Translation of diffusion MRI-derived quantitative biomarkers into clinical decision making has been hampered by within-scanner and cross-scanner variability. We compare intra-scan, cross-scan, and cross-protocol variability of multi-shell diffusion MRI for three subjects and evaluated two Random Matrix Theory (RMT)-based denoising techniques to enhance repeatability. Without denoising, best scan-rescan repeatability was found for intra-scanner measurements with the highest SNR (shortest TE), RMT-based denoising greatly reduced variability across scanners and TE, resulting in coefficients of variation about 5% for all comparisons. Increased precision across scanners and protocols should increase statistical power and further enable clinical trials of quantitative higher-order diffusion MRI.
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