Volume 47, Issue 4 pp. 988-994

Original Research

Optimization of region-of-interest sampling strategies for hepatic MRI proton density fat fraction quantification

Cheng William Hong MD, MS,

Cheng William Hong MD, MS

Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, California, USA

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Tanya Wolfson MA,

Tanya Wolfson MA

Computational and Applied Statistics Laboratory, University of California San Diego, San Diego, California, USA

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Ethan Z. Sy BS,

Ethan Z. Sy BS

Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, California, USA

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Alexandra N. Schlein BS,

Alexandra N. Schlein BS

Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, California, USA

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Jonathan C. Hooker BS,

Jonathan C. Hooker BS

Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, California, USA

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Soudabeh Fazeli Dehkordy MD, MPH,

Soudabeh Fazeli Dehkordy MD, MPH

Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, California, USA

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Gavin Hamilton PhD,

Gavin Hamilton PhD

Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, California, USA

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Scott B. Reeder MD, PhD,

Scott B. Reeder MD, PhD

Departments of Radiology, Medical Physics, Biomedical Engineering, Medicine, and Emergency Medicine, University of Wisconsin Madison, Madison, Wisconsin, USA

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Rohit Loomba MD, MHSc,

Rohit Loomba MD, MHSc

NAFLD Research Center, Division of Gastroenterology, Department of Medicine, University of California San Diego, San Diego, California, USA

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Claude B. Sirlin MD,

Corresponding Author

Claude B. Sirlin MD

[email protected]

Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, California, USA

Address reprint requests to: C.B.S., Department of Radiology, University of California, San Diego, Altman Clinical and Translational Research Institute, 9452 Medical Center Dr., La Jolla, CA 92037. E-mail: [email protected]Search for more papers by this author

Cheng William Hong MD, MS,

Cheng William Hong MD, MS

Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, California, USA

Search for more papers by this author

Tanya Wolfson MA,

Tanya Wolfson MA

Computational and Applied Statistics Laboratory, University of California San Diego, San Diego, California, USA

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Ethan Z. Sy BS,

Ethan Z. Sy BS

Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, California, USA

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Alexandra N. Schlein BS,

Alexandra N. Schlein BS

Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, California, USA

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Jonathan C. Hooker BS,

Jonathan C. Hooker BS

Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, California, USA

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Soudabeh Fazeli Dehkordy MD, MPH,

Soudabeh Fazeli Dehkordy MD, MPH

Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, California, USA

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Gavin Hamilton PhD,

Gavin Hamilton PhD

Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, California, USA

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Scott B. Reeder MD, PhD,

Scott B. Reeder MD, PhD

Departments of Radiology, Medical Physics, Biomedical Engineering, Medicine, and Emergency Medicine, University of Wisconsin Madison, Madison, Wisconsin, USA

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Rohit Loomba MD, MHSc,

Rohit Loomba MD, MHSc

NAFLD Research Center, Division of Gastroenterology, Department of Medicine, University of California San Diego, San Diego, California, USA

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Claude B. Sirlin MD,

Corresponding Author

Claude B. Sirlin MD

[email protected]

Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, California, USA

First published: 26 August 2017

https://doi.org/10.1002/jmri.25843

Citations: 26

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Abstract

BACKGROUND

Clinical trials utilizing proton density fat fraction (PDFF) as an imaging biomarker for hepatic steatosis have used a laborious region-of-interest (ROI) sampling strategy of placing an ROI in each hepatic segment.

PURPOSE

To identify a strategy with the fewest ROIs that consistently achieves close agreement with the nine-ROI strategy.

STUDY TYPE

Retrospective secondary analysis of prospectively acquired clinical research data.

POPULATION

A total of 391 adults (173 men, 218 women) with known or suspected NAFLD.

FIELD STRENGTH/SEQUENCE

Confounder-corrected chemical-shift-encoded 3T MRI using a 2D multiecho gradient-recalled echo technique.

ASSESSMENT

An ROI was placed in each hepatic segment. Mean nine-ROI PDFF and segmental PDFF standard deviation were computed. Segmental and lobar PDFF were compared. PDFF was estimated using every combinatorial subset of ROIs and compared to the nine-ROI average.

STATISTICAL TESTING

Mean nine-ROI PDFF and segmental PDFF standard deviation were summarized descriptively. Segmental PDFF was compared using a one-way analysis of variance, and lobar PDFF was compared using a paired t-test and a Bland–Altman analysis. The PDFF estimated by every subset of ROIs was informally compared to the nine-ROI average using median intraclass correlation coefficients (ICCs) and Bland–Altman analyses.

RESULTS

The study population's mean whole-liver PDFF was 10.1 ± 8.9% (range: 1.1–44.1%). Although there was no significant difference in average segmental (P = 0.452) or lobar (P = 0.154) PDFF, left and right lobe PDFF differed by at least 1.5 percentage points in 25.1% (98/391) of patients. Any strategy with ≥4 ROIs had ICC >0.995. 115 of 126 four-ROI strategies (91%) had limits of agreement (LOA) <1.5%, including four-ROI strategies with two ROIs from each lobe, which all had LOA <1.5%. 14/36 (39%) of two-ROI strategies and 74/84 (88%) of three-ROI strategies had ICC >0.995, and 2/36 (6%) of two-ROI strategies and 46/84 (55%) of three-ROI strategies had LOA <1.5%.

DATA CONCLUSION

Four-ROI sampling strategies with two ROIs in the left and right lobes achieve close agreement with nine-ROI PDFF.

Level of Evidence: 3

Technical Efficacy: Stage 2

J. Magn. Reson. Imaging 2018;47:988–994.

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Volume47, Issue4

April 2018

Pages 988-994

Optimization of region-of-interest sampling strategies for hepatic MRI proton density fat fraction quantification

Abstract

BACKGROUND

PURPOSE

STUDY TYPE

POPULATION

FIELD STRENGTH/SEQUENCE

ASSESSMENT

STATISTICAL TESTING

RESULTS

DATA CONCLUSION

References

Citing Literature

References

Information

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Optimization of region-of-interest sampling strategies for hepatic MRI proton density fat fraction quantification

Abstract

BACKGROUND

PURPOSE

STUDY TYPE

POPULATION

FIELD STRENGTH/SEQUENCE

ASSESSMENT

STATISTICAL TESTING

RESULTS

DATA CONCLUSION

References

Citing Literature

References

Related

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