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. To evaluate the repeatability, reproducibility, and observer variability of kidney cortical T1 mapping in human volunteers without known renal disease. Prospective. 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. 1.5 T and 3 T, a modified Look-Locker imaging (MOLLI) sequence with a balanced steady-state free precession (bSSFP) readout. 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. Bland Altman analysis, coefficient of variation (CoV), intra-class coefficient (ICC), and repeatability coefficient (RC). 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). Kidney cortical T1 mapping is a highly repeatable and reproducible method across MRI manufacturers, field strengths, and observer conditions. 2 TECHNICAL EFFICACY: Stage 2.
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