Eamon K Doyle1,2, Kristin Toy3, Bertin Valdez2, Jonathan M Chia4, Thomas Coates5, John C Wood1,2. 1. Department of Biomedical Engineering, University of Southern California, Los Angeles, California, USA. 2. Division of Cardiology, Children's Hospital Los Angeles, Los Angeles, California, USA. 3. College of Medicine, University of Toledo, Toledo, Ohio, USA. 4. Philips HealthTech, Gainesville, Florida, USA. 5. Division of Hematology, Children's Hospital Los Angeles, Los Angeles, California, USA.
Abstract
PURPOSE: 1.5T gradient echo-based R2∗ estimates are standard-of-care for assessing liver iron concentration (LIC). Despite growing popularity of 3T, echo time (TE) limitations prevent 3T liver iron quantitation in the upper half of the clinical range (LIC ⪆20 mg/g). In this work, a 3D radial pulse sequence was assessed to double the dynamic range of 3T LIC estimates. THEORY AND METHODS: The minimum TE limits the dynamic range of pulse sequences to estimate R2∗. 23 chronically-transfused human volunteers were imaged with 1.5T Cartesian gradient echo (1.5T-GRE), 3T Cartesian gradient echo (3T-GRE), and 3T ultrashort TE radial (3T-UTE) pulse sequences; minimum TEs were 0.96, 0.76, and 0.19 ms, respectively. R2∗ was estimated with an exponential signal model, normalized to 1.5T equivalents, and converted to LIC. Bland-Altman analysis compared 3T-based estimates to 1.5T-GRE. RESULTS: LIC by 3T-GRE was unbiased versus 1.5T-GRE for LIC ≤ 25 mg/g (sd = 9.6%); 3T-GRE failed to quantify LIC > 25 mg/g. At high iron loads, 3T-UTE was unbiased (sd = 14.5%) compared to 1.5T-GRE. Further, 3T-UTE estimated LIC up to 50 mg/g, exceeding 1.5T-GRE limits. CONCLUSION: 3T-UTE imaging can reliably estimate high liver iron burdens. In conjunction with 3T-GRE, 3T-UTE allows clinical LIC estimation across a wide range of liver iron loads. Magn Reson Med 79:1579-1585, 2018.
PURPOSE: 1.5T gradient echo-based R2∗ estimates are standard-of-care for assessing liver iron concentration (LIC). Despite growing popularity of 3T, echo time (TE) limitations prevent 3T liver iron quantitation in the upper half of the clinical range (LIC ⪆20 mg/g). In this work, a 3D radial pulse sequence was assessed to double the dynamic range of 3T LIC estimates. THEORY AND METHODS: The minimum TE limits the dynamic range of pulse sequences to estimate R2∗. 23 chronically-transfused human volunteers were imaged with 1.5T Cartesian gradient echo (1.5T-GRE), 3T Cartesian gradient echo (3T-GRE), and 3T ultrashort TE radial (3T-UTE) pulse sequences; minimum TEs were 0.96, 0.76, and 0.19 ms, respectively. R2∗ was estimated with an exponential signal model, normalized to 1.5T equivalents, and converted to LIC. Bland-Altman analysis compared 3T-based estimates to 1.5T-GRE. RESULTS: LIC by 3T-GRE was unbiased versus 1.5T-GRE for LIC ≤ 25 mg/g (sd = 9.6%); 3T-GRE failed to quantify LIC > 25 mg/g. At high iron loads, 3T-UTE was unbiased (sd = 14.5%) compared to 1.5T-GRE. Further, 3T-UTE estimated LIC up to 50 mg/g, exceeding 1.5T-GRE limits. CONCLUSION: 3T-UTE imaging can reliably estimate high liver iron burdens. In conjunction with 3T-GRE, 3T-UTE allows clinical LIC estimation across a wide range of liver iron loads. Magn Reson Med 79:1579-1585, 2018.
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