Short- and midterm repeatability of magnetic resonance elastography in healthy volunteers at 3.0 T.

The purpose of this study was to evaluate the short- and midterm repeatability of liver stiffness measurements with magnetic resonance elastography (MRE) in healthy subjects at 3.0T. Twenty-two healthy volunteers were enrolled in this prospective study. The stiffness measurements were obtained from three slices with three repeated acquisitions for each slice (session 1) by two independent raters. After a mean period of 7±2days (session 2) and 195±15days (session 3), each subject was scanned again using the same protocol and MR system. The liver stiffness differences were calculated between sessions or raters. The intraclass correlation coefficient (ICC) was calculated to assess interrater agreement and intersession agreement. The stiffness differences over the short- and midterm intervals was (-0.004±0.086) kPa for sessions 1-2, lower than (-0.055±0.150) kPa for sessions 1-3 and (-0.051±0.173) kPa for sessions 2-3. The liver stiffness was more repeatable for the short-term interval with the mean overall ICC of 0.96 (sessions 1-2) (95% confidence interval [CI]: 0.90-0.98) compared with 0.91 (sessions 1-3) (95% CI: 0.78-0.96) and 0.87 (sessions 2-3) (95% CI: 0.69-0.95) for the midterm intervals. The overall ICC of interrater agreement was excellent at 0.987 (95% CI: 0.983 to 0.990). These results confirm that MRE is a reproducible technique for liver stiffness quantification over short- and midterm intervals up to 6months in a healthy population at 3.0T.

[1]  E. Schiff,et al.  Long‐term entecavir therapy results in the reversal of fibrosis/cirrhosis and continued histological improvement in patients with chronic hepatitis B , 2010, Hepatology.

[2]  Scott B Reeder,et al.  Repeatability of magnetic resonance elastography for quantification of hepatic stiffness , 2010, Journal of magnetic resonance imaging : JMRI.

[3]  H. El‐Serag,et al.  Epidemiology of viral hepatitis and hepatocellular carcinoma. , 2012, Gastroenterology.

[4]  M. Manns,et al.  Food intake increases liver stiffness in patients with chronic or resolved hepatitis C virus infection , 2009, Liver international : official journal of the International Association for the Study of the Liver.

[5]  M. Lindstrom,et al.  Effects of postprandial state and mesenteric blood flow on the repeatability of MR elastography in asymptomatic subjects , 2011, Journal of magnetic resonance imaging : JMRI.

[6]  R. Chung,et al.  Monitoring during and after antiviral therapy for hepatitis B , 2009, Hepatology.

[7]  R. Ehman,et al.  Assessment of chronic hepatitis and fibrosis: comparison of MR elastography and diffusion-weighted imaging. , 2011, AJR. American journal of roentgenology.

[8]  R. Ehman,et al.  Effects of gadoxetic acid on liver elasticity measurement by using magnetic resonance elastography. , 2012, Magnetic resonance imaging.

[9]  Armando Manduca,et al.  Feasibility of in vivo MR elastographic splenic stiffness measurements in the assessment of portal hypertension. , 2009, AJR. American journal of roentgenology.

[10]  A. Manduca,et al.  Dynamic postprandial hepatic stiffness augmentation assessed with MR elastography in patients with chronic liver disease. , 2011, AJR. American journal of roentgenology.

[11]  Sabrina Fox‐Bosetti,et al.  Test–retest repeatability of MR elastography for noninvasive liver fibrosis assessment in hepatitis C , 2011, Journal of magnetic resonance imaging : JMRI.

[12]  F. Gallagher,et al.  MR elastography: Spleen stiffness measurements in healthy volunteers--preliminary experience. , 2010, AJR. American journal of roentgenology.

[13]  A. Manduca,et al.  Assessment of hepatic fibrosis with magnetic resonance elastography. , 2007, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[14]  Armando Manduca,et al.  Automated liver stiffness measurements with magnetic resonance elastography , 2013, Journal of magnetic resonance imaging : JMRI.

[15]  E. Merkle,et al.  Short- and midterm reproducibility of apparent diffusion coefficient measurements at 3.0-T diffusion-weighted imaging of the abdomen. , 2009, Radiology.

[16]  H. Schoemaker,et al.  Assessment of changes in liver blood flow after food intake--comparison of ICG clearance and echo-Doppler. , 1996, British journal of clinical pharmacology.

[17]  D. Garway-Heath,et al.  Factors affecting the test-retest variability of Heidelberg retina tomograph and Heidelberg retina tomograph II measurements , 2005, British Journal of Ophthalmology.

[18]  Y. Ben-Shlomo,et al.  Validity of patient-derived disability and clinical data in multiple sclerosis , 2010, Multiple sclerosis.

[19]  Richard L Ehman,et al.  Diffraction-biased shear wave fields generated with longitudinal magnetic resonance elastography drivers. , 2008, Magnetic resonance imaging.

[20]  C. Thio Diagnosis, Diagnostic Tests and Monitoring of Hepatitis B Virus in Monoinfected and HIV-Coinfected Patients , 2006, Antiviral therapy.

[21]  Hui Zhu,et al.  Performance of magnetic resonance elastography and diffusion‐weighted imaging for the staging of hepatic fibrosis: A meta‐analysis , 2012, Hepatology.

[22]  Ellen R. Girden,et al.  ANOVA: Repeated Measures , 1991 .

[23]  M. Meyer,et al.  Hepatic vascular flow measurements by phase contrast MRI and doppler echography: A comparative and reproducibility study , 2010, Journal of magnetic resonance imaging : JMRI.

[24]  G. Casola,et al.  MR imaging of liver fibrosis: current state of the art. , 2009, Radiographics : a review publication of the Radiological Society of North America, Inc.

[25]  I Joubert,et al.  Magnetic resonance elastography: feasibility of liver stiffness measurements in healthy volunteers at 3T. , 2012, Clinical radiology.

[26]  Laurent Castera,et al.  Noninvasive methods to assess liver disease in patients with hepatitis B or C. , 2012, Gastroenterology.

[27]  L. S. Schultze Kool,et al.  Variability of splanchnic blood flow measurements using MR velocity mapping under fasting and post-prandial conditions--comparison with echo-Doppler. , 1997, Journal of hepatology.

[28]  Eugene R. Schiff,et al.  Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection , 2002, American Journal of Gastroenterology.

[29]  Anne-Claire Vergnaud,et al.  Liver stiffness values in apparently healthy subjects: influence of gender and metabolic syndrome. , 2008, Journal of hepatology.

[30]  J. Fleiss The design and analysis of clinical experiments , 1987 .