Repeatability and reproducibility of MRI apparent diffusion coefficient applied on four different regions of interest for patients with axial spondyloarthritis and healthy volunteers scanned twice within a week
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- bjro.20200004
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Objectives: The apparent diffusion coefficient (ADC) may be used as a biomarker for diagnosis and/or monitoring treatment response in patients with axial spondyloarthritis (axSpA), but this requires reliable ADC measurements. This study assessed test-retest repeatability and reproducibility of ADC measurements using four different region of interest (ROI) settings.
Methods: In this prospective study, the sacroiliac joints (SIJs) of 25 patients with axSpA and 24 age- and sex-matched healthy volunteers were imaged twice at a mean interval of 6.8 days in a 1.5 T scanner using, multishot echoplanar diffusion-weighted sequences. ADCs at four ROI settings were assessed: 5 mm and 10 mm anatomic band-shaped, 15 mm linear, and 40 mm2 circular.
Results: Intraclass correlation coefficient (ICC) assessments showed that the interstudy repeatability was good for median ADC (ADCmed) and 95th-percentile ADC (ADC95) measurements in patients with axSpA (0.77-0.83 and 0.75-0.83, respectively), but poor-to-moderate in healthy subjects (0.27-0.55 and 0.13-0.37, respectively). For all ROI settings, intrareader reproducibility was excellent for ADCmed-measurements (ICC:0.85-0.99) and moderate-to-excellent for ADC95 measurements (ICC:0.68-0.96). The 5 mm ROI had the least estimated bias and highest level of agreement on Bland-Altman plots. The interreader reproducibility was moderate (ICC:0.71). The 15 mm linear ROI produced significantly greater ADCmed and ADC95 measurements than all other ROI settings (p < 0.01-0.02), except for the circular ROI ADC95 measurements.
Conclusion: ROI settings influence ADC measurements. Interstudy repeatability of SIJ ADC measurements is independent of ROI settings. However, the 5 mm ROI showed the least bias and random error and seems preferable.
Advances in knowledge: ADC measurements are affected by ROI settings, and this should be taken into account when assessing ADC maps.
Originalsprog | Engelsk |
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Artikelnummer | 20200004 |
Tidsskrift | BJR open |
Vol/bind | 2 |
Udgave nummer | 1 |
Antal sider | 8 |
ISSN | 2513-9878 |
DOI | |
Status | Udgivet - 2020 |
Bibliografisk note
© 2020 The Authors. Published by the British Institute of Radiology.
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