TWIST datasets from 15 randomly selected 1.5 Tesla pelvic MR studies were postprocessed. Five readers recorded kinetic parameters (K<sup>trans</sup> [volume transfer constant], v<sub>e</sub> [extracellular extravascular space volume], k<sub>ep</sub> [flux rate constant], iAUC [initial area under the gadolinium‐time curve]) of the largest uterine fibroid using three region‐of‐interest (ROI) selection methods. Measurements were randomized and repeated three times, and measures of reproducibility were calculated.</p> </sec> <sec id="jmri23974-sec-0003" sec-type="section"> <title>Results</title> <p>The intra‐rater coefficients of variation (CVs, brackets indicate 95% confidence intervals) varied from 4.6% to 7.6% (K<sup>trans</sup> 7.6% [6.1%, 9.1%], k<sub>ep</sub> 7.2% [5.9%, 8.5%], v<sub>e</sub> 4.6% [3.8%, 5.4%], and iAUC 7.2% [6.1%, 8.3%]). v<sub>e</sub> was the most reproducible (<italic>P</italic> < 0.05). Inter‐rater reproducibility was significantly (<italic>P</italic> < 0.05) greater for the large ROI method (range of intraclass correlation coefficients [ICCs] = 0.80–0.98 versus 0.48–0.63 [user‐defined ROI] versus 0.41–0.69 [targeted ROI]). The uterine fibroid accounted for the greatest fraction of variance for the large ROI method (range across kinetic parameters: 83–98% versus 56–69% [user‐defined ROI] versus 47–74% [targeted ROI]). The reader accounted for the greatest fraction of variance for the user‐defined ROI method (0.4–14.1% versus 0.1–3.0% [large ROI] versus <0.1–1.5% [targeted ROI]).</p> </sec> <sec id="jmri23974-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Changes in TWIST‐derived DCE‐MRI kinetic parameters of up to 9–15% may be attributable to measurement error. Large DCE‐MRI regions of interest are the most reproducible across multiple readers. J. Magn. Reson. Imaging 2013;38:329–335. © 2012 Wiley Periodicals, Inc.</p> </sec> </abstract>