Repeatability, Reproducibility, and Observer Variability of Cortical T1 Mapping for Renal Tissue Characterization

Background: The global rise in kidney diseases underscores the need for reliable, noninvasive imaging biomarkers. Among these, renal cortical T1 has shown promise but further technical validation is still required.

Purpose: To evaluate the repeatability, reproducibility, and observer variability of kidney cortical T1 mapping in human volunteers without known renal disease.

Study type: Prospective.

Subjects: Three cohorts without renal disease: 1) 25 volunteers (median age 38 [interquartile range, IQR: 28-42] years, female N = 11) for scan-rescan assessments on GE 1.5 T and Siemens 1.5 T; 2) 29 volunteers (median age 29 [IQR: 24-40] years, female N = 15) for scan-rescan assessments on Siemens 3 T; and 3) 16 volunteers (median age 34 [IQR: 31-42] years, female N = 8) for cross-scanner reproducibility.

Field strength/sequences: 1.5 T and 3 T, a modified Look-Locker imaging (MOLLI) sequence with a balanced steady-state free precession (bSSFP) readout.

Assessment: Kidney cortical T1 data was acquired on GE 1.5 T scanner, Siemens 1.5 T and 3 T scanners. Within-scanner repeatability and inter/intra-observer variability: GE 1.5 T and Siemens 1.5 T, and cross-scanner manufacturer reproducibility: Siemens 1.5 T-GE 1.5 T.

Statistical tests: Bland Altman analysis, coefficient of variation (CoV), intra-class coefficient (ICC), and repeatability coefficient (RC).

Results: Renal cortical T1 mapping showed high repeatability and reliability across scanner field strengths and manufacturers (repeatability: CoV 1.9%-2.8%, ICC 0.79-0.88, pooled RC 73 msec; reproducibility: CoV 3.0%, ICC 0.75, RC 90 msec). The method also showed robust observer variability (CoV 0.6%-1.4%, ICC 0.93-0.98, RC 22-48 msec).

Data conclusion: Kidney cortical T1 mapping is a highly repeatable and reproducible method across MRI manufacturers, field strengths, and observer conditions.

Evidence level: 2 TECHNICAL EFFICACY: Stage 2.