Christian A Barrera1, Hansel J Otero2, Helge D Hartung3, David M Biko2, Suraj D Serai2. 1. Department of Radiology, The Children's Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA 19104, USA. Electronic address: barreracac@email.chop.edu. 2. Department of Radiology, The Children's Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA 19104, USA. 3. Department of Pediatrics, The Children's Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA 19104, USA.
Abstract
OBJECTIVE: To determine the optimal MRI protocol and sequences for liver and cardiac iron estimation in children. METHODS: We evaluated patients ≤18 years with cardiac and liver MRIs for iron content estimation. Liver T2 was determined by a third-party company. Cardiac and Liver T2* values were measured by an observer. Liver T2* values were calculated using the available liver parenchyma in the cardiac MRI. Linear correlations and Bland-Altman plots were run between liver T2 and T2*, cardiac T2* values; and liver T2* on dedicated cardiac and liver MRIs. RESULTS: 139 patients were included. Mean liver T2 and T2* values were 8.6 ± 5.4 ms and 4.5 ± 4.1 ms, respectively. A strong correlation between liver T2 and T2* values was observed (r = 0.96, p < 0.001) with a bias (+4.1 ms). Mean cardiac bright- and dark-blood T2* values were 26.5 ± 12.9 ms and 27.2 ± 11.9 ms, respectively. Cardiac T2* values showed a strong correlation (r = 0.81, p < 0.001) with a low bias (-1.0 ms). The mean liver T2* on liver and cardiac MRIs were 4.9 ± 4.7 ms and 4.6 ± 3.9 ms, respectively. A strong correlation between T2* values was observed (r = 0.96, p < 0.001) with a small bias (-0.2 ms). CONCLUSION: MRI protocols for iron concentration in the liver and the heart can be simplified to avoid redundant information and reduce scan time. In most patients, a single breath-hold GRE sequence can be used to evaluate the iron concentration in both the liver and heart.
OBJECTIVE: To determine the optimal MRI protocol and sequences for liver and cardiac iron estimation in children. METHODS: We evaluated patients ≤18 years with cardiac and liver MRIs for iron content estimation. Liver T2 was determined by a third-party company. Cardiac and Liver T2* values were measured by an observer. Liver T2* values were calculated using the available liver parenchyma in the cardiac MRI. Linear correlations and Bland-Altman plots were run between liver T2 and T2*, cardiac T2* values; and liver T2* on dedicated cardiac and liver MRIs. RESULTS: 139 patients were included. Mean liver T2 and T2* values were 8.6 ± 5.4 ms and 4.5 ± 4.1 ms, respectively. A strong correlation between liver T2 and T2* values was observed (r = 0.96, p < 0.001) with a bias (+4.1 ms). Mean cardiac bright- and dark-blood T2* values were 26.5 ± 12.9 ms and 27.2 ± 11.9 ms, respectively. Cardiac T2* values showed a strong correlation (r = 0.81, p < 0.001) with a low bias (-1.0 ms). The mean liver T2* on liver and cardiac MRIs were 4.9 ± 4.7 ms and 4.6 ± 3.9 ms, respectively. A strong correlation between T2* values was observed (r = 0.96, p < 0.001) with a small bias (-0.2 ms). CONCLUSION: MRI protocols for iron concentration in the liver and the heart can be simplified to avoid redundant information and reduce scan time. In most patients, a single breath-hold GRE sequence can be used to evaluate the iron concentration in both the liver and heart.
Authors: Adam M Bush; Christopher M Sandino; Shreya Ramachandran; Frank Ong; Nicholas Dwork; Evan J Zucker; Ali B Syed; John M Pauly; Marcus T Alley; Shreyas S Vasanawala Journal: J Magn Reson Imaging Date: 2020-05-26 Impact factor: 4.813