Assessment of agreement between manual and automated processing of liver MR elastography for shear stiffness estimation in children and young adults with autoimmune liver disease

Assessment of agreement between manual and automated processing of liver MR elastography for shear stiffness estimation in children and young adults with autoimmune liver disease

Purpose To compare automated versus standard of care manual processing of 2D gradient recalled echo (GRE) liver MR Elastography (MRE) in children and young adults. Materials and methods 2D GRE liver MRE data from research liver MRI examinations performed as part of an autoimmune liver disease regist...

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Published in:Abdominal radiology (New York) Vol. 46; no. 8; pp. 3927 - 3934
Main Authors: Gandhi, Deep B., Pednekar, Amol, Braimah, Adebayo B., Dudley, Jonathan, Tkach, Jean A., Trout, Andrew T., Miethke, Alexander G., Franck, Marnix D., Heilman, Jeremiah A., Dzyubak, Bogdan, Lake, David S., Dillman, Jonathan R.
Format: Journal Article
Language:English
Published: New York Springer US 01-08-2021
Subjects:
Adolescent
Adult
Child
Echo-Planar Imaging
Elasticity Imaging Techniques
Gastroenterology
Hepatobiliary
Hepatology
Humans
Imaging
Liver - diagnostic imaging
Liver Diseases - diagnostic imaging
Magnetic Resonance Imaging
Male
Medicine
Medicine & Public Health
Radiology
Reproducibility of Results
Retrospective Studies
Young Adult
Shear stiffness
Magnetic resonance elastography (MRE)
Automated region of interest
Pediatric
Liver
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Summary:Purpose To compare automated versus standard of care manual processing of 2D gradient recalled echo (GRE) liver MR Elastography (MRE) in children and young adults. Materials and methods 2D GRE liver MRE data from research liver MRI examinations performed as part of an autoimmune liver disease registry between March 2017 and March 2020 were analyzed retrospectively. All liver MRE data were acquired at 1.5 T with 60 Hz mechanical vibration frequency. For manual processing, two independent readers (R1, R2) traced regions of interest on scanner generated shear stiffness maps. Automated processing was performed using MREplus+ (Resoundant Inc.) using 90% (A90) and 95% (A95) confidence masks. Agreement was evaluated using intra-class correlation coefficients (ICC) and Bland–Altman analyses. Classification performance was evaluated using receiver operating characteristic curve (ROC) analyses. Results In 65 patients with mean age of 15.5 ± 3.8 years (range 8–23 years; 35 males) median liver shear stiffness was 2.99 kPa (mean 3.55 ± 1.69 kPa). Inter-reader agreement for manual processing was very strong (ICC = 0.99, mean bias = 0.01 kPa [95% limits of agreement (LoA): − 0.41 to 0.44 kPa]). Correlation between manual and A95 automated processing was very strong (R1: ICC = 0.988, mean bias = 0.13 kPa [95% LoA: − 0.40 to 0.68 kPa]; R2: ICC = 0.987, mean bias = 0.13 kPa [95% LoA: − 0.44 to 0.69 kPa]). Automated measurements were perfectly replicable (ICC = 1.0; mean bias = 0 kPa). Conclusion Liver shear stiffness values obtained using automated processing showed excellent agreement with manual processing. Automated processing of liver MRE was perfectly replicable.
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ISSN:2366-004X
2366-0058
DOI:10.1007/s00261-021-03073-0