Gaspard d'Assignies1,2, Anita Paisant1,3, Edouard Bardou-Jacquet3,4,5, Anne Boulic1, Elise Bannier1,6, Fabrice Lainé3,4, Martine Ropert5,7, Jeff Morcet3, Hervé Saint-Jalmes2,8, Yves Gandon9,10. 1. Department of Radiology, Rennes University Hospital, 2 rue H. Le Guilloux, 35033, Rennes, France. 2. LTSI, INSERM U1099, University of Rennes 1, Beaulieu Campus, 35042, Rennes, France. 3. Clinical investigation centre, Rennes University Hospital, CIC INSERM 1414, 2 rue H. Le Guilloux, 35033, Rennes, France. 4. Department of Hepatology, Rennes University Hospital, 2 rue H. Le Guilloux, 35033, Rennes, France. 5. INSERM UMR991, Rennes University Hospital, 2 rue H. Le Guilloux, 35033, Rennes, France. 6. VisAGeS U746 Unit/Project, INSERM/INRIA, IRISA, UMR CNRS 6074, University of Rennes 1, Beaulieu Campus, 35042, Rennes, France. 7. Department of Biochemistry, Rennes University Hospital, 2 rue H. Le Guilloux, 35033, Rennes, France. 8. CRLCC, Centre Eugène Marquis, F-35000, Rennes, France. 9. Department of Radiology, Rennes University Hospital, 2 rue H. Le Guilloux, 35033, Rennes, France. yves.gandon@chu-rennes.fr. 10. LTSI, INSERM U1099, University of Rennes 1, Beaulieu Campus, 35042, Rennes, France. yves.gandon@chu-rennes.fr.
Abstract
OBJECTIVES: To evaluate the performance and limitations of the R2* and signal intensity ratio (SIR) methods for quantifying liver iron concentration (LIC) at 3 T. METHODS: A total of 105 patients who underwent a liver biopsy with biochemical LIC (LICb) were included prospectively. All patients underwent a 3-T MRI scan with a breath-hold multiple-echo gradient-echo sequence (mGRE). LIC calculated by 3-T SIR algorithm (LICSIR) and by R2* (LICR2*) were correlated with LICb. Sensitivity and specificity were calculated. The comparison of methods was analysed for successive classes. RESULTS: LICb was strongly correlated with R2* (r = 0.95, p < 0.001) and LICSIR (r = 0.92, p < 0.001). In comparison to LICb, LICR2* and LICSIR detect liver iron overload with a sensitivity/specificity of 0.96/0.93 and 0.92/0.95, respectively, and a bias ± SD of 7.6 ± 73.4 and 14.8 ± 37.6 μmol/g, respectively. LICR2* presented the lowest differences for patients with LICb values under 130 μmol/g. Above this value, LICSIR has the lowest differences. CONCLUSIONS: At 3 T, R2* provides precise LIC quantification for lower overload but the SIR method is recommended to overcome R2* limitations in higher overload. Our software, available at www.mrquantif.org , uses both methods jointly and selects the best one. KEY POINTS: • Liver iron can be accurately quantified by MRI at 3 T • At 3 T, R2* provides precise quantification of slight liver iron overload • At 3 T, SIR method is recommended in case of high iron overload • Slight liver iron overload present in metabolic syndrome can be depicted • Treatment can be monitored with great confidence.
OBJECTIVES: To evaluate the performance and limitations of the R2* and signal intensity ratio (SIR) methods for quantifying liver iron concentration (LIC) at 3 T. METHODS: A total of 105 patients who underwent a liver biopsy with biochemical LIC (LICb) were included prospectively. All patients underwent a 3-T MRI scan with a breath-hold multiple-echo gradient-echo sequence (mGRE). LIC calculated by 3-T SIR algorithm (LICSIR) and by R2* (LICR2*) were correlated with LICb. Sensitivity and specificity were calculated. The comparison of methods was analysed for successive classes. RESULTS: LICb was strongly correlated with R2* (r = 0.95, p < 0.001) and LICSIR (r = 0.92, p < 0.001). In comparison to LICb, LICR2* and LICSIR detect liver iron overload with a sensitivity/specificity of 0.96/0.93 and 0.92/0.95, respectively, and a bias ± SD of 7.6 ± 73.4 and 14.8 ± 37.6 μmol/g, respectively. LICR2* presented the lowest differences for patients with LICb values under 130 μmol/g. Above this value, LICSIR has the lowest differences. CONCLUSIONS: At 3 T, R2* provides precise LIC quantification for lower overload but the SIR method is recommended to overcome R2* limitations in higher overload. Our software, available at www.mrquantif.org , uses both methods jointly and selects the best one. KEY POINTS: • Liver iron can be accurately quantified by MRI at 3 T • At 3 T, R2* provides precise quantification of slight liver iron overload • At 3 T, SIR method is recommended in case of high iron overload • Slight liver iron overload present in metabolic syndrome can be depicted • Treatment can be monitored with great confidence.
Entities:
Keywords:
Haemochromatosis; Haemosiderosis; Iron; Liver; Magnetic resonance imaging
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