Inter-vendor and inter-observer reliability of diffusion tensor imaging in the musculoskeletal system: a multiscanner MR study

Abstract
To evaluate the inter-observer and inter-vendor reliability of diffusion tensor imaging parameters in the musculoskeletal system. This prospective study included six healthy volunteers three men (mean age: 42; range: 31–52 years) and three women (mean age: 36; range: 30–44 years). Each subject was scanned using different 3 Tesla magnetic resonance scanners from three different vendors at three different sites bilaterally. First, the intra-class correlation coefficient was used to determine between-observers agreement for overall measurements and clinical sites. Next, between-group comparisons were made through the nonparametric Friedman’s test. Finally, the Bland–Altman method was used to determine agreement among the three scanner measurements, comparing them two by two. A total of 792 measurement were calculated. ICC reported high levels of agreement between the two observers. ICC related to MD, FA, and RD measurements ranged from 0.88 (95% CI 0.85–0.90) to 0.95 (95% CI 0.94–0.96), from 0.85 (95% CI 0.81–0.88) to 0.95 (95% CI 0.93–0.96), and from 0.89 (0.85–0.90) to 0.92 (0.90–0.94). No statistically significant inter-vendor differences were observed. The Bland–Altmann method confirmed a high correlation between parameter values. An excellent inter-observer and inter-vendor reliability was found in our study.