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Comparison between multi-echo T2* with and without fat saturation pulse for quantification of liver iron overload
Liana Sanches-Rocha1, Bruna Serpa, Eduardo Figueiredo
1Department of Imaging (MRI), Hospital Israelita Albert Einstein, 627, Albert Einstein Avenue, 1o.SS Bl.B 05652-900 São Paulo, Brazil.
Purpose:
To test a magnetic resonance image (MRI) technique that uses an additional pulse in multi-echo T2* sequence that works to suppress the fat signal, in subjects with liver iron overload and concomitant presence of fat in the liver, which have been revealed as a major drawback that compromises the correct iron quantification by MRI.
Materials And Methods:
Fifty magnetic resonance images of the liver (1.5T scanner) of individuals with blood ferritin increases were retrospectively reviewed for the presence of steatosis, using the sequence in and out of phase, and iron overloading, using two sequences T2 * multi-echo: one standard and other with additional fat suppression pulse. T2 * values and their standard deviations were analyzed statistically.
Results:
Our results showed that a significantly lower standard deviation of T2* values is obtained when the fat saturation pulse is applied in patients with steatosis. We found that modulation of fat signal on liver iron overload resulted in a different categorization of some patients. In one case, the patient was re-classified within normal levels of liver iron.
Conclusion:
Our findings may contribute to a better measure of liver iron overload with relevant implications for patient treatment and care.
Insights
A new magnetic resonance imaging (MRI) technique effectively suppresses fat signals in the liver, improving the accuracy of liver iron overload measurement in patients with both conditions.
Area of Science:
- Radiology
- Medical Imaging
- Biophysics
Background:
- Accurate quantification of liver iron overload is crucial for patient management.
- The presence of hepatic steatosis (fat in the liver) complicates Magnetic Resonance Imaging (MRI) based iron quantification.
- Existing MRI techniques may yield inaccurate iron measurements due to confounding fat signals.
Purpose of the Study:
- To evaluate an enhanced multi-echo T2* MRI sequence with an additional fat suppression pulse.
- To assess the efficacy of this technique in subjects with concurrent liver iron overload and steatosis.
- To determine if fat suppression improves the reliability of liver iron quantification.
Main Methods:
- Retrospective review of 50 liver MRI scans (1.5T) from individuals with elevated ferritin.
- Utilized in-phase/out-of-phase sequences for steatosis detection.
- Compared standard multi-echo T2* sequence with a modified sequence incorporating a fat suppression pulse.
- Analyzed T2* values and their standard deviations statistically.
Main Results:
- Application of the fat saturation pulse significantly reduced the standard deviation of T2* values in patients with steatosis.
- Modulating the fat signal led to altered patient categorization regarding liver iron levels.
- One case demonstrated a re-classification from overloaded to normal liver iron levels after fat signal modulation.
Conclusions:
- The developed MRI technique enhances the precision of liver iron overload assessment.
- Improved accuracy has significant implications for patient treatment and clinical care decisions.
- This fat-suppression method offers a more reliable approach to diagnosing and monitoring iron overload in the presence of steatosis.
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