Rationale and Objectives
A critical performance metric for any quantitative imaging biomarker is its ability
to reliably generate similar values on repeat testing. This is known as the repeatability
of the biomarker, and it is used to determine the minimum detectable change needed
in order to show that a change over time is real change and not just due to measurement
error. Test-retest studies are the classic approach for estimating repeatability;
however, these studies can be infeasible when the imaging is expensive, time-consuming,
invasive, or requires contrast agents. The objective of this study was to develop
and test a method for estimating repeatability without a test-retest study.
Materials and Methods
We present a statistical method for estimating repeatability and testing whether an
imaging method meets a specified criterion for repeatability in the absence of a test-retest
study. The new method is applicable for the particular situation where a reference
standard is available. A Monte Carlo simulation study was conducted to evaluate the
performance of the new method.
Results
The proposed estimator is unbiased, and hypothesis tests with the new estimator have
nominal type I error rate and power similar to a test-retest study. We considered
the situation where the reference standard provides the true value, as well as when
the reference standard itself has various magnitudes of measurement error. An example
from CT imaging biomarkers of atherosclerosis illustrates the new method.
Conclusion
Precision of a QIB can be measured without a test-retest study in the situation where
a reference standard is available.
Keywords
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Article info
Publication history
Published online: July 13, 2021
Accepted:
June 12,
2021
Received in revised form:
June 4,
2021
Received:
April 23,
2021
Identification
Copyright
© 2021 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
