Quantitative Assessment of Intrahepatic Lipids Using Fat-Selective Imaging With Spectral-Spatial Excitation and In-/Opposed-Phase Gradient Echo Imaging Techniques Within a Study Population of Extremely Obese Patients

Springer, Fabian; Machann, Jürgen; Schwenzer, Nina F.; Ballweg, Verbena; Würslin, Christian; Schneider, Juliane; Fritsche, Andreas; Claussen, Claus D.; Schick, Fritz

doi:10.1097/rli.0b013e3181df2afb

Cited by 15 publications

(9 citation statements)

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“…Over the past years, T 1 times of AT have been widely used to correct for the T 1 bias in the calculation of liver fat content (23)(24)(25), for example. For this purpose, many researchers have relied on the values reported by de Bazelaire et al (19), although they were obtained from six healthy non-obese volunteers and for subcutaneous fat only.…”

Section: Discussionmentioning

confidence: 99%

Comparison ofT₁relaxation times in adipose tissue of severely obese patients and healthy lean subjects measured by 1.5 T MRI

et al. 2014

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Subcutaneous (SAT) and visceral adipose tissue (VAT) differ in composition, endocrine function and localization in the body. VAT is considered to play a role in the pathogenesis of insulin resistance, type 2 diabetes, fatty liver disease, and other obesity-related disorders. It has been shown that the amount, distribution, and (cellular) composition of adipose tissue (AT) correlate well with metabolic conditions. In this study, T1 relaxation times of AT were measured in severely obese subjects and compared with those of healthy lean controls. Here, we tested the hypothesis that T1 relaxation times of AT differ between lean and obese individuals, but also between VAT and SAT as well as superficial (sSAT) and deep SAT (dSAT) in the same individual. Twenty severely obese subjects (BMI 41.4 ± 4.8 kg/m(2) ) and ten healthy lean controls matched for age (BMI 21.5 ± 1.9 kg/m(2) ) underwent MRI at 1.5 T using a single-shot fast spin-echo sequence (short-tau inversion recovery) at six different inversion times (TI range 100-1000 ms). T1 relaxation times were computed for all subjects by fitting the TI -dependent MR signal intensities of user-defined regions of interest in both SAT and VAT to a model function. T1 times in sSAT and dSAT were only measured in obese patients. For both obese patients and controls, the T1 times of SAT (275 ± 14 and 301 ± 12 ms) were significantly (p < 0.01) shorter than the respective values in VAT (294 ± 20 and 360 ± 35 ms). Obese subjects also showed significant (p < 0.01) T1 differences between sSAT (268 ± 11 ms) and dSAT (281 ± 19 ms). More important, T1 differences in both SAT and VAT were highly significant (p < 0.001) between obese patients and healthy subjects. The results of our pilot study suggest that T1 relaxation times differ between severely obese patients and lean controls, and may potentially provide an additional means for the non-invasive assessment of AT conditions and dysfunction.

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Section: Discussionmentioning

confidence: 99%

Comparison ofT₁relaxation times in adipose tissue of severely obese patients and healthy lean subjects measured by 1.5 T MRI

et al. 2014

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“…These techniques rely on multiecho 2D or 3D spoiled gradient-echo methods to separate water and fat signals to generate fat-fraction maps. As long as important confounding factors such as T1 bias, noise bias, T2* effects, spectral modeling of fat, and eddy currents have been addressed [28–35], these methods can be used to generate confounder-corrected maps of proton-density fat fraction [36–39]. …”

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confidence: 99%

Accuracy of Liver Fat Quantification With Advanced CT, MRI, and Ultrasound Techniques: Prospective Comparison With MR Spectroscopy

Kramer

Pickhardt

Kliewer

et al. 2017

American Journal of Roentgenology

193

184

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OBJECTIVE The purpose of this study was to prospectively evaluate the accuracy of proton-density fat-fraction, single- and dual-energy CT (SECT and DECT), gray-scale ultrasound (US), and US shear-wave elastography (US-SWE) in the quantification of hepatic steatosis with MR spectroscopy (MRS) as the reference standard. SUBJECTS AND METHODS Fifty adults who did not have symptoms (23 men, 27 women; mean age, 57 ± 5 years; body mass index, 27 ± 5) underwent liver imaging with unenhanced SECT, DECT, gray-scale US, US-SWE, proton-density fat-fraction MRI, and MRS for this prospective trial. MRS voxels for the reference standard were colocalized with all other modalities under investigation. For SECT (120 kVp), attenuation values were recorded. For rapid-switching DECT (80/140 kVp), monochromatic images (70–140 keV) and fat density–derived material decomposition images were reconstructed. For proton-density fat fraction MRI, a quantitative chemical shift–encoded method was used. For US, echogenicity was evaluated on a qualitative 0–3 scale. Quantitative US shear-wave velocities were also recorded. Data were analyzed by linear regression for each technique compared with MRS. RESULTS There was excellent correlation between MRS and both proton-density fat-fraction MRI (r2 = 0.992; slope, 0.974; intercept, −0.943) and SECT (r2 = 0.856; slope, −0.559; intercept, 35.418). DECT fat attenuation had moderate correlation with MRS measurements (r2 = 0.423; slope, 0.034; intercept, 8.459). There was good correlation between qualitative US echogenicity and MRS measurements with a weighted kappa value of 0.82. US-SWE velocity did not have reliable correlation with MRS measurements (r2 = 0.004; slope, 0.069; intercept, 6.168). CONCLUSION Quantitative MRI proton-density fat fraction and SECT fat attenuation have excellent linear correlation with MRS measurements and can serve as accurate noninvasive biomarkers for quantifying steatosis. Material decomposition with DECT does not improve the accuracy of fat quantification over conventional SECT attenuation. US-SWE has poor accuracy for liver fat quantification.

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“…Thus, analysis of a representative region-of-interest within the liver parenchyma may provide sufficient information about IHL content independent of the technique used. Nevertheless, regional differences in IHL may exist, especially if pronounced hepatic steatosis is present [23].…”

Section: Discussionmentioning

confidence: 99%

Assessment of relevant hepatic steatosis in obese adolescents by rapid fat-selective GRE imaging with spatial-spectral excitation: a quantitative comparison with spectroscopic findings

et al. 2010

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Quantitative Assessment of Intrahepatic Lipids Using Fat-Selective Imaging With Spectral-Spatial Excitation and In-/Opposed-Phase Gradient Echo Imaging Techniques Within a Study Population of Extremely Obese Patients

Cited by 15 publications

References 35 publications

Comparison ofT₁relaxation times in adipose tissue of severely obese patients and healthy lean subjects measured by 1.5 T MRI

Comparison ofT₁relaxation times in adipose tissue of severely obese patients and healthy lean subjects measured by 1.5 T MRI

Accuracy of Liver Fat Quantification With Advanced CT, MRI, and Ultrasound Techniques: Prospective Comparison With MR Spectroscopy

Assessment of relevant hepatic steatosis in obese adolescents by rapid fat-selective GRE imaging with spatial-spectral excitation: a quantitative comparison with spectroscopic findings

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Quantitative Assessment of Intrahepatic Lipids Using Fat-Selective Imaging With Spectral-Spatial Excitation and In-/Opposed-Phase Gradient Echo Imaging Techniques Within a Study Population of Extremely Obese Patients

Cited by 15 publications

References 35 publications

Comparison ofT1relaxation times in adipose tissue of severely obese patients and healthy lean subjects measured by 1.5 T MRI

Comparison ofT1relaxation times in adipose tissue of severely obese patients and healthy lean subjects measured by 1.5 T MRI

Accuracy of Liver Fat Quantification With Advanced CT, MRI, and Ultrasound Techniques: Prospective Comparison With MR Spectroscopy

Assessment of relevant hepatic steatosis in obese adolescents by rapid fat-selective GRE imaging with spatial-spectral excitation: a quantitative comparison with spectroscopic findings

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Comparison ofT₁relaxation times in adipose tissue of severely obese patients and healthy lean subjects measured by 1.5 T MRI

Comparison ofT₁relaxation times in adipose tissue of severely obese patients and healthy lean subjects measured by 1.5 T MRI