Multi-echo Dixon and breath-hold T2-corrected multi-echo single-voxel MRS for quantifying hepatic iron overload in rabbits

Abstract

Background Three-dimensional (3D) multi-echo-Dixon (ME-Dixon) and breath-hold T2-corrected multi-echo single-voxel MR spectroscopy (HISTO) can simultaneously quantify liver fat and liver iron. However, their diagnostic efficacy and application scope for quantitative iron in co-existing fatty liver have not been adequately evaluated. Purpose To evaluate the accuracy of ME-Dixon and HISTO for quantitative analysis of hepatic iron in rabbits with iron deposition and fatty liver using liver–iron concentration (LIC) as a reference standard. Material and Methods ME-Dixon, HISTO, and conventional two-dimensional multi-echo gradient echo (GRE) sequences were performed on 42 rabbits. The following parameters were calculated: R2* from ME-Dixon and GRE; proton density fat fraction (PDFF) from the ME-Dixon, HISTO (normal TE range), and HISTO-H (extended TE range); and R2_water from HISTO and HISTO-H. The LIC and liver–fat concentration (LFC) were measured through chemical analysis, and their relationship with the MRI parameters were assessed. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to evaluate the diagnostic efficiency. Results LIC was significantly correlated with R2_HISTO-H, R2*_Dixon, and R2*_GRE ( r = 0.858, 0.910, 0.931, respectively; P < 0.001) and weakly with R2_HISTO ( r = 0.424; P = 0.008). A strong correlation was also observed between the LFC and PDFF obtained from HISTO, HISTO-H, and ME-Dixon ( r = 0.776, 0.811, 0.888, respectively; P < 0.001). ME-Dixon showed the best performance with moderate iron overload (AUC = 0.983). Conclusion 3D ME-Dixon is useful for quantifying the LIC, especially with co-existing fatty liver. Its diagnostic performance is also superior to that of the HISTO sequence.

Magnetic resonance spectroscopy for quantification of liver iron deposition in hereditary hemochromatosis of a Chinese family: Four case reports

“…[ 17 ] Studies have shown that MR techniques for detecting iron deposits in the liver correlate well with liver biopsies. [ 10 , 18 19 20 ]…”

“…[18] HISTO is a T2-corrected multi-echo single-voxel MR spectroscopy sequence that acquires multiple echoes in a single acquisition within one breath-hold. [10,19,27] We use this sequence to quantify liver iron deposition because of its inherent ability to separate water resonance from other confounding sources of proton resonance. Zhan et al reported that the ability of MRS to detect hepatic iron overload is equal to that of multi-echo Dixon at 3T.…”

High‐Speed T2‐Corrected Multiecho Magnetic Resonance Spectroscopy for Quantitatively Detecting Skeletal Muscle Fatty Infiltration and Predicting the Loss of Ambulation in Patients With Duchenne Muscular Dystrophy

“…[16][17][18] Recently, high-speed T 2 -corrected multiecho (HISTO) MRS was developed to assess lipids by using multiple short-echo times to correct T 2 bias and using long repetition times to correct T 1 bias by enabling the simultaneous acquisition of multiple echoes, 19,20 which is faster and more accurate in acquiring and measuring lipid components than traditional MRS. [21][22][23] Previous studies have shown the benefit of HISTO-MRS for the precise quantitative assessment of fatty deposition in the liver. 23,24 However, only one study has examined the utilization and feasibility of HISTO-MRS as a rapid and noninvasive MRS technique for quantifying the fat infiltration of skeleton muscles in children with confirmed DMD, 25 Meanwhile, the relationship between muscle fat infiltration measured by HISTO-MRS and clinical motor functional ability remains unknown. The predictive value of HISTO-MRS for the loss of ambulation of DMD remains lacking.…”