Clinical Quality Control of MRI Total Kidney Volume Measurements in Autosomal Dominant Polycystic Kidney Disease.
Clinical Quality Control of MRI Total Kidney Volume Measurements in Autosomal Dominant Polycystic Kidney Disease.
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DOI：
10.3390/tomography9040107
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发表时间：
2023-07-12
期刊：
影响因子：
--
通讯作者：
Prince MR
中科院分区：
文献类型：
--
作者：
Zhu C;Dev H;Sharbatdaran A;He X;Shimonov D;Chevalier JM;Blumenfeld JD;Wang Y;Teichman K;Shih G;Goel A;Prince MR
MRI测量的肾脏总体积是评估常染色体显性多囊肾病进展和治疗反应的重要生物标志物。然而，我们已经注意到，可以有实质性的差异，在肾脏体积测量中获得的各种脉冲序列中通常包括在一个MRI examin.In这里，我们研究肾脏体积测量的变异性之间的五个常用的MRI脉冲序列在腹部MRI检查105例ADPKD患者。由三名专家观察员使用模型辅助分割，对ADPKD患者的轴向T2、冠状面T2、轴向单次激发快速自旋回波（SSFP）、冠状面SSFP和轴向3D T1图像进行独立测量。分析离群值测量值的数据采集误差。大多数离群值（88%）是由于扫描期间的呼吸导致断层配准错误（有间隙或重复成像断层）（n = 35）、采集期间使用多次屏气导致的断层配准错误（n = 25）、由两次重叠采集组成（n = 17）或肾脏不完全在视野内（n = 4）。在排除离群值测量值后，5个测量值之间的变异系数从4.6%降低至3.2%。与所有序列无误差的平均值相比，轴向和冠状T2加权成像测量的TKV比平均值高1.2%和1.8%，轴向SSFP高0.4%，冠状SSFP低1.7%，轴向T1低1.5%，表明与不同MRI对比机制相关的固有测量偏倚。总之，MRI数据采集错误很常见，但可以使用离群值分析进行识别并排除，以提高器官体积测量的一致性。T2序列上的较大体积测量和轴向T1序列上的较小体积测量的偏差也可以通过对所采集的所有无误差序列的数据进行平均来减轻。
Total kidney volume measured on MRI is an important biomarker for assessing the progression of autosomal dominant polycystic kidney disease and response to treatment. However, we have noticed that there can be substantial differences in the kidney volume measurements obtained from the various pulse sequences commonly included in an MRI exam. Here we examine kidney volume measurement variability among five commonly acquired MRI pulse sequences in abdominal MRI exams in 105 patients with ADPKD. Right and left kidney volumes were independently measured by three expert observers using model-assisted segmentation for axial T2, coronal T2, axial single-shot fast spin echo (SSFP), coronal SSFP, and axial 3D T1 images obtained on a single MRI from ADPKD patients. Outlier measurements were analyzed for data acquisition errors. Most of the outlier values (88%) were due to breathing during scanning causing slice misregistration with gaps or duplication of imaging slices (n = 35), slice misregistration from using multiple breath holds during acquisition (n = 25), composing of two overlapping acquisitions (n = 17), or kidneys not entirely within the field of view (n = 4). After excluding outlier measurements, the coefficient of variation among the five measurements decreased from 4.6% pre to 3.2%. Compared to the average of all sequences without errors, TKV measured on axial and coronal T2 weighted imaging were 1.2% and 1.8% greater, axial SSFP was 0.4% greater, coronal SSFP was 1.7% lower and axial T1 was 1.5% lower than the mean, indicating intrinsic measurement biases related to the different MRI contrast mechanisms. In conclusion, MRI data acquisition errors are common but can be identified using outlier analysis and excluded to improve organ volume measurement consistency. Bias toward larger volume measurements on T2 sequences and smaller volumes on axial T1 sequences can also be mitigated by averaging data from all error-free sequences acquired.
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