Image quality in whole-body MRI using the MY-RADS protocol in a prospective multi-centre multiple myeloma study

Sam Keaveney; Alina Dragan; Mihaela Rata; Matthew Blackledge; Erica Scurr; Jessica M. Winfield; Joshua Shur; Dow Mu Koh; Nuria Porta; Antonio Candito; Alexander King; Winston Rennie; Suchi Gaba; Priya Suresh; Paul Malcolm; Amy Davis; Anjumara Nilak; Aarti Shah; Sanjay Gandhi; Mauro Albrizio; Arnold Drury; Guy Pratt; Gordon Cook; Sadie Roberts; Matthew Jenner; Sarah Brown; Martin Kaiser; Christina Messiou

doi:10.1186/s13244-023-01498-3

Image quality in whole-body MRI using the MY-RADS protocol in a prospective multi-centre multiple myeloma study

Sam Keaveney^*, Alina Dragan, Mihaela Rata, Matthew Blackledge, Erica Scurr, Jessica M. Winfield, Joshua Shur, Dow Mu Koh, Nuria Porta, Antonio Candito, Alexander King, Winston Rennie, Suchi Gaba, Priya Suresh, Paul Malcolm, Amy Davis, Anjumara Nilak, Aarti Shah, Sanjay Gandhi, Mauro AlbrizioArnold Drury, Guy Pratt, Gordon Cook, Sadie Roberts, Matthew Jenner, Sarah Brown, Martin Kaiser, Christina Messiou

^*Corresponding author for this work

Cancer and Genomic Sciences

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: The Myeloma Response Assessment and Diagnosis System (MY-RADS) guidelines establish a standardised acquisition and analysis pipeline for whole-body MRI (WB-MRI) in patients with myeloma. This is the first study to assess image quality in a multi-centre prospective trial using MY-RADS.

Methods: The cohort consisted of 121 examinations acquired across ten sites with a range of prior WB-MRI experience, three scanner manufacturers and two field strengths. Image quality was evaluated qualitatively by a radiologist and quantitatively using a semi-automated pipeline to quantify common artefacts and image quality issues. The intra- and inter-rater repeatability of qualitative and quantitative scoring was also assessed.

Results: Qualitative radiological scoring found that the image quality was generally good, with 94% of examinations rated as good or excellent and only one examination rated as non-diagnostic. There was a significant correlation between radiological and quantitative scoring for most measures, and intra- and inter-rater repeatability were generally good. When the quality of an overall examination was low, this was often due to low quality diffusion-weighted imaging (DWI), where signal to noise ratio (SNR), anterior thoracic signal loss and brain geometric distortion were found as significant predictors of examination quality.

Conclusions: It is possible to successfully deliver a multi-centre WB-MRI study using the MY-RADS protocol involving scanners with a range of manufacturers, models and field strengths. Quantitative measures of image quality were developed and shown to be significantly correlated with radiological assessment. The SNR of DW images was identified as a significant factor affecting overall examination quality.

Trial registration: ClinicalTrials.gov, NCT03188172 , Registered on 15 June 2017.

Critical relevance statement: Good overall image quality, assessed both qualitatively and quantitatively, can be achieved in a multi-centre whole-body MRI study using the MY-RADS guidelines.

Key points:
• A prospective multi-centre WB-MRI study using MY-RADS can be successfully delivered.
• Quantitative image quality metrics were developed and correlated with radiological assessment.
• SNR in DWI was identified as a significant predictor of quality, allowing for rapid quality adjustment.

Original language	English
Article number	170
Number of pages	14
Journal	Insights into Imaging
Volume	14
Issue number	1
Early online date	15 Oct 2023
DOIs	https://doi.org/10.1186/s13244-023-01498-3
Publication status	Published - Dec 2023

Bibliographical note

Funding Information:
We would like to acknowledge Janssen and Celgene (for supporting the MUKnine OPTIMUM study), as well as support from Cancer Research UK National Cancer Imaging Translational Accelerator (NCITA), the National Institute for Health and Care Research (NIHR) Biomedical Research Centre and the Clinical Research Facility in Imaging at The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Publisher Copyright:
© 2023, European Society of Radiology (ESR).

Keywords

Multi-centre trial
Myeloma
Quality control
Whole-body MRI

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging

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Keaveney, S., Dragan, A., Rata, M., Blackledge, M., Scurr, E., Winfield, J. M., Shur, J., Koh, D. M., Porta, N., Candito, A., King, A., Rennie, W., Gaba, S., Suresh, P., Malcolm, P., Davis, A., Nilak, A., Shah, A., Gandhi, S., ... Messiou, C. (2023). Image quality in whole-body MRI using the MY-RADS protocol in a prospective multi-centre multiple myeloma study. Insights into Imaging, 14(1), Article 170. https://doi.org/10.1186/s13244-023-01498-3

@article{c2e1901c258b4162a399c265ac0b3878,

title = "Image quality in whole-body MRI using the MY-RADS protocol in a prospective multi-centre multiple myeloma study",

abstract = "Background: The Myeloma Response Assessment and Diagnosis System (MY-RADS) guidelines establish a standardised acquisition and analysis pipeline for whole-body MRI (WB-MRI) in patients with myeloma. This is the first study to assess image quality in a multi-centre prospective trial using MY-RADS. Methods: The cohort consisted of 121 examinations acquired across ten sites with a range of prior WB-MRI experience, three scanner manufacturers and two field strengths. Image quality was evaluated qualitatively by a radiologist and quantitatively using a semi-automated pipeline to quantify common artefacts and image quality issues. The intra- and inter-rater repeatability of qualitative and quantitative scoring was also assessed. Results: Qualitative radiological scoring found that the image quality was generally good, with 94% of examinations rated as good or excellent and only one examination rated as non-diagnostic. There was a significant correlation between radiological and quantitative scoring for most measures, and intra- and inter-rater repeatability were generally good. When the quality of an overall examination was low, this was often due to low quality diffusion-weighted imaging (DWI), where signal to noise ratio (SNR), anterior thoracic signal loss and brain geometric distortion were found as significant predictors of examination quality. Conclusions: It is possible to successfully deliver a multi-centre WB-MRI study using the MY-RADS protocol involving scanners with a range of manufacturers, models and field strengths. Quantitative measures of image quality were developed and shown to be significantly correlated with radiological assessment. The SNR of DW images was identified as a significant factor affecting overall examination quality. Trial registration: ClinicalTrials.gov, NCT03188172 , Registered on 15 June 2017. Critical relevance statement: Good overall image quality, assessed both qualitatively and quantitatively, can be achieved in a multi-centre whole-body MRI study using the MY-RADS guidelines. Key points: • A prospective multi-centre WB-MRI study using MY-RADS can be successfully delivered. • Quantitative image quality metrics were developed and correlated with radiological assessment. • SNR in DWI was identified as a significant predictor of quality, allowing for rapid quality adjustment.",

keywords = "Multi-centre trial, Myeloma, Quality control, Whole-body MRI",

author = "Sam Keaveney and Alina Dragan and Mihaela Rata and Matthew Blackledge and Erica Scurr and Winfield, {Jessica M.} and Joshua Shur and Koh, {Dow Mu} and Nuria Porta and Antonio Candito and Alexander King and Winston Rennie and Suchi Gaba and Priya Suresh and Paul Malcolm and Amy Davis and Anjumara Nilak and Aarti Shah and Sanjay Gandhi and Mauro Albrizio and Arnold Drury and Guy Pratt and Gordon Cook and Sadie Roberts and Matthew Jenner and Sarah Brown and Martin Kaiser and Christina Messiou",

note = "Funding Information: We would like to acknowledge Janssen and Celgene (for supporting the MUKnine OPTIMUM study), as well as support from Cancer Research UK National Cancer Imaging Translational Accelerator (NCITA), the National Institute for Health and Care Research (NIHR) Biomedical Research Centre and the Clinical Research Facility in Imaging at The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. Publisher Copyright: {\textcopyright} 2023, European Society of Radiology (ESR).",

year = "2023",

month = dec,

doi = "10.1186/s13244-023-01498-3",

language = "English",

volume = "14",

journal = "Insights into Imaging",

issn = "1869-4101",

publisher = "Springer",

number = "1",

}

Keaveney, S, Dragan, A, Rata, M, Blackledge, M, Scurr, E, Winfield, JM, Shur, J, Koh, DM, Porta, N, Candito, A, King, A, Rennie, W, Gaba, S, Suresh, P, Malcolm, P, Davis, A, Nilak, A, Shah, A, Gandhi, S, Albrizio, M, Drury, A, Pratt, G, Cook, G, Roberts, S, Jenner, M, Brown, S, Kaiser, M & Messiou, C 2023, 'Image quality in whole-body MRI using the MY-RADS protocol in a prospective multi-centre multiple myeloma study', Insights into Imaging, vol. 14, no. 1, 170. https://doi.org/10.1186/s13244-023-01498-3

TY - JOUR

T1 - Image quality in whole-body MRI using the MY-RADS protocol in a prospective multi-centre multiple myeloma study

AU - Keaveney, Sam

AU - Dragan, Alina

AU - Rata, Mihaela

AU - Blackledge, Matthew

AU - Scurr, Erica

AU - Winfield, Jessica M.

AU - Shur, Joshua

AU - Koh, Dow Mu

AU - Porta, Nuria

AU - Candito, Antonio

AU - King, Alexander

AU - Rennie, Winston

AU - Gaba, Suchi

AU - Suresh, Priya

AU - Malcolm, Paul

AU - Davis, Amy

AU - Nilak, Anjumara

AU - Shah, Aarti

AU - Gandhi, Sanjay

AU - Albrizio, Mauro

AU - Drury, Arnold

AU - Pratt, Guy

AU - Cook, Gordon

AU - Roberts, Sadie

AU - Jenner, Matthew

AU - Brown, Sarah

AU - Kaiser, Martin

AU - Messiou, Christina

N1 - Funding Information: We would like to acknowledge Janssen and Celgene (for supporting the MUKnine OPTIMUM study), as well as support from Cancer Research UK National Cancer Imaging Translational Accelerator (NCITA), the National Institute for Health and Care Research (NIHR) Biomedical Research Centre and the Clinical Research Facility in Imaging at The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. Publisher Copyright: © 2023, European Society of Radiology (ESR).

PY - 2023/12

Y1 - 2023/12

N2 - Background: The Myeloma Response Assessment and Diagnosis System (MY-RADS) guidelines establish a standardised acquisition and analysis pipeline for whole-body MRI (WB-MRI) in patients with myeloma. This is the first study to assess image quality in a multi-centre prospective trial using MY-RADS. Methods: The cohort consisted of 121 examinations acquired across ten sites with a range of prior WB-MRI experience, three scanner manufacturers and two field strengths. Image quality was evaluated qualitatively by a radiologist and quantitatively using a semi-automated pipeline to quantify common artefacts and image quality issues. The intra- and inter-rater repeatability of qualitative and quantitative scoring was also assessed. Results: Qualitative radiological scoring found that the image quality was generally good, with 94% of examinations rated as good or excellent and only one examination rated as non-diagnostic. There was a significant correlation between radiological and quantitative scoring for most measures, and intra- and inter-rater repeatability were generally good. When the quality of an overall examination was low, this was often due to low quality diffusion-weighted imaging (DWI), where signal to noise ratio (SNR), anterior thoracic signal loss and brain geometric distortion were found as significant predictors of examination quality. Conclusions: It is possible to successfully deliver a multi-centre WB-MRI study using the MY-RADS protocol involving scanners with a range of manufacturers, models and field strengths. Quantitative measures of image quality were developed and shown to be significantly correlated with radiological assessment. The SNR of DW images was identified as a significant factor affecting overall examination quality. Trial registration: ClinicalTrials.gov, NCT03188172 , Registered on 15 June 2017. Critical relevance statement: Good overall image quality, assessed both qualitatively and quantitatively, can be achieved in a multi-centre whole-body MRI study using the MY-RADS guidelines. Key points: • A prospective multi-centre WB-MRI study using MY-RADS can be successfully delivered. • Quantitative image quality metrics were developed and correlated with radiological assessment. • SNR in DWI was identified as a significant predictor of quality, allowing for rapid quality adjustment.

AB - Background: The Myeloma Response Assessment and Diagnosis System (MY-RADS) guidelines establish a standardised acquisition and analysis pipeline for whole-body MRI (WB-MRI) in patients with myeloma. This is the first study to assess image quality in a multi-centre prospective trial using MY-RADS. Methods: The cohort consisted of 121 examinations acquired across ten sites with a range of prior WB-MRI experience, three scanner manufacturers and two field strengths. Image quality was evaluated qualitatively by a radiologist and quantitatively using a semi-automated pipeline to quantify common artefacts and image quality issues. The intra- and inter-rater repeatability of qualitative and quantitative scoring was also assessed. Results: Qualitative radiological scoring found that the image quality was generally good, with 94% of examinations rated as good or excellent and only one examination rated as non-diagnostic. There was a significant correlation between radiological and quantitative scoring for most measures, and intra- and inter-rater repeatability were generally good. When the quality of an overall examination was low, this was often due to low quality diffusion-weighted imaging (DWI), where signal to noise ratio (SNR), anterior thoracic signal loss and brain geometric distortion were found as significant predictors of examination quality. Conclusions: It is possible to successfully deliver a multi-centre WB-MRI study using the MY-RADS protocol involving scanners with a range of manufacturers, models and field strengths. Quantitative measures of image quality were developed and shown to be significantly correlated with radiological assessment. The SNR of DW images was identified as a significant factor affecting overall examination quality. Trial registration: ClinicalTrials.gov, NCT03188172 , Registered on 15 June 2017. Critical relevance statement: Good overall image quality, assessed both qualitatively and quantitatively, can be achieved in a multi-centre whole-body MRI study using the MY-RADS guidelines. Key points: • A prospective multi-centre WB-MRI study using MY-RADS can be successfully delivered. • Quantitative image quality metrics were developed and correlated with radiological assessment. • SNR in DWI was identified as a significant predictor of quality, allowing for rapid quality adjustment.

KW - Multi-centre trial

KW - Myeloma

KW - Quality control

KW - Whole-body MRI

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U2 - 10.1186/s13244-023-01498-3

DO - 10.1186/s13244-023-01498-3

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AN - SCOPUS:85174283266

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JO - Insights into Imaging

JF - Insights into Imaging

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ER -

Image quality in whole-body MRI using the MY-RADS protocol in a prospective multi-centre multiple myeloma study

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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