Quantification of Hepatic Iron Deposition in Patients With Liver Disease: Comparison of Chemical Shift Imaging With Single-Echo T2*-Weighted Imaging

Lim, Ruth; Tuvia, Keren; Hajdu, Cristina; Losada, Mariela; Gupta, Raavi; Parikh, Tejas; Babb, James S.; Taouli, Bachir

doi:10.2214/ajr.09.3036

Cited by 29 publications

(18 citation statements)

References 38 publications

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“…Interestingly, the detection level of the both methods, visual grading and rSI difference, are consistent with the recently published observation by Alú stiza and Castiella [14]. In a recent retrospective study by Lim et al [18], routine in-phase and out-of-phase imaging was found to be of value for detection of significant hepatic siderosis in patients with chronic liver disease. Although they compared iron indexes with a semi-quantitative reference standard, the results are in good agreement with our study.…”

Section: Discussionsupporting

confidence: 88%

Iron overload: accuracy of in-phase and out-of-phase MRI as a quick method to evaluate liver iron load in haematological malignancies and chronic liver disease

Virtanen

Pudas²,

Ratilainen³

et al. 2012

BJR

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Objectives: The purpose of this prospective study was to evaluate the accuracy of inphase and out-of-phase imaging to assess hepatic iron concentration in patients with haematological malignancies and chronic liver disease. Methods: MRI-based hepatic iron concentration (M-HIC, mmol g -1 ) was used as a reference standard. 42 patients suspected of having iron overload and 12 control subjects underwent 1.5 T in-and out-of-phase and M-HIC liver imaging. Two methods, semi-quantitative visual grading made by two independent readers and quantitative relative signal intensity (rSI) grading from the signal intensity differences of in-phase and out-of-phase images, were used. Statistical analyses were performed using the Spearman and Kruskal-Wallis tests, receiver operator curves and k coefficients. Results: The correlations between M-HIC and visual gradings of Reader 1 (r50.9534, p,0.0001) and Reader 2 (r50.9456, p,0.0001) were higher than the correlations of the rSI method (r50.7719, p,0.0001). There was excellent agreement between the readers (weighted k50.9619). Both visual grading and rSI were similar in detecting liver iron overload: rSI had 84.85% sensitivity and 100% specificity; visual grading had 85% sensitivity and 100% specificity. The differences between the grades of visual grading were significant (p,0.0001) and the method was able to distinguish different degrees of iron overload at the threshold of 151 mmol g -1 with 100% positive predictive value and negative predictive value. Conclusion: Detection and grading of liver iron can be performed reliably with inphase and out-of-phase imaging. Liver fat is a potential pitfall, which limits the use of rSI.

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Section: Discussionsupporting

confidence: 88%

Iron overload: accuracy of in-phase and out-of-phase MRI as a quick method to evaluate liver iron load in haematological malignancies and chronic liver disease

Virtanen

Pudas²,

Ratilainen³

et al. 2012

BJR

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“…This was not feasible using previously proposed methods, as discussed e. g. in [4,21]. By utilizing the fact that SIR-ULM correlates linearly to LIC for the smallest T E used, we were able to derive a relationship for the whole LIC range covered by our patient cohort, with the only exception being small, i. e. normal, LIC values.…”

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confidence: 92%

MRI-Based Liver Iron Content Determination at 3T in Regularly Transfused Patients by Signal Intensity Ratio Using an Alternative Analysis Approach Based on R2* Theory

Wunderlich

Cario

Bommer

et al. 2016

Fortschr Röntgenstr

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▼Objectives: To evaluate the feasibility of addressing liver iron content (LIC) in regularly transfused patients by MR imaging at 3 T based on the signal intensity ratio (SIR). An innovative data analysis approach was developed for this purpose. Methods: 47 consecutive examinations of regularly transfused patients were included. In all cases, we expected high LIC levels. Patients were scanned with MRI at 3 T with multi-echo gradient echo sequences (GRE) at four different flip angles between 20°and 90°with echo times (TE) ranging from 0.9 to 9.8 ms. Spin-echo protocols were acquired to determine the LIC with a reference MRI method working at 1.5 T. 3 T GRE data were analyzed using the liver-to-muscle SIR. Since the method known for 1.5 T was not expected to be applicable for analyzing 3 T data, theoretic dependence of the SIR on the LIC was derived from the equation describing R 2 * signal decay. Obtained SIR values were correlated to reference LIC to get a relation for calculating LIC from SIR quantities. LIC values and their uncertainties were determined from GRE data and correlated to LIC reference values. For two LIC thresholds, the diagnostic accuracy was determined. Results: LIC was reliably determined from SIR in our patient cohort even for large LIC values. Median of LIC uncertainties was 10 %, and the diagnostic accuracy was 0.92 and 0.91, respectively. Conclusion: Determination of even high LIC, resulting in small SIR values, is feasible at 3 T using appropriate SIR analysis.

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“…Therefore, there have been attempts at noninvasive in vivo methods for hepatic iron quantifi cation, such as superconducting quantum interference devices, magnetic resonance (MR) imaging, and dual-energy (DE) computed tomography (CT) (5)(6)(7)(8)(9)(10). In the past, DE CT had to be separately performed with sequential scanning at different energies, inevitably leading to redundant postprocessing time and spatial and temporal misregistration artifacts.…”

Section: Phantom Studymentioning

confidence: 99%

Feasibility and Accuracy of Dual-Source Dual-Energy CT for Noninvasive Determination of Hepatic Iron Accumulation

Joe¹,

Kim²,

Lee³

et al. 2012

Radiology

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Quantification of Hepatic Iron Deposition in Patients With Liver Disease: Comparison of Chemical Shift Imaging With Single-Echo T2*-Weighted Imaging

Abstract: Routine chemical shift imaging and single-echo T2*-weighted imaging have excellent diagnostic performance for detection of significant hepatic siderosis (grade >or= 2). Concomitant steatosis lowers the diagnostic performance of both sequences without reaching significance.

Cited by 29 publications

References 38 publications

Iron overload: accuracy of in-phase and out-of-phase MRI as a quick method to evaluate liver iron load in haematological malignancies and chronic liver disease

Iron overload: accuracy of in-phase and out-of-phase MRI as a quick method to evaluate liver iron load in haematological malignancies and chronic liver disease

MRI-Based Liver Iron Content Determination at 3T in Regularly Transfused Patients by Signal Intensity Ratio Using an Alternative Analysis Approach Based on R2* Theory

Feasibility and Accuracy of Dual-Source Dual-Energy CT for Noninvasive Determination of Hepatic Iron Accumulation

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