Reproducibility of MRI‐determined proton density fat fraction across two different MR scanner platforms

Kang, Geraldine H.; Cruite, Irene; Shiehmorteza, Masoud; Wolfson, Tanya; Gamst, Anthony; Hamilton, Gavin; Bydder, Mark; Middleton, Michael S.; Sirlin, Claude B.

doi:10.1002/jmri.22701

Cited by 132 publications

(141 citation statements)

References 32 publications

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“…This method provides a more direct measure of liver fat content than prior MR techniques that relied on measurements of the image signal fat-fraction. 33 It has been shown to accurately measure liver fat fraction when compared with the magnetic resonance spectroscopy (MRS) technique 34 and reliably measures pancreatic fat content when compared with other MRI imaging techniques. 35 …”

Section: Methodsmentioning

confidence: 99%

Association between novel MRI‐estimated pancreatic fat and liver histology‐determined steatosis and fibrosis in non‐alcoholic fatty liver disease

Patel

Peterson

Brenner

et al. 2013

Aliment Pharmacol Ther

111

112

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SUMMARY Background Ectopic fat deposition in the pancreas and its association with hepatic steatosis have not previously been examined in patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD). Aim To quantify pancreatic fat using a novel magnetic resonance imaging (MRI) technique and determine whether it is associated with hepatic steatosis and/or fibrosis in patients with NAFLD. Methods This is a cross-sectional study including 43 adult patients with biopsy-proven NAFLD who underwent clinical evaluation, biochemical testing and MRI. The liver biopsy assessment was performed using the NASH-CRN histological scoring system, and liver and pancreas fat quantification was performed using a novel, validated MRI biomarker; the proton density fat fraction. Results The average MRI-determined pancreatic fat in patients with NAFLD was 8.5% and did not vary significantly between head, body, and tail of the pancreas. MRI-determined pancreatic fat content increased significantly with increasing histology-determined hepatic steatosis grade; 4.6% in grade 1; 7.7% in grade 2; 13.0% in grade 3 (P = 0.004) respectively. Pancreatic fat content was lower in patients with histology-determined liver fibrosis than in those without fibrosis (11.2% in stage 0 fibrosis vs. 5.8% in stage 1–2 fibrosis, and 6.9% in stage 3–4 fibrosis, P = 0.013). Pancreatic fat did not correlate with age, body mass index or diabetes status. Conclusions In patients with NAFLD, increased pancreatic fat is associated with hepatic steatosis. However, liver fibrosis is inversely associated with pancreatic fat content. Further studies are needed to determine underlying mechanisms to understand if pancreatic steatosis affects progression of NAFLD.

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Section: Methodsmentioning

confidence: 99%

Association between novel MRI‐estimated pancreatic fat and liver histology‐determined steatosis and fibrosis in non‐alcoholic fatty liver disease

Patel

Peterson

Brenner

et al. 2013

Aliment Pharmacol Ther

111

112

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“…To our knowledge, our study is the first to identify MR imaging thresholds based on PDFF. This is important because PDFF addresses the confounding effects that corrupt fat fraction estimation with simpler techniques, and it therefore shows promise as a standardized biomarker, reproducible across platforms and field strengths (24), and robust to acquisition parameter variation (46).…”

Section: Discussionmentioning

confidence: 99%

“…The 1.5-T MR imager was used in the first 4 years of the study and the 3-T imager in the last year of the study, when it became the designated research imager at our institution. MR imaging-PDFF estimation by the two imagers has previously been shown (24) to be highly correlated (r = 0.992) with an average absolute discrepancy of less than 1 percentage point.…”

Section: Mr Imaging Examinationmentioning

confidence: 99%

Nonalcoholic Fatty Liver Disease: MR Imaging of Liver Proton Density Fat Fraction to Assess Hepatic Steatosis

Tang¹,

Tan²,

Sun³

et al. 2013

Radiology

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441

399

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Purpose:To evaluate the diagnostic performance of magnetic resonance (MR) imaging-estimated proton density fat fraction (PDFF) for assessing hepatic steatosis in nonalcoholic fatty liver disease (NAFLD) by using centrally scored histopathologic validation as the reference standard. Materials and Methods:This prospectively designed, cross-sectional, internal review board-approved, HIPAA-compliant study was conducted in 77 patients who had NAFLD and liver biopsy. MR imaging-PDFF was estimated from magnitude-based low flip angle multiecho gradient-recalled echo images after T2* correction and multifrequency fat modeling. Histopathologic scoring was obtained by consensus of the Nonalcoholic Steatohepatitis (NASH) Clinical Research Network Pathology Committee. Spearman correlation, additivity and variance stabilization for regression for exploring the effect of a number of potential confounders, and receiver operating characteristic analyses were performed. Results:Liver MR imaging-PDFF was systematically higher, with higher histologic steatosis grade (P , .001), and was significantly correlated with histologic steatosis grade (r = 0.69, P , .001). The correlation was not confounded by age, sex, lobular inflammation, hepatocellular ballooning, NASH diagnosis, fibrosis, or magnetic field strength (P = .65). Area under the receiver operating characteristic curves was 0.989 (95% confidence interval: 0.968, 1.000) for distinguishing patients with steatosis grade 0 (n = 5) from those with grade 1 or higher (n = 72), 0.825 (95% confidence interval: 0.734, 0.915) to distinguish those with grade 1 or lower (n = 31) from those with grade 2 or higher (n = 46), and 0.893 (95% confidence interval: 0.809, 0.977) to distinguish those with grade 2 or lower (n = 58) from those with grade 3 (n = 19). Conclusion:MR imaging-PDFF showed promise for assessment of hepatic steatosis grade in patients with NAFLD. For validation, further studies with larger sample sizes are needed.q RSNA, 2013

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“…PDFF quantification can be performed with commercially available tools (IDEAL-IQ ® , GE; mDIXON Quant ® , PHILIPS), or using in-house developed software. MECSE-MR imaging sequences are accurate for quantification of hepatic steatosis [41,43,44], being repeatable [45] and reproducible across different MR scanner platforms at 1.5T and 3T scanners [46].…”

Section: Mr Quantification Of Hepatic Fat (Proton Density Fat Fraction)mentioning

confidence: 99%

Liver MRI: From basic protocol to advanced techniques

Donato

França

Candelária

et al. 2017

European Journal of Radiology

106

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A B S T R A C TLiver MR is a well-established modality with multiparametric capabilities. However, to take advantage of its full capacity, it is mandatory to master the technique and optimize imaging protocols, apply advanced imaging concepts and understand the use of different contrast media. Physiologic artefacts although inherent to upper abdominal studies can be minimized using triggering techniques and new strategies for motion control. For standardization, the liver MR protocol should include motion-resistant T2-w sequences, in-op phase GRE T1 and T2-w fast spin echo sequences with fat suppression. Diffusion-weighted imaging (DWI) is mandatory, especially for detection of sub-centimetre metastases. Contrast-enhanced MR is the cornerstone of liver MR, especially for lesion characterization. Although extracellular agents are the most extensively used contrast agents, hepatobiliary contrast media can provide an extra-layer of functional diagnostic information adding to the diagnostic value of liver MR. The use of high field strength (3T) increases SNR but is more challenging especially concerning artefact control. Quantitative MR belongs to the new and evolving field of radiomics where the use of emerging biomarkers such as perfusion or DWI can derive new information regarding disease detection, prognostication and evaluation of tumour response. This information can overcome some of the limitations of current tests, especially when using vascular disruptive agents for oncologic treatment assessment. MR is, today, a robust, mature, multiparametric imaging modality where clinical applications have greatly expanded from morphology to advanced imaging. This new concept should be acknowledged by all those involved in producing high quality, high-end liver MR studies.

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Reproducibility of MRI‐determined proton density fat fraction across two different MR scanner platforms

Cited by 132 publications

References 32 publications

Association between novel MRI‐estimated pancreatic fat and liver histology‐determined steatosis and fibrosis in non‐alcoholic fatty liver disease

Association between novel MRI‐estimated pancreatic fat and liver histology‐determined steatosis and fibrosis in non‐alcoholic fatty liver disease

Nonalcoholic Fatty Liver Disease: MR Imaging of Liver Proton Density Fat Fraction to Assess Hepatic Steatosis

Liver MRI: From basic protocol to advanced techniques

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