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Ultra-short echo time images quantify high liver iron.

Eamon K Doyle1,2, Kristin Toy3, Bertin Valdez2

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|June 24, 2017
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A new 3T ultrashort TE radial (3T-UTE) pulse sequence reliably estimates high liver iron concentration (LIC) in patients. This method, combined with standard 3T gradient echo, expands clinical LIC assessment across all iron loads.

Keywords:
T2∗LiverUTEiron overloadrelaxometry

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Area of Science:

  • Magnetic Resonance Imaging
  • Medical Physics
  • Radiology

Background:

  • 1.5T gradient echo (GRE) R2∗ estimation is standard for liver iron concentration (LIC).
  • 3T MRI faces echo time limitations, hindering LIC quantification in patients with high iron loads (LIC ⪆20 mg/g).

Purpose of the Study:

  • To assess a 3D radial pulse sequence with an ultrashort echo time (UTE) to extend the dynamic range of 3T MRI for LIC estimation.
  • To enable accurate LIC assessment across a wider clinical range using 3T MRI.

Main Methods:

  • 23 chronically-transfused volunteers were imaged using 1.5T GRE, 3T GRE, and 3T UTE pulse sequences.
  • R2∗ values were estimated, normalized to 1.5T equivalents, and converted to LIC.
  • Bland-Altman analysis compared 3T-based LIC estimates to 1.5T GRE reference values.

Main Results:

  • 3T GRE accurately quantified LIC up to 25 mg/g but failed at higher concentrations.
  • 3T UTE provided unbiased LIC estimates at high iron loads (sd = 14.5%) compared to 1.5T GRE.
  • 3T UTE successfully estimated LIC up to 50 mg/g, surpassing the limits of 1.5T GRE.

Conclusions:

  • 3T UTE imaging reliably quantifies high liver iron burdens.
  • Combining 3T GRE and 3T UTE enables comprehensive clinical LIC assessment across diverse patient populations.
  • This approach overcomes previous dynamic range limitations of 3T MRI for liver iron quantification.