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- Title
Inter- and intra-reader agreement for gadoxetic acid-enhanced MRI parameter readings in patients with chronic liver diseases.
- Authors
Beer, Lucian; Mandorfer, Mattias; Bastati, Nina; Poetter-Lang, Sarah; Tamandl, Dietmar; Stoyanova, Dilyana Plamenova; Elmer, Michael Christoph; Semmler, Georg; Simbrunner, Benedikt; Hodge, Jacqueline C.; Sirlin, Claude B.; Reiberger, Thomas; Ba-Ssalamah, Ahmed
- Abstract
<bold>Objectives: </bold>To examine inter- and intra-observer agreement for four simple hepatobiliary phase (HBP)-based scores on gadoxetic acid (GA)-enhanced MRI and their correlation with liver function in patients with mixed chronic liver disease (CLD).<bold>Methods: </bold>This single-center, retrospective study included 287 patients (62% male, 38% female, mean age 53.5 ± 13.7 years) with mixed CLD (20.9% hepatitis C, 19.2% alcoholic liver disease, 8% hepatitis B) who underwent GA-enhanced MRI of the liver for clinical care between 2010 and 2015. Relative liver enhancement (RLE), contrast uptake index (CUI), hepatic uptake index (HUI), and liver-to-spleen contrast index (LSI) were calculated by two radiologists independently using unenhanced and GA-enhanced HPB (obtained 20 min after GA administration) images; 50 patients selected at random were reviewed twice by one reader to assess intra-observer reliability. Agreement was assessed by intraclass correlation coefficient (ICC). The albumin-bilirubin (ALBI) score, the model of end-stage liver disease (MELD), and the Child-Turcotte-Pugh (CTP) score were calculated as standards of reference for hepatic function.<bold>Results: </bold>Intra-observer ICCs ranged from 0.814 (0.668-0.896) for CUI to 0.969 (0.945-0.983) for RLE. Inter-observer ICCs ranged from 0.777 (0.605-0.874) for HUI to 0.979 (0.963-0.988) for RLE. All HBP-based scores correlated significantly (all p < 0.001) with the ALBI, MELD, and CTP scores and were able to discriminate patients with a MELD score ≥ 15 versus ≤ 14, with area under the curve values ranging from 0.760 for RLE to 0.782 for HUI.<bold>Conclusion: </bold>GA-enhanced, MRI-derived, HBP-based parameters showed excellent inter- and intra-observer agreement. All HBP-based parameters correlated with clinical and laboratory scores of hepatic dysfunction, with no significant differences between each other.<bold>Key Points: </bold>• Radiological parameters that quantify the hepatic uptake of gadoxetic acid are highly reproducible. • These parameters can be used interchangeably because they correlate with each other and with scores of hepatic dysfunction. • Assessment of these parameters may be helpful in monitoring disease progression.
- Subjects
CONTRAST-enhanced magnetic resonance imaging; CHRONICALLY ill; ALCOHOLIC liver diseases; INTRACLASS correlation; HEPATITIS B; HEPATITIS C
- Publication
European Radiology, 2019, Vol 29, Issue 12, p6600
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-019-06182-z