Serai Suraj D, Obuchowski Nancy A, Venkatesh Sudhakar K, Sirlin Claude B, Miller Frank H, Ashton Edward, Cole Patricia E, Ehman Richard L
From the Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 5031, Cincinnati, OH 45229 (S.D.S.); Department of Quantitative Health Sciences, the Cleveland Clinic Foundation, Cleveland, Ohio (N.A.O.); Department of Radiology, Mayo Clinic, Rochester, Minn (S.K.V., R.L.E.); Department of Radiology, UCSD Liver Imaging Group, San Diego, Calif (C.B.S.); Department of Radiology, Northwestern Memorial Hospital, Chicago, Ill (F.H.M.); Virtualscopics, Rochester, NY (E.A.); and Clinical and Translational Science-Imaging, Takeda Pharmaceuticals, Deerfield, Ill (P.E.C.).
Radiology. 2017 Oct;285(1):92-100. doi: 10.1148/radiol.2017161398. Epub 2017 May 22.
Purpose To perform a meta-analysis to generate an estimate of the repeatability coefficient (RC) for magnetic resonance (MR) elastography of the liver. Materials and Methods A systematic search of databases was performed for publications on MR elastography during the 10-year period between 2006 and 2015. The identified studies were screened independently and were verified reciprocally by all authors. Two reviewers independently determined the percentage RC and effective sample size from each article. A forest plot was constructed of the percentage RC estimates from the 12 studies. Bootstrap 95% confidence intervals (CIs) were constructed for the summary percentage RCs. Results Twelve studies comprising 274 patients met the eligibility criteria and were included for analysis. A flow diagram of studies included according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was prepared for the inclusion and exclusion criteria. All studies included in the meta-analysis fulfilled four or more of the seven categories of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2. The estimated summary RC was 22% (95% CI: 16.1%, 28.2%). The three main sources for this heterogeneity were the trained versus untrained operator drawing contours to choose regions of interest, the time between two replicate examinations, and, finally, the field strength of the MR imaging unit. The RC estimates tended to be higher for studies that did not use a well-trained operator, those with 1.5-T field strength imaging units, and those with longer time intervals between examinations. Conclusion The meta-analysis results provide the basis for the following draft longitudinal Quantitative Imaging Biomarkers Alliance MR elastography claim: A measured change in hepatic stiffness of 22% or greater, at the same site and with use of the same equipment and acquisition sequence, indicates that a true change in stiffness has occurred with 95% confidence. RSNA, 2017.
目的 进行一项荟萃分析，以估算肝脏磁共振弹性成像的重复性系数（RC）。材料与方法 对2006年至2015年这10年间关于磁共振弹性成像的出版物进行了系统的数据库检索。对所识别的研究进行独立筛选，并由所有作者相互核实。两名审阅者独立确定每篇文章的RC百分比和有效样本量。构建了一个森林图，展示12项研究的RC百分比估算值。为汇总RC百分比构建了自展法95%置信区间（CI）。结果 12项研究共纳入274例患者，符合纳入标准并纳入分析。根据系统评价和荟萃分析的首选报告项目指南，绘制了纳入研究的流程图，以显示纳入和排除标准。荟萃分析中纳入的所有研究均满足诊断准确性研究质量评估（QUADAS）-2七类中的四类或更多。估算的汇总RC为22%（95%CI：16.1%，28.2%）。这种异质性的三个主要来源是：受过培训与未受过培训的操作人员绘制轮廓以选择感兴趣区域、两次重复检查之间的时间，以及最后磁共振成像设备的场强。对于未使用训练有素的操作人员的研究、使用1.5-T场强成像设备的研究以及检查间隔时间较长的研究，RC估算值往往较高。结论 荟萃分析结果为以下纵向定量成像生物标志物联盟磁共振弹性成像声明草案提供了依据：在同一部位，使用相同设备和采集序列，肝脏硬度测量变化达到22%或更大，表明硬度发生了真实变化，置信度为95%。RSNA，2017年。
