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Quantitative susceptibility mapping in combination with water-fat separation for simultaneous liver iron and fat fraction quantification

  • Gastrointestinal
  • Published:
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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 mapping (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 mapping

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).

Author information

Author notes

  1. Huimin Lin and Hongjiang Wei contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, NO. 197 Ruijin Er Road, Shanghai, 200025, China

    Huimin Lin, Naying He, Jun Shen & Fuhua Yan

  2. Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA

    Hongjiang Wei & Chunlei Liu

  3. Application Development, Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China

    Caixia Fu

  4. Department of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Shu Cheng

  5. Department of Biological Statistics, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Baisong Wang

  6. MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China

    Xu Yan

  7. Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA

    Chunlei Liu

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  1. Huimin Lin
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Correspondence to Fuhua Yan.

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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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Institutional Review Board approval was obtained.

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• performed at one institution

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Lin, H., Wei, H., He, N. et al. Quantitative susceptibility mapping 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

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