Abstract
Rationale and Objective: Primary sclerosing cholangitis, a chronic liver disease causes heterogeneous parenchymal changes and fibrosis. Liver stiffness measurement (LSM) with magnetic resonance Elastography (MRE) may be affected by this heterogeneous distribution. We evaluated interobserver agreement of LSM in primary sclerosing cholangitis (PSC) with manual and automated methods to study the influence of heterogeneous changes. Materials and Methods: A total of 79 consecutive patients with PSC who had a liver MRI and MRE formed the study group. Three readers with 1–3 years’ experience in MRE and a MRE expert (11 years’ experience) independently performed LSM. Each reader manually drew free hand (fROI) and average (aROI) on stiffness maps. Automatic liver elasticity calculation (ALEC) was used to generate automated LSM. The expert fROI was the reference standard. Correlation analysis and absolute intra-class correlation coefficient (ICC) analysis was performed. Results: LSM data of 79 livers and 315 sections were evaluated. There was excellent ICC between expert and reader fROIs (0.989, 95% confidence interval, and 0.985–0.993) and aROIs (0.971, 95% confidence interval, and 0.953–0.983) and ALEC (0.972, 0.957–0.982) with fROI performing better. The areas measured with fROIs and ALEC had moderate ICC with Expert fROI (0.64 and 0.56, respectively) whereas aROI area had a poor ICC of 0.12. Comparison of multiple methods showed significant differences in LSM between expert fROI and aROI of two readers and no significant differences for fROIs of all three readers. Conclusion: LSM with MRE in PSC patients shows excellent interobserver agreement with both fROI and aROI methods with better performance with fROI. fROI may therefore be preferred for LSM measurements in PSC.
| Original language | English (US) |
|---|---|
| Journal | Academic radiology |
| DOIs | |
| State | Published - Jan 1 2019 |
| Externally published | Yes |
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Keywords
- Interobserver agreement
- Liver stiffness
- Magnetic resonance elastography
- Primary sclerosing cholangitis
- Reproducibility
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
Cite this
Magnetic Resonance Elastography in Primary Sclerosing Cholangitis : Interobserver Agreement for Liver Stiffness Measurement with Manual and Automated Methods. / Hoodeshenas, Safa; Welle, Christopher L.; Navin, Patrick J.; Dzyubak, Bogdan; Eaton, John E.; Ehman, Richard Lorne; Venkatesh, Sudhakar K.
In: Academic radiology, 01.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Magnetic Resonance Elastography in Primary Sclerosing Cholangitis
T2 - Interobserver Agreement for Liver Stiffness Measurement with Manual and Automated Methods
AU - Hoodeshenas, Safa
AU - Welle, Christopher L.
AU - Navin, Patrick J.
AU - Dzyubak, Bogdan
AU - Eaton, John E.
AU - Ehman, Richard Lorne
AU - Venkatesh, Sudhakar K
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Rationale and Objective: Primary sclerosing cholangitis, a chronic liver disease causes heterogeneous parenchymal changes and fibrosis. Liver stiffness measurement (LSM) with magnetic resonance Elastography (MRE) may be affected by this heterogeneous distribution. We evaluated interobserver agreement of LSM in primary sclerosing cholangitis (PSC) with manual and automated methods to study the influence of heterogeneous changes. Materials and Methods: A total of 79 consecutive patients with PSC who had a liver MRI and MRE formed the study group. Three readers with 1–3 years’ experience in MRE and a MRE expert (11 years’ experience) independently performed LSM. Each reader manually drew free hand (fROI) and average (aROI) on stiffness maps. Automatic liver elasticity calculation (ALEC) was used to generate automated LSM. The expert fROI was the reference standard. Correlation analysis and absolute intra-class correlation coefficient (ICC) analysis was performed. Results: LSM data of 79 livers and 315 sections were evaluated. There was excellent ICC between expert and reader fROIs (0.989, 95% confidence interval, and 0.985–0.993) and aROIs (0.971, 95% confidence interval, and 0.953–0.983) and ALEC (0.972, 0.957–0.982) with fROI performing better. The areas measured with fROIs and ALEC had moderate ICC with Expert fROI (0.64 and 0.56, respectively) whereas aROI area had a poor ICC of 0.12. Comparison of multiple methods showed significant differences in LSM between expert fROI and aROI of two readers and no significant differences for fROIs of all three readers. Conclusion: LSM with MRE in PSC patients shows excellent interobserver agreement with both fROI and aROI methods with better performance with fROI. fROI may therefore be preferred for LSM measurements in PSC.
AB - Rationale and Objective: Primary sclerosing cholangitis, a chronic liver disease causes heterogeneous parenchymal changes and fibrosis. Liver stiffness measurement (LSM) with magnetic resonance Elastography (MRE) may be affected by this heterogeneous distribution. We evaluated interobserver agreement of LSM in primary sclerosing cholangitis (PSC) with manual and automated methods to study the influence of heterogeneous changes. Materials and Methods: A total of 79 consecutive patients with PSC who had a liver MRI and MRE formed the study group. Three readers with 1–3 years’ experience in MRE and a MRE expert (11 years’ experience) independently performed LSM. Each reader manually drew free hand (fROI) and average (aROI) on stiffness maps. Automatic liver elasticity calculation (ALEC) was used to generate automated LSM. The expert fROI was the reference standard. Correlation analysis and absolute intra-class correlation coefficient (ICC) analysis was performed. Results: LSM data of 79 livers and 315 sections were evaluated. There was excellent ICC between expert and reader fROIs (0.989, 95% confidence interval, and 0.985–0.993) and aROIs (0.971, 95% confidence interval, and 0.953–0.983) and ALEC (0.972, 0.957–0.982) with fROI performing better. The areas measured with fROIs and ALEC had moderate ICC with Expert fROI (0.64 and 0.56, respectively) whereas aROI area had a poor ICC of 0.12. Comparison of multiple methods showed significant differences in LSM between expert fROI and aROI of two readers and no significant differences for fROIs of all three readers. Conclusion: LSM with MRE in PSC patients shows excellent interobserver agreement with both fROI and aROI methods with better performance with fROI. fROI may therefore be preferred for LSM measurements in PSC.
KW - Interobserver agreement
KW - Liver stiffness
KW - Magnetic resonance elastography
KW - Primary sclerosing cholangitis
KW - Reproducibility
UR - http://www.scopus.com/inward/record.url?scp=85062694089&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062694089&partnerID=8YFLogxK
U2 - 10.1016/j.acra.2019.02.004
DO - 10.1016/j.acra.2019.02.004
M3 - Article
AN - SCOPUS:85062694089
JO - Academic Radiology
JF - Academic Radiology
SN - 1076-6332
ER -