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Inter‐ and intra‐rater reproducibility of quantitative dynamic contrast enhanced MRI using TWIST perfusion data in a uterine fibroid model
Author(s) -
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.
Publication year - 2013
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.23974
Subject(s) - reproducibility , intraclass correlation , nuclear medicine , region of interest , medicine , dynamic contrast enhanced mri , magnetic resonance imaging , uterine fibroids , mathematics , radiology , statistics , surgery
Purpose 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. Materials and Methods 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 trans [volume transfer constant], v e [extracellular extravascular space volume], k ep [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. Results The intra‐rater coefficients of variation (CVs, brackets indicate 95% confidence intervals) varied from 4.6% to 7.6% (K trans 7.6% [6.1%, 9.1%], k ep 7.2% [5.9%, 8.5%], v e 4.6% [3.8%, 5.4%], and iAUC 7.2% [6.1%, 8.3%]). v e was the most reproducible ( P < 0.05). Inter‐rater reproducibility was significantly ( P < 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]). Conclusion 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.