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

Jakob Møllenbach Møller; Mikkel Østergaard; Henrik S Thomsen; Stine Hangaard; Inge J Sørensen; Ole Rintek Madsen; Susanne J Pedersen

doi:10.1259/bjro.20200004

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

Jakob Møllenbach Møller, Mikkel Østergaard, Henrik S Thomsen, Stine Hangaard, Inge J Sørensen, Ole Rintek Madsen, Susanne J Pedersen

Research output: Contribution to journal › Journal article › Research › peer-review

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Abstract

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.

Original language	English
Article number	20200004
Journal	BJR open
Volume	2
Issue number	1
Number of pages	8
ISSN	2513-9878
DOIs	https://doi.org/10.1259/bjro.20200004
Publication status	Published - 2020

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Møller, J. M., Østergaard, M., Thomsen, H. S., Hangaard, S., Sørensen, I. J., Madsen, O. R., & Pedersen, S. J. (2020). 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. BJR open, 2(1), [20200004]. https://doi.org/10.1259/bjro.20200004

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. / Møller, Jakob Møllenbach; Østergaard, Mikkel ; Thomsen, Henrik S; Hangaard, Stine; Sørensen, Inge J; Madsen, Ole Rintek; Pedersen, Susanne J.

In: BJR open, Vol. 2, No. 1, 20200004, 2020.

Research output: Contribution to journal › Journal article › Research › peer-review

Møller, JM, Østergaard, M , Thomsen, HS, Hangaard, S, Sørensen, IJ, Madsen, OR & Pedersen, SJ 2020, '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', BJR open, vol. 2, no. 1, 20200004. https://doi.org/10.1259/bjro.20200004

Møller, Jakob Møllenbach ; Østergaard, Mikkel ; Thomsen, Henrik S ; Hangaard, Stine ; Sørensen, Inge J ; Madsen, Ole Rintek ; Pedersen, Susanne J. / 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. In: BJR open. 2020 ; Vol. 2, No. 1.

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title = "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",

abstract = "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.",

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T1 - 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

AU - Møller, Jakob Møllenbach

AU - Østergaard, Mikkel

AU - Thomsen, Henrik S

AU - Hangaard, Stine

AU - Sørensen, Inge J

AU - Madsen, Ole Rintek

AU - Pedersen, Susanne J

PY - 2020

Y1 - 2020

N2 - 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.

AB - 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.

U2 - 10.1259/bjro.20200004

DO - 10.1259/bjro.20200004

M3 - Journal article

C2 - 33409446

VL - 2

JO - BJR open

JF - BJR open

SN - 2513-9878

IS - 1

M1 - 20200004

ER -