Abstract
Purpose
The purpose of this study is determine if both liver T2* and cardiac T2* can be measured on a single breath-hold acquisition.
Materials and methods
For this IRB-approved retrospective study, 137 patients with dedicated Cardiac MRI and Liver MRI examinations obtained sequentially on 1.5T scanners and on the same day were included for analysis. Both the cardiac and liver MRI examinations utilized GRE sequences for quantification of tissue iron. Specifically, T2* was measured using an 8-echo, multi-echo gradient echo single breath-hold sequence. Liver T2* was measured in a blinded manner on images from each of the cardiac and dedicated liver MRI examinations and were correlated. Bland–Altman difference plot was used to assess mean bias.
Results
137 examinations from 93 subjects met inclusion criteria. 10 examination pairs were excluded because the first echo time (TE) on the cardiac MRI was insufficiently short for the very high liver iron content. After exclusion, 127 studies from 89 subjects (67.4% males) were included in the final analysis. The mean subject age (± standard deviation) was 11.5 ± 7.5 years (range 0–29.3 years; median 10.5 years). Mean liver T2* measured on cardiac MRI was 8.3 ± 7.7 ms and mean liver T2* measured on dedicated liver MRI was 7.8 ± 7.4 ms (p < 0.001). There was strong positive correlation between the two liver T2* measurements (r = 0.989, p < 0.0001; 95% CI 0.985–0.992). With the exception of borderline outliers, all values fell within two standard deviations on the Bland–Altman difference plots, with a mean bias of 0.5 ms (range − 1.8 to + 2.7 ms).
Conclusion
In most patients with suspected or known iron overload, a single breath-hold GRE sequence may be sufficient to evaluate the iron concentration (T2*) of both the myocardium and the liver.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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This was an IRB-approved HIPAA-compliant retrospective study and the need for informed consent was waived by the IRB.
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Serai, S.D., Trout, A.T., Fleck, R.J. et al. Measuring liver T2* and cardiac T2* in a single acquisition. Abdom Radiol 43, 2303–2308 (2018). https://doi.org/10.1007/s00261-018-1477-4
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DOI: https://doi.org/10.1007/s00261-018-1477-4