Peripheral Nerve Diffusion Tensor Imaging Interreader and Test-retest Reliability as Quantified by the Standard Error of Measurement

Purpose Diffusion tensor imaging (DTI) is increasingly being used in magnetic resonance neurography (MRN). The purpose of this study was to determine the interreader and test-retest reliability of peripheral nerve DTI in MRN with focus on the sciatic nerve. Methods In this prospective study 27 healthy volunteers each underwent 3 scans of a short DTI protocol on separate days consisting of a T2-weighted turbo spin-echo and single-shot DTI sequence of the sciatic nerve of the dominant leg. The DTI parameters fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were obtained after manual nerve segmentation by two independent readers. Intraclass correlation coefficients (ICC), standard error of measurement (SEM), and Bland-Altman plots were calculated as measures for both interreader and test-retest agreement for all readout parameters. Results The mean +/- standard deviation was 0.507 +/- 0.05 for FA, 1308.5 +/- 162.4x 10(-6)mm(2)/s for MD, 905.6 +/- 145.4x10(-6)mm(2)/s for RD and 2114.1 +/- 219.2x 10(-6)mm(2)/s for AD. The SEM for FA was 0.02 for interreader and test-retest agreement, the SEM for MD, RD, and AD ranged between 46.2x 10(-6)mm(2)/s (RD) and 70.1x 10(-6)mm(2)/s (AD) for interreader reliability and between 45.9x 10(-6)mm(2)/s (RD) and 70.1x 10(-6)mm(2)/s (AD) for test-retest reliability. The ICC for interreader reliability of DTI parameters ranged between 0.81 and 0.92 and ICC for test-retest reliability between 0.76 and 0.91. Conclusion Peripheral nerve DTI of the sciatic nerve is reliable and reproducible. The measures presented here may serve as first orientation values of measurement accuracy when interpreting parameters of sciatic nerve DTI.