MRI liver fat quantification in an oncologic population: the added value of complex chemical shift-encoded MRI

Corrias, Giuseppe; Krebs, Simone; Eskreis‐Winkler, Sarah; Ryan, Davinia; Zheng, Junting; Capanu, Marinela; Saba, Luca; Monti, Serena; Fung, Maggie; Reeder, Scott B.; Mannelli, Lorenzo

doi:10.1016/j.clinimag.2018.08.002

Cited by 15 publications

(13 citation statements)

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“…Although MRI imaging techniques are considered to be more precise for quantifying hepatic steatosis, our study suggests that DECT based fat quantification may be another useful tool, perhaps comparable to the recently developed CSE-MRI method. [22][23][24] DECT is also more effective in allowing correction of beam irradiation, and for this reason the MMD technique may be less influenced by body size compared to single-energy CT. 19,[25][26][27] Some patients with increased fat content progress to cirrhosis and hepatocellular carcinoma. DECT allows the discrimination of substance using monochromatic image (MI), and steatosis exhibit specifically the CT value of each energy level.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparison of Multimaterial Decomposition Fat Fraction with DECT and Proton Density Fat Fraction with IDEAL IQ MRI for Quantification of Liver Steatosis in a Population Exposed to Chemotherapy

et al. 2021

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Introduction: Oncologic patients who develop chemotherapy-associated liver injury (CALI) secondary to chemotherapy treatment tend to have worse outcomes. Biopsy remains the gold standard for the diagnosis of hepatic steatosis. The purpose of this article is to compare 2 alternatives: Proton-Density-Fat-Fraction (PDFF) MRI and MultiMaterial-Decomposition (MMD) DECT. Materials and Methods: 49 consecutive oncologic patients treated with Chemotherapy underwent abdominal DECT and abdominal MRI within 2 weeks of each other. Two radiologists tracked Regions of Interest independently both in the PDFF fat maps and in the MMD DECT fat maps. Non-parametric exact Wilcoxon signed rank test and Cohen’s K were used to compare the 2 sequences and to evaluate the agreement. Results: There was no statistically significant difference in the fat fraction measured as a continuous value between PDFF and DECT between 2 readers. Within the same imaging method (PDFF) the degree of agreement based on the k coefficient between reader 1 and reader 2 is 0.88 (p-value < 0.05). Similarly, for single-source DECT(ssDECT) the degree of agreement based on the k coefficient between reader 1 and reader 2 is 0.97 (p-value < 0.05). Conclusions: The results of this study demonstrate that the hepatic fat fraction of ssDECT with MMD are not significantly different from PDFF. This could be an advantage in an oncological population that undergoes serial CT scans for follow up of chemotherapy response.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of Multimaterial Decomposition Fat Fraction with DECT and Proton Density Fat Fraction with IDEAL IQ MRI for Quantification of Liver Steatosis in a Population Exposed to Chemotherapy

et al. 2021

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“…Clinicians increasingly demand the quantification of liver fat to grade the level of hepatic damage, not only in living donors for liver transplantation and for patients who must undergo liver resections or bariatric surgery but also in patients receiving potentially hepatotoxic therapies. The ability of MR-based methods to detect and quantify steatosis has been investigated in the past 30 years, and substantial correlations between pathologically and radiologically determined fat fractions have been demonstrated[ 77 - 79 ].…”

Section: Yellow Livermentioning

confidence: 99%

Imaging of the chemotherapy-induced hepatic damage: Yellow liver, blue liver, and pseudocirrhosis

Calistri¹,

Rastrelli²,

Nardi³

et al. 2021

WJG

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The liver is the major drug-metabolizing and drug-detoxifying organ. Many drugs can cause liver damage through various mechanisms; however, the liver response to injury includes a relatively narrow spectrum of alterations that, regardless of the cause, are represented by phlogosis, oxidative stress and necrosis. The combination of these alterations mainly results in three radiological findings: vascular alterations, structural changes and metabolic function reduction. Chemotherapy has changed in recent decades in terms of the drugs, protocols and duration, allowing patients a longer life expectancy. As a consequence, we are currently observing an increase in chemotherapy-associated liver injury patterns once considered unusual. Recognizing this form of damage in an early stage is crucial for reconsidering the therapy regimen and thus avoiding severe complications. In this frontier article, we analyze the role of imaging in detecting some of these pathological patterns, such as pseudocirrhosis, “yellow liver” due to chemotherapy-associated steatosis-steatohepatitis, and “blue liver”, including sinusoidal obstruction syndrome, veno-occlusive disease and peliosis.

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“…Iterative Decomposition of water and fat with Echo Asymmetry and Least squares estimation (IDEAL-IQ), a chemical shift-encoded (CSE) sequence, is considered the state-of-the-art technique in fat quantification ( 15 , 16 ). Compared with other sequences such as T1-in-and-out-of-phase (IOP) MRI, CSE-MRI is a more sophisticated fat quantification approach which corrects for a number of confounding factors including T1 bias, noise bias and eddy currents ( 17 – 19 ). An iterative least-squares decomposition algorithm is used to solve for proton density fat fraction (PDFF) maps enabling the quantitative assessment of fatty lesions, which have been widely applied in the imaging of non-alcoholic fatty liver disease ( 20 , 21 ) as well as bone marrow fat in hematological diseases ( 22 ).…”

Section: Introductionmentioning

confidence: 99%

Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial

et al. 2022

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ObjectiveTo study the diagnostic performance of chemical shift-encoded MRI (CSE-MRI) in the diagnosis of axial spondyloarthritis (axSpA).MethodsCSE-MRI images were acquired for consecutive patients complaining of back pain as well as healthy volunteers. Proton density fat fraction (PDFF) values were measured independently by two readers. Diagnostic performance of CSE-MRI was analyzed by sensitivity analysis and ROC curve analysis. Logistic regression analysis was employed to investigate the risk factors of extensive fat deposition in the SIJs.ResultsA total of 52 r-axSpA patients, 37 nr-axSpA patients, 24 non-SpA patients and 34 healthy volunteers were included. Mean PDFF values in the SIJs of patients with r-axSpA and nr-axSpA (72.7% and 64.5%) were significantly higher than non-SpA patients and healthy volunteers (56.0% and 57.6%) (p<0.001). By defining extensive fat deposition in the SIJs as ≥8 ROIs with PDFF values over 70%, its sensitivity and specificity in diagnosing axSpA reached 72.47% and 86.21%%. By joining bone marrow edema (BME) with ≥8 ROIs (PDFF>70%), 22 (24.71%) and 23 (25.84%) more axSpA patients were classified as SIJ MRI (+) by reader 1 and 2, but specificities decreased by 15.52% and 10.34%. Multivariate logistic regression analysis confirmed longer disease duration as the independent risk factor of extensive fat deposition in SIJs (OR=1.15, 95%CI[1.03, 1.32]), while bDMARDs medication was a protective factor (OR=0.15, 95%CI[0.04, 0.51]).ConclusionCSE-MRI is a reliable tool to quantitively assess the fat metaplasia in the SIJs of axSpA patients. Extensive fat deposition in the SIJs could add incremental diagnostic value to BME, but at the cost of decreased specificities.

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MRI liver fat quantification in an oncologic population: the added value of complex chemical shift-encoded MRI

Abstract: The novel CSE-MRI method described here provides increased reproducibility and confidence in diagnosing hepatic steatosis in a oncologic clinical setting. IDEAL-IQ has been proved to be more reproducible than conventional IOP imaging.

Cited by 15 publications

References 51 publications

Comparison of Multimaterial Decomposition Fat Fraction with DECT and Proton Density Fat Fraction with IDEAL IQ MRI for Quantification of Liver Steatosis in a Population Exposed to Chemotherapy

Comparison of Multimaterial Decomposition Fat Fraction with DECT and Proton Density Fat Fraction with IDEAL IQ MRI for Quantification of Liver Steatosis in a Population Exposed to Chemotherapy

Imaging of the chemotherapy-induced hepatic damage: Yellow liver, blue liver, and pseudocirrhosis

Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial

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