Abstract
Purposes
To evaluate the feasibility of simultaneous quantification of liver iron concentration (LIC) and fat fraction (FF) using water-fat separation and quantitative susceptibility map** (QSM).
Methods
Forty-five patients suspected of liver iron overload (LIO) were included. A volumetric interpolated breath-hold examination sequence for QSM and FF, a fat-saturated gradient echo sequence for R2*, a spin echo sequence for LIC measurements and MRS analyses for FF (FF-MRS) were performed. Magnetic susceptibility and FF were calculated using a water-fat separation method (FF-MRI). Correlation and receiver operating characteristic analyses were performed.
Results
Magnetic susceptibility showed strong correlation with LIC (rs=0.918). The optimal susceptibility cut-off values were 0.34, 0.63, 1.29 and 2.23 ppm corresponding to LIC thresholds of 1.8, 3.2, 7.0 and 15.0 mg/g dry weight. The area under the curve (AUC) were 0.948, 0.970, 1 and 1, respectively. No difference in AUC was found between susceptibility and R2* at all LIC thresholds. Correlation was found between FF-MRI and FF-MRS (R2=0.910).
Conclusions
QSM has a high diagnostic performance for LIC quantification, similar to that of R2*. FF-MRI provides simultaneous fat quantification. Findings suggest QSM in combination with water-fat separation has potential value for evaluating LIO, especially in cases with coexisting steatosis.
Key Points
• Magnetic susceptibility showed strong correlation with LIC (r s =0.918).
• QSM showed high diagnostic performance for LIC, similar to that of R 2 * .
• Simultaneously estimated FF-MRI showed strong correlation with MR-Spectroscopy-based FF (R 2 =0.910).
• QSM combining water-fat separation has quantitative value for LIO with coexisted steatosis.
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Abbreviations
- AUC:
-
Area under the curve
- FF-MRI:
-
FF calculated with a water-fat separation method
- FF-MRS:
-
MR Spectroscopy based FF
- FF:
-
Fat fraction
- FOV:
-
Field of view
- GRE:
-
Gradient echo
- ICC:
-
Intraclass correlation coefficients
- LIC:
-
Liver iron concentration
- LIO:
-
Liver iron overload
- mg/g dw:
-
mg/g dry weight
- QSM:
-
Quantitative susceptibility map**
- ROC:
-
Receiver operating characteristic
- ROI:
-
Region of interest
- VIBE:
-
Volumetric interpolated breath-hold examination
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Acknowledgements
We thank Stephan Kannengiesser for helpful discussion.
Funding
This study has received funding by National Natural Science Foundation of China (81671649), National Institute of Mental Health (R01MH096979, R24MH106096), National Institute of Neurological Disorders and Stroke (R01NS079653), and National Heart, Lung, and Blood Institute (R21HL122759).
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The scientific guarantor of this publication is Fuhua Yan.
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The authors of this manuscript declare relationships with the following companies: Caixia Fu and Xu Yan are employees of Siemens Healthcare.
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One of the authors has significant statistical expertise.
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Written informed consent was obtained from all subjects in this study.
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Lin, H., Wei, H., He, N. et al. Quantitative susceptibility map** in combination with water-fat separation for simultaneous liver iron and fat fraction quantification. Eur Radiol 28, 3494–3504 (2018). https://doi.org/10.1007/s00330-017-5263-4
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DOI: https://doi.org/10.1007/s00330-017-5263-4