Abdominal MR elastography with multiple driver arrays: performance and repeatability

To evaluate the performance and repeatability assessing liver, spleen, and kidney stiffness with magnetic resonance elastography (MRE), using arrays of pneumatic passive drivers.

An array of four flexible, pneumatically activated passive drivers for abdominal MRE were developed and tested in this study. Multiple MRE acquisitions were performed prospectively in a series of eleven volunteers, with activation of all combinations of the four drivers, individually and simultaneously. MRE exams were repeated three times to study within-day and between-day test-retest repeatability. Semi-quantitative evaluation of wave propagation and penetration, and quantitative assessment of tissue stiffness was conducted for liver, spleen, and kidneys.

When driver location and amplitude were sufficient to achieve necessary shear wave illumination in any given region of interest, the results showed excellent test-retest repeatability in abdominal organ stiffness with both single and multiple driver configurations. The results confirmed that multiple driver arrays provided suitable shear wave illumination over a larger region of the abdomen, allowing more reliable stiffness measurements in multiple organs. MRE assessment of the spleen was found to be prone to effects of excessive shear wave amplitude, however.

A multiple driver array provides shear wave illumination over a larger region of the abdomen than obtained with a single driver, for MRE assessment of multiple abdominal organs, providing excellent test-retest repeatability in stiffness measurements. However, careful tuning of the location and amplitude of each driver is essential to achieve consistent results.