Vitali Koch, Jennifer Gotta, Victoria Chernyak, Duygu Cengiz, Katerina Torgashov, Katrin Eichler, Valérie Vilgrain, Simon S Martin, Nicole S Ziegengeist, Paul Konrad, Christian Booz, Ibrahim Yel, Tommaso D'Angelo, Scherwin Mahmoudi, Jan-Erik Scholtz, Simon Bernatz, Leona S Alizadeh, Marina Cimprich, Levent A Solim, Axel Thalhammer, Tatjana Gruber-Rouh, Renate M Hammerstingl, Stefan Zeuzem, Fabian Finkelmeier, Anita Pathil-Warth, Melis Onay, Maximilian N Kinzler, Omar Darwish, Giacomo Annio, Stuart A Taylor, Peter Wild, Iulia Dahmer, Eva Herrmann, Haidara Almansour, Thomas J Vogl, Leon D Gruenewald, Ralph Sinkus
{"title":"Biomechanical Assessment of Liver Integrity: Prospective Evaluation of Mechanical Versus Acoustic MR Elastography.","authors":"Vitali Koch, Jennifer Gotta, Victoria Chernyak, Duygu Cengiz, Katerina Torgashov, Katrin Eichler, Valérie Vilgrain, Simon S Martin, Nicole S Ziegengeist, Paul Konrad, Christian Booz, Ibrahim Yel, Tommaso D'Angelo, Scherwin Mahmoudi, Jan-Erik Scholtz, Simon Bernatz, Leona S Alizadeh, Marina Cimprich, Levent A Solim, Axel Thalhammer, Tatjana Gruber-Rouh, Renate M Hammerstingl, Stefan Zeuzem, Fabian Finkelmeier, Anita Pathil-Warth, Melis Onay, Maximilian N Kinzler, Omar Darwish, Giacomo Annio, Stuart A Taylor, Peter Wild, Iulia Dahmer, Eva Herrmann, Haidara Almansour, Thomas J Vogl, Leon D Gruenewald, Ralph Sinkus","doi":"10.1002/jmri.29560","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance elastography (MRE) can quantify tissue biomechanics noninvasively, including pathological hepatic states like metabolic dysfunction-associated steatohepatitis.</p><p><strong>Purpose: </strong>To compare the performance of 2D/3D-MRE using the gravitational (GT) transducer concept with the current commercial acoustic (AC) solution utilizing a 2D-MRE approach. Additionally, quality index markers (QIs) were proposed to identify image pixels with sufficient quality for reliably estimating tissue biomechanics.</p><p><strong>Study type: </strong>Prospective.</p><p><strong>Population: </strong>One hundred seventy participants with suspected or confirmed liver disease (median age, 57 years [interquartile range (IQR), 46-65]; 66 females), and 11 healthy volunteers (median age, 31 years [IQR, 27-34]; 5 females).</p><p><strong>Field strength/sequence: </strong>Participants were scanned twice at 1.5 T and 60 Hz vibration frequency: first, using AC-MRE (2D-MRE, spin-echo EPI sequence, 11 seconds breath-hold), and second, using GT-MRE (2D- and 3D-MRE, gradient-echo sequence, 14 seconds breath-hold).</p><p><strong>Assessment: </strong>Image analysis was performed by four independent radiologists and one biomedical engineer. Additionally, superimposed analytic plane shear waves of known wavelength and attenuation at fixed shear modulus were used to propose pertinent QIs.</p><p><strong>Statistical tests: </strong>Spearman's correlation coefficient (r) was applied to assess the correlation between modalities. Interreader reproducibility was evaluated using Bland-Altman bias and reproducibility coefficients. P-values <0.05 were considered statistically significant.</p><p><strong>Results: </strong>Liver stiffness quantified via GT-2D/3D correlated well with AC-2D (r ≥ 0.89 [95% CI: 0.85-0.92]) and histopathological grading (r ≥ 0.84 [95% CI: 0.72-0.91]), demonstrating excellent agreement in Bland-Altman plots and between readers (κ ≥ 0.86 [95% CI: 0.81-0.91]). However, GT-2D showed a bias in overestimating stiffness compared to GT-3D. Proposed QIs enabled the identification of pixels deviating beyond 10% from true stiffness based on a combination of total wave amplitude, temporal sinusoidal nonlinearity, and wave signal-to-noise ratio for GT-3D.</p><p><strong>Conclusion: </strong>GT-MRE represents an alternative to AC-MRE for noninvasive liver tissue characterization. Both GT-2D and 3D approaches correlated strongly with the established commercial approach, offering advanced capabilities in abdominal imaging compared to AC-MRE.</p><p><strong>Evidence level: </strong>1 TECHNICAL EFFICACY: Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":null,"pages":null},"PeriodicalIF":3.3000,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Magnetic Resonance Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jmri.29560","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Magnetic resonance elastography (MRE) can quantify tissue biomechanics noninvasively, including pathological hepatic states like metabolic dysfunction-associated steatohepatitis.
Purpose: To compare the performance of 2D/3D-MRE using the gravitational (GT) transducer concept with the current commercial acoustic (AC) solution utilizing a 2D-MRE approach. Additionally, quality index markers (QIs) were proposed to identify image pixels with sufficient quality for reliably estimating tissue biomechanics.
Study type: Prospective.
Population: One hundred seventy participants with suspected or confirmed liver disease (median age, 57 years [interquartile range (IQR), 46-65]; 66 females), and 11 healthy volunteers (median age, 31 years [IQR, 27-34]; 5 females).
Field strength/sequence: Participants were scanned twice at 1.5 T and 60 Hz vibration frequency: first, using AC-MRE (2D-MRE, spin-echo EPI sequence, 11 seconds breath-hold), and second, using GT-MRE (2D- and 3D-MRE, gradient-echo sequence, 14 seconds breath-hold).
Assessment: Image analysis was performed by four independent radiologists and one biomedical engineer. Additionally, superimposed analytic plane shear waves of known wavelength and attenuation at fixed shear modulus were used to propose pertinent QIs.
Statistical tests: Spearman's correlation coefficient (r) was applied to assess the correlation between modalities. Interreader reproducibility was evaluated using Bland-Altman bias and reproducibility coefficients. P-values <0.05 were considered statistically significant.
Results: Liver stiffness quantified via GT-2D/3D correlated well with AC-2D (r ≥ 0.89 [95% CI: 0.85-0.92]) and histopathological grading (r ≥ 0.84 [95% CI: 0.72-0.91]), demonstrating excellent agreement in Bland-Altman plots and between readers (κ ≥ 0.86 [95% CI: 0.81-0.91]). However, GT-2D showed a bias in overestimating stiffness compared to GT-3D. Proposed QIs enabled the identification of pixels deviating beyond 10% from true stiffness based on a combination of total wave amplitude, temporal sinusoidal nonlinearity, and wave signal-to-noise ratio for GT-3D.
Conclusion: GT-MRE represents an alternative to AC-MRE for noninvasive liver tissue characterization. Both GT-2D and 3D approaches correlated strongly with the established commercial approach, offering advanced capabilities in abdominal imaging compared to AC-MRE.
期刊介绍:
The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.