{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:03:35Z","timestamp":1784937815653,"version":"3.55.0"},"reference-count":20,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"NIHR","doi-asserted-by":"publisher","award":["15912"],"award-info":[{"award-number":["15912"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Identifying high-grade strictures (HGS) in patients with primary sclerosing cholangitis (PSC) relies upon subjective assessments of magnetic resonance cholangiopancreatography (MRCP). Quantitative MRCP (MRCP+) provides objective evaluation of MRCP examinations, which may help make these assessments more consistent and improve patient management and selection for intervention. We evaluated the impact of MRCP+ on clinicians\u2019 confidence in diagnosing HGS in patients with PSC. Methods: Three expert abdominal radiologists independently assessed 28 patients with PSC. Radiological reads of MRCPs were performed twice, in a random order, three weeks apart, then a third time with MRCP+. HGS presence was recorded on semi-quantitative confidence scales. The cases where readers definitively agreed on presence\/absence of HGS were used to assess inter- and intra-reader agreement and confidence. Results: When using MRCP alone, high intra-reader agreement was observed in identifying HGS within both intra- and extrahepatic ducts (64.3% and 70.8%, respectively), while inter-reader agreement was significantly lower for intrahepatic ducts (42.9%) than extrahepatic ducts (66.1%) (p &lt; 0.01). Using MRCP+ in the third read significantly improved inter-reader agreement for intrahepatic HGS detection to 67.9% versus baseline reads (p = 0.02) and was comparable with extrahepatic ducts. Reader confidence tended to increase when supplemented with MRCP+, and inter-reader variability decreased. MRCP+ metrics had good performance in identifying HGS in both extra-hepatic (AUC:0.85) and intra-hepatic ducts (AUC:0.75). Conclusions: MRCP evaluation supported by quantitative metrics tended to increase individual reader confidence and reduce inter-reader variability for detecting HGS. Our results indicate that MRCP+ might help standardize MRCP assessment and subsequent management for patients with PSC.<\/jats:p>","DOI":"10.3390\/jcm14155530","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T10:13:51Z","timestamp":1754475231000},"page":"5530","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Exploring the Role of MRCP+ for Enhancing Detection of High-Grade Strictures in Primary Sclerosing Cholangitis"],"prefix":"10.3390","volume":"14","author":[{"given":"James","family":"Franklin","sequence":"first","affiliation":[{"name":"Department of Medical Science & Public Health, Institute of Medical Imaging and Visualisation, Bournemouth University, Poole BH12 5BB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Robinson","sequence":"additional","affiliation":[{"name":"Radiology Department, Royal Berkshire NHS Foundation Trust, Reading RG1 5AN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0629-7146","authenticated-orcid":false,"given":"Carlos","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Perspectum Ltd., Oxford OX4 2LL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Shumbayawonda","sequence":"additional","affiliation":[{"name":"Perspectum Ltd., Oxford OX4 2LL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kartik","family":"Jhaveri","sequence":"additional","affiliation":[{"name":"Joint Department of Medical Imaging, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada"},{"name":"Faculty of Medicine, University of Toronto, Toronto, ON M5S 3K3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1056\/NEJMra1506330","article-title":"Primary Sclerosing Cholangitis","volume":"375","author":"Lazaridis","year":"2016","journal-title":"N. 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