Fat and iron quantification in the liver: past, present, and future

Area of Science:

• Radiology
• Medical Imaging
• Hepatology

Background:

• Diffuse liver diseases, including fat and iron overload, can lead to lipotoxicity and iron toxicity, causing progressive liver damage and failure.
• Intracellular fat and iron alter tissue magnetic properties in a dose-dependent manner.

Purpose of the Study:

• To describe the physical principles and evolution of magnetic resonance (MR) techniques for quantifying liver fat and iron.
• To introduce standardized radiological metrics for objective assessment and monitoring of liver fat and iron overload.

Main Methods:

• Utilizing dedicated magnetic resonance pulse sequences and advanced postprocessing algorithms.
• Developing and applying standardized radiological metrics for numerical reporting of overload severity.

Main Results:

• Objective quantification of liver fat and iron on a continuous scale is achievable using MR imaging.
• Standardized metrics enable objective diagnosis, grading, and longitudinal monitoring of liver disease.

Conclusions:

• Noninvasive MR quantification of liver fat and iron offers a valuable alternative or complement to liver biopsy.
• Quantitative liver fat and iron imaging is nearing routine clinical adoption and may become standard of care.