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- W3140622640 abstract "Quantifying fat replacement of the vastus lateralis (VL) by MRI proton density fat fraction (PDFF) is a key efficacy endpoint in DMD clinical trials, due to its sensitivity and lack of dependency on patient motivation. For multi-center clinical trials, a central review is recommended to reduce observer variability, in which an initial technologist measurement is overread/adjusted by a central physician reviewer. Understanding the variability associated with each role is important. We propose that the technologist is a greater source of variability in the MRI-PDFF measurements than the physician. MRI scans of the lower limb (N=13) optimized for PDFF quantitation were extracted from an anonymous clinical trial data repository. The VL was segmented from T1-weighted images by two technologists, in three slices, at the widest part of the VL. A physician reviewed the segmentation, which was applied to the PDFF map to calculate the average fat fraction in the VL. Inter-technologist variability, inter-physician variability with the same technologist, and intra-physician variability with different technologists, were assessed using an intraclass correlation coefficient (ICC) based on a single rating, absolute agreement, 2-way random-effects model. Overall reproducibility of VL fat fraction measurement was excellent. The inter-technologist variability was the largest source of measurement error (ICC = 0.972) compared to the inter-physician variability with the same technologist (ICC = 0.996). The physician overread did not reduce variability, as the intra-physician variability reflected the underlying differences between technologists (ICC = 0.973). The variability between technologists was not driven by variations in slice selection, as shown by the lack of improvement when measurements were performed on the same slices (ICC = 0.972). Instead, the greatest improvement in variability can be expected from improving the skills of the technologist to precisely contour the muscle to exclude subcutaneous fat partial volume effects." @default.
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- W3140622640 date "2020-10-01" @default.
- W3140622640 modified "2023-10-17" @default.
- W3140622640 title "MUSCLE IMAGING – MRI" @default.
- W3140622640 doi "https://doi.org/10.1016/j.nmd.2020.08.159" @default.
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