The repeatability of bilateral diffusion tensor imaging (DTI) in the upper leg muscles of healthy adults

• Published in: European radiology Vol. 30; no. 3; pp. 1709 - 1718
• Main Authors: Monte, Jithsa R., Hooijmans, Melissa T., Froeling, Martijn, Oudeman, Jos, Tol, Johannes L., Maas, Mario, Strijkers, Gustav J., Nederveen, Aart J.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2020; Springer Nature B.V
• Subjects: Adult; Adults; Algorithms; Anisotropy; Coefficient of variation; Diagnostic Radiology; Diffusion Magnetic Resonance Imaging - methods; Diffusion Tensor Imaging - methods; Eigenvalues; Female; Humans; Imaging; Internal Medicine; Interventional Radiology; Leg; Leg - diagnostic imaging; Legs; Magnetic Resonance; Magnetic resonance imaging; Male; Mathematical analysis; Measurement methods; Medicine; Medicine & Public Health; Muscle, Skeletal - diagnostic imaging; Muscles; Neuroradiology; Parameter estimation; Perfusion; Quadriceps muscle; Radiology; Reference Values; Reproducibility; Reproducibility of Results; Standard data; Tensors; Ultrasound; Young Adult; Hamstring muscles; Quadriceps muscle; Magnetic resonance imaging; Diffusion tensor imaging
• ISSN: 0938-7994; 1432-1084; 1432-1084
• DOI: 10.1007/s00330-019-06403-5

Objectives Assessment of the repeatability of diffusion parameter estimations in the upper leg muscles of healthy adults over the time course of 2 weeks, from a simultaneous bilateral upper leg DTI measurement. Methods SE-EPI DTI datasets were acquired at 3 T in the upper legs of 15 active adults at a time interval of 2 weeks. ROIs were manually drawn for four quadriceps and three hamstring muscles of both legs. The following DTI parameters were analyzed: 1st, 2nd, and 3rd eigenvalue ( λ 1 , λ 2 , and λ 3 ), mean diffusivity (MD), and fractional anisotropy (FA). DTI parameters per muscle were calculated with and without intravoxel incoherent motion (IVIM) correction together with SNR levels per muscle. Bland-Altman plots and within-subject coefficient of variation (wsCV) were calculated. Left-right differences between muscles were assessed. Results The Bland-Altman analysis showed good repeatability of all DTI parameters except FA for both the IVIM-corrected and standard data. wsCV values show that MD has the highest repeatability (4.5% IVIM; 5.6% standard), followed by λ 2 (4.9% IVIM; 5.5% standard), λ 1 (5.3% IVIM; 7.5% standard), and λ 3 (5.7% IVIM; 5.7% standard). wsCV values of FA were 15.2% for the IVIM-corrected data and 13.9% for the standard analysis. The SNR (41.8 ± 16.0 right leg, 41.7 ± 17.1 left leg) and wsCV values were similar for the left and right leg and no left-right bias was detected. Conclusions Repeatability was good for standard DTI data and slightly better for IVIM-corrected DTI data. Our protocol is suitable for DTI of the upper legs with overall good SNR. Key Points • The presented DTI protocol is repeatable and therefore suitable for bilateral DT imaging of the upper legs. • Additional B1 + calibrations improve SNR and repeatability. • Correcting for perfusion effects improves repeatability.