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Repeatability, reproducibility, and accuracy of quantitative mri of the breast in the community radiology setting.

ABSTRACT: Quantitative diffusion-weighted MRI (DW-MRI) and dynamic contrast-enhanced MRI (DCE-MRI) have the potential to impact patient care by providing noninvasive biological information in breast cancer. To quantify the repeatability, reproducibility, and accuracy of apparent diffusion coefficient (ADC) and T1 -mapping of the breast in community radiology practices. Prospective. Ice-water DW-MRI and T1 gel phantoms were used to assess accuracy. Normal subjects (n = 3) and phantoms across three sites (one academic, two community) were used to assess reproducibility. Test-retest analysis at one site in normal subjects (n = 12) was used to assess repeatability. 3T Siemens Skyra MRI quantitative DW-MRI and T1 -mapping. Quantitative DW-MRI and T1 -mapping parametric maps of phantoms and fibroglandular and adipose tissue of the breast. Average values of breast tissue were quantified and Bland-Altman analysis was performed to assess the repeatability of the MRI techniques, while the Friedman test assessed reproducibility. ADC measurements were reproducible across sites, with an average difference of 1.6% in an ice-water phantom and 7.0% in breast fibroglandular tissue. T1 measurements in gel phantoms had an average difference of 2.8% across three sites, whereas breast fibroglandular and adipose tissue had 8.4% and 7.5% average differences, respectively. In the repeatability study, we found no bias between first and second scanning sessions (P = 0.1). The difference between repeated measurements was independent of the mean for each MRI metric (P = 0.156, P = 0.862, P = 0.197 for ADC, T1 of fibroglandular tissue, and T1 of adipose tissue, respectively). Community radiology practices can perform repeatable, reproducible, and accurate quantitative T1 -mapping and DW-MRI. This has the potential to dramatically expand the number of sites that can participate in multisite clinical trials and increase clinical translation of quantitative MRI techniques for cancer response assessment. 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.

SUBMITTER: Sorace AG

PROVIDER: S-EPMC6151298 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Repeatability, reproducibility, and accuracy of quantitative mri of the breast in the community radiology setting.

Sorace Anna G AG Wu Chengyue C Barnes Stephanie L SL Jarrett Angela M AM Avery Sarah S Patt Debra D Goodgame Boone B Luci Jeffery J JJ Kang Hakmook H Abramson Richard G RG Yankeelov Thomas E TE Virostko John J

Journal of magnetic resonance imaging : JMRI 20180323

<h4>Background</h4>Quantitative diffusion-weighted MRI (DW-MRI) and dynamic contrast-enhanced MRI (DCE-MRI) have the potential to impact patient care by providing noninvasive biological information in breast cancer.<h4>Purpose/hypothesis</h4>To quantify the repeatability, reproducibility, and accuracy of apparent diffusion coefficient (ADC) and T<sub>1</sub> -mapping of the breast in community radiology practices.<h4>Study type</h4>Prospective.<h4>Subjects/phantom</h4>Ice-water DW-MRI and T<sub> ...[more]

PMID: 29570895

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Project description:BackgroundMagnetic resonance cholangiopancreatography (MRCP) is an important tool for noninvasive imaging of biliary disease, however, its assessment is currently subjective, resulting in the need for objective biomarkers.PurposeTo investigate the accuracy, scan/rescan repeatability, and cross-scanner reproducibility of a novel quantitative MRCP tool on phantoms and in vivo. Additionally, to report normative ranges derived from the healthy cohort for duct measurements and tree-level summary metrics.Study typeProspective.Phantoms/subjectsPhantoms: two bespoke designs, one with varying tube-width, curvature, and orientation, and one exhibiting a complex structure based on a real biliary tree. Subjects Twenty healthy volunteers, 10 patients with biliary disease, and 10 with nonbiliary liver disease.Sequence/field strengthMRCP data were acquired using heavily T2 -weighted 3D multishot fast/turbo spin echo acquisitions at 1.5T and 3T.AssessmentDigital instances of the phantoms were synthesized with varying resolution and signal-to-noise ratio. Physical 3D-printed phantoms were scanned across six scanners (two field strengths for each of three manufacturers). Human subjects were imaged on four scanners (two fieldstrengths for each of two manufacturers).Statistical testsBland-Altman analysis and repeatability coefficient (RC).ResultsAccuracy of the diameter measurement approximated the scanning resolution, with 95% limits of agreement (LoA) from -1.1 to 1.0 mm. Excellent phantom repeatability was observed, with LoA from -0.4 to 0.4 mm. Good reproducibility was observed across the six scanners for both phantoms, with a range of LoA from -1.1 to 0.5 mm. Inter- and intraobserver agreement was high. Quantitative MRCP detected strictures and dilatations in the phantom with 76.6% and 85.9% sensitivity and 100% specificity in both. Patients and healthy volunteers exhibited significant differences in metrics including common bile duct (CBD) maximum diameter (7.6 mm vs. 5.2 mm P = 0.002), and overall biliary tree volume 12.36 mL vs. 4.61 mL, P = 0.0026).Data conclusionThe results indicate that quantitative MRCP provides accurate, repeatable, and reproducible measurements capable of objectively assessing cholangiopathic change. Evidence Level: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;52:807-820.

Project description:BackgroundThe introduction of novel short course treatment regimens for the radical cure of Plasmodium vivax requires reliable point-of-care diagnosis that can identify glucose-6-phosphate dehydrogenase (G6PD) deficient individuals. While deficient males can be identified using a qualitative diagnostic test, the genetic make-up of females requires a quantitative measurement. SD Biosensor (Republic of Korea) has developed a handheld quantitative G6PD diagnostic (STANDARD G6PD test), that has approximately 90% accuracy in field studies for identifying individuals with intermediate or severe deficiency. The device can only be considered for routine care if precision of the assay is high.Methods and findingsCommercial lyophilised controls (ACS Analytics, USA) with high, intermediate, and low G6PD activities were assessed 20 times on 10 Biosensor devices and compared to spectrophotometry (Pointe Scientific, USA). Each device was then dispatched to one of 10 different laboratories with a standard set of the controls. Each control was tested 40 times at each laboratory by a single user and compared to spectrophotometry results. When tested at one site, the mean coefficient of variation (CV) was 0.111, 0.172 and 0.260 for high, intermediate, and low controls across all devices respectively; combined G6PD Biosensor readings correlated well with spectrophotometry (rs = 0.859, p<0.001). When tested in different laboratories, correlation was lower (rs = 0.604, p<0.001) and G6PD activity determined by Biosensor for the low and intermediate controls overlapped. The use of lyophilised human blood samples rather than fresh blood may have affected these findings. Biosensor G6PD readings between sites did not differ significantly (p = 0.436), whereas spectrophotometry readings differed markedly between sites (p<0.001).ConclusionsRepeatability and inter-laboratory reproducibility of the Biosensor were good; though the device did not reliably discriminate between intermediate and low G6PD activities of the lyophilized specimens. Clinical studies are now required to assess the devices performance in practice.

Project description:PurposeTo determine the in vitro accuracy, test-retest repeatability, and interplatform reproducibility of T1 quantification protocols used for dynamic contrast-enhanced MRI at 1.5 and 3 T.MethodsA T1 phantom with 14 samples was imaged at eight centers with a common inversion-recovery spin-echo (IR-SE) protocol and a variable flip angle (VFA) protocol using seven flip angles, as well as site-specific protocols (VFA with different flip angles, variable repetition time, proton density, and Look-Locker inversion recovery). Factors influencing the accuracy (deviation from reference NMR T1 measurements) and repeatability were assessed using general linear mixed models. Interplatform reproducibility was assessed using coefficients of variation.ResultsFor the common IR-SE protocol, accuracy (median error across platforms = 1.4-5.5%) was influenced predominantly by T1 sample (P < 10-6 ), whereas test-retest repeatability (median error = 0.2-8.3%) was influenced by the scanner (P < 10-6 ). For the common VFA protocol, accuracy (median error = 5.7-32.2%) was influenced by field strength (P = 0.006), whereas repeatability (median error = 0.7-25.8%) was influenced by the scanner (P < 0.0001). Interplatform reproducibility with the common VFA was lower at 3 T than 1.5 T (P = 0.004), and lower than that of the common IR-SE protocol (coefficient of variation 1.5T: VFA/IR-SE = 11.13%/8.21%, P = 0.028; 3 T: VFA/IR-SE = 22.87%/5.46%, P = 0.001). Among the site-specific protocols, Look-Locker inversion recovery and VFA (2-3 flip angles) protocols showed the best accuracy and repeatability (errors < 15%).ConclusionsThe VFA protocols with 2 to 3 flip angles optimized for different applications achieved acceptable balance of extensive spatial coverage, accuracy, and repeatability in T1 quantification (errors < 15%). Further optimization in terms of flip-angle choice for each tissue application, and the use of B1 correction, are needed to improve the robustness of VFA protocols for T1 mapping. Magn Reson Med 79:2564-2575, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Project description:BackgroundThe purpose of this study was to determine whether advanced quantitative magnetic resonance imaging (MRI) can be deployed outside of large, research-oriented academic hospitals and into community care settings to predict eventual pathological complete response (pCR) to neoadjuvant therapy (NAT) in patients with locally advanced breast cancer.MethodsPatients with stage II/III breast cancer (N = 28) were enrolled in a multicenter study performed in community radiology settings. Dynamic contrast-enhanced (DCE) and diffusion-weighted (DW)-MRI data were acquired at four time points during the course of NAT. Estimates of the vascular perfusion and permeability, as assessed by the volume transfer rate (Ktrans) using the Patlak model, were generated from the DCE-MRI data while estimates of cell density, as assessed by the apparent diffusion coefficient (ADC), were calculated from DW-MRI data. Tumor volume was calculated using semi-automatic segmentation and combined with Ktrans and ADC to yield bulk tumor blood flow and cellularity, respectively. The percent change in quantitative parameters at each MRI scan was calculated and compared to pathological response at the time of surgery. The predictive accuracy of each MRI parameter at different time points was quantified using receiver operating characteristic curves.ResultsTumor size and quantitative MRI parameters were similar at baseline between groups that achieved pCR (n = 8) and those that did not (n = 20). Patients achieving a pCR had a larger decline in volume and cellularity than those who did not achieve pCR after one cycle of NAT (p < 0.05). At the third and fourth MRI, changes in tumor volume, Ktrans, ADC, cellularity, and bulk tumor flow from baseline (pre-treatment) were all significantly greater (p < 0.05) in the cohort who achieved pCR compared to those patients with non-pCR.ConclusionsQuantitative analysis of DCE-MRI and DW-MRI can be implemented in the community care setting to accurately predict the response of breast cancer to NAT. Dissemination of quantitative MRI into the community setting allows for the incorporation of these parameters into the standard of care and increases the number of clinical community sites able to participate in novel drug trials that require quantitative MRI.

Project description:PurposeTo compare the bias and inherent reliability of the quantitative (T1 and T2 ) imaging metrics generated from the magnetic resonance fingerprinting (MRF) technique using the ISMRM/NIST system phantom in an international multicenter setting.MethodISMRM/NIST MRI system phantom provides standard reference T1 and T2 relaxation values (vendor-provided) for each of the 14 vials in T1 and T2 arrays. MRF-SSFP scans repeated over 30 days on GE 1.5 and 3.0 T scanners at three collaborative centers. MRF estimated T1, and T2 values averaged over 30 days were compared with the phantom vendor-provided and spin-echo (SE) based convention gold standard (GS) method. Repeatability and reproducibility were characterized by the within-case coefficient of variation (wCV) of the MRF data acquired over 30 days, along with the biases.ResultFor the wide ranges of MRF estimated T1 values, vials #1-8 (T1 relaxation time between 2033 and 184 ms) exhibited a wCV less than 3% and 4%, respectively, on 3.0 and 1.5 T scanners. T2 values in vials #1-8 (T2 relaxation, 1044-45 ms) have shown wCV to be <7% on both 3.0 and 1.5 T scanners. A stronger linear correlation overall for T1 (R2 = 0.9960 and 0.9963 at center-1 and center-2 on 3.0 T scanner, and R2 = 0.9951 and 0.9988 at center-1 and center-3 on 1.5 T scanner) compared to T2 (R2 = 0.9971 and 0.9972 at center-1 and center-2 on 3.0 T scanner, and R2 = 0.9815 and 0.9754 at center-1 and center-3 on 1.5 T scanner). Bland-Altman (BA) analysis showed MRF based T1 and T2 values were within the limit of agreement (LOA) except for one data point. The mean difference or bias and 95% lower bound (LB) and upper bound (UB) LOA are reported in the format; mean bias: 95% LB LOA: 95% UB LOA. The biases for T1 values were 21.34: -50.00: 92.69, 21.32: -47.29: 89.94 ms, and for T2 values were -19.88: -42.37: 2.61, -19.06: -43.58: 5.45 ms on 3.0 T scanner at center-1 and center-2, respectively. Similarly, on 1.5 T scanner biases for T1 values were 26.54: -53.41: 106.50, 9.997: -51.94: 71.94 ms, and for T2 values were -23.84: -135.40: 87.76, -37.30: 134.30: 59.73 ms at center-1 and center-3, respectively. Additionally, the correlation between the SE based GS and MRF estimated T1 and T2 values (R2 = 0.9969 and 0.9977) showed a similar trend as we observed between vendor-provided and MRF estimated T1 and T2 values (R2 = 0.9963 and 0.9972). In addition to correlation, BA analysis showed that all the vials are within the LOA between the GS and vendor-provided for the T1 values and except one vial for T2 . All the vials are within the LOA between GS and MRF except one vial in T1 and T2 array. The wCV for reproducibility was <3% for both T1 and T2 values in vials #1-8, for all the 14 vials, wCV calculated for reproducibility was <4% for T1 values and <5% for T2 .ConclusionThis study shows that MRF is highly repeatable (wCV <4% for T1 and <7% for T2 ) and reproducible (wCV < 3% for both T1 and T2 ) in certain vials (vials #1-8).

Project description:IntroductionQuantitative longitudinal magnetic resonance imaging and spectroscopy (MRI/S) is used to assess progress of brain disorders and treatment effects. Understanding the significance of MRI/S changes requires knowledge of the inherent technical and physiological consistency of these measurements. This longitudinal study examined the variance and reproducibility of commonly used quantitative MRI/S measurements in healthy subjects while controlling physiological and technical parameters.MethodsTwenty-five subjects were imaged three times over 5 days on a Siemens 3T Verio scanner equipped with a 32-channel phase array coil. Structural (T1, T2-weighted, and diffusion-weighted imaging) and physiological (pseudocontinuous arterial spin labeling, proton magnetic resonance spectroscopy) data were collected. Consistency of repeated images was evaluated with mean relative difference, mean coefficient of variation, and intraclass correlation (ICC). Finally, a "reproducibility rating" was calculated based on the number of subjects needed for a 3% and 10% difference.ResultsStructural measurements generally demonstrated excellent reproducibility (ICCs 0.872-0.998) with a few exceptions. Moderate-to-low reproducibility was observed for fractional anisotropy measurements in fornix and corticospinal tracts, for cortical gray matter thickness in the entorhinal, insula, and medial orbitofrontal regions, and for the count of the periependymal hyperintensive white matter regions. The reproducibility of physiological measurements ranged from excellent for most of the magnetic resonance spectroscopy measurements to moderate for permeability-diffusivity coefficients in cingulate gray matter to low for regional blood flow in gray and white matter.DiscussionThis study demonstrates a high degree of longitudinal consistency across structural and physiological measurements in healthy subjects, defining the inherent variability in these commonly used sequences. Additionally, this study identifies those areas where caution should be exercised in interpretation. Understanding this variability can serve as the basis for interpretation of MRI/S data in the assessment of neurological disorders and treatment effects.

Dataset Information

Repeatability, reproducibility, and accuracy of quantitative mri of the breast in the community radiology setting.

Publications

Repeatability, reproducibility, and accuracy of quantitative mri of the breast in the community radiology setting.

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