title: Colon wall motility: comparison of novel quantitative semi-automatic measurements using cine MRI.
abstract: BACKGROUND
  Recently, cine magnetic resonance imaging (MRI) has shown promise for visualizing movement of the colonic wall, although assessment of data has been subjective and observer dependent. This study aimed to develop an objective and semi-automatic imaging metric of ascending colonic wall movement, using image registration techniques.
  
  
  METHODS
  Cine balanced turbo field echo MRI images of ascending colonic motility were acquired over 2 min from 23 healthy volunteers (HVs) at baseline and following two different macrogol stimulus drinks (11 HVs drank 1 L and 12 HVs drank 2 L). Motility metrics derived from large scale geometric and small scale pixel movement parameters following image registration were developed using the post ingestion data and compared to observer grading of wall motion. Inter and intra-observer variability in the highest correlating metric was assessed using Bland-Altman analysis calculated from two separate observations on a subset of data.
  
  
  RESULTS
  All the metrics tested showed significant correlation with the observer rating scores. Line analysis (LA) produced the highest correlation coefficient of 0.74 (95% CI: 0.55-0.86), p < 0.001 (Spearman Rho). Bland-Altman analysis of the inter- and intra-observer variability for the LA metric, showed almost zero bias and small limits of agreement between observations (-0.039 to 0.052 intra-observer and -0.051 to 0.054 inter-observer, range of measurement 0-0.353).
  
  
  CONCLUSIONS
  The LA index of colonic motility derived from cine MRI registered data provides a quick, accurate and non-invasive method to detect wall motion within the ascending colon following a colonic stimulus in the form of a macrogol drink.
authors.affiliation: Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK.|NIHR Biomedical Research Unit in Gastrointestinal and Liver Diseases, Nottingham University Hospitals Trust and the University of Nottingham, Nottingham, UK.
authors.forename: C L
authors.initials: CL
authors.lastname: Hoad
authors.affiliation: Centre for Medical Imaging, Division of Medicine, University College London, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Menys
authors.affiliation: NIHR Biomedical Research Unit in Gastrointestinal and Liver Diseases, Nottingham University Hospitals Trust and the University of Nottingham, Nottingham, UK.
authors.forename: K
authors.initials: K
authors.lastname: Garsed
authors.affiliation: NIHR Biomedical Research Unit in Gastrointestinal and Liver Diseases, Nottingham University Hospitals Trust and the University of Nottingham, Nottingham, UK.|Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK.
authors.forename: L
authors.initials: L
authors.lastname: Marciani
authors.affiliation: Centre for Medical Imaging, Division of Medicine, University College London, London, UK.
authors.forename: V
authors.initials: V
authors.lastname: Hamy
authors.affiliation: Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK.
authors.forename: K
authors.initials: K
authors.lastname: Murray
authors.affiliation: Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK.
authors.forename: C
authors.initials: C
authors.lastname: Costigan
authors.affiliation: Centre for Medical Imaging, Division of Medicine, University College London, London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Atkinson
authors.affiliation: NIHR Biomedical Research Unit in Gastrointestinal and Liver Diseases, Nottingham University Hospitals Trust and the University of Nottingham, Nottingham, UK.
authors.forename: G
authors.initials: G
authors.lastname: Major
authors.affiliation: NIHR Biomedical Research Unit in Gastrointestinal and Liver Diseases, Nottingham University Hospitals Trust and the University of Nottingham, Nottingham, UK.|Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, UK.
authors.forename: R C
authors.initials: RC
authors.lastname: Spiller
authors.affiliation: Centre for Medical Imaging, Division of Medicine, University College London, London, UK.
authors.forename: S A
authors.initials: SA
authors.lastname: Taylor
authors.affiliation: Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK.
authors.forename: P A
authors.initials: PA
authors.lastname: Gowland
mesh_terms: D000328:Adult; D003106:Colon / Q000187:drug effects / Q000502:physiology*; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D011092:Polyethylene Glycols / Q000494:pharmacology; D015203:Reproducibility of Results
chemical_list: C520497:MoviPrep; D011092:Polyethylene Glycols
keywords: ascending colon; cine MRI; imaging metric; motility