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Author Spotlight: A Non-Invasive Tool to Assess and Differentiate Fat Patterns in Liver Using 3D Dixon MRI
Published on: October 20, 2023
Free-breathing 3-D quantification of infant body composition and hepatic fat using a stack-of-radial magnetic
Tess Armstrong1,2, Karrie V Ly3,4, Shahnaz Ghahremani1
1Department of Radiological Sciences, University of California Los Angeles, 300 UCLA Medical Plaza, Ste. B119, Los Angeles, CA, 90095, USA.
Insights
A new free-breathing MRI technique significantly improves liver image quality in infants compared to traditional methods. This advanced approach is feasible for quantifying infant body composition and hepatic fat, crucial for metabolic syndrome risk assessment.
Area of Science:
- Pediatric imaging
- Medical physics
- Metabolic disease research
Background:
- Body composition and liver fat are key indicators for metabolic syndrome risk.
- Conventional MRI techniques face limitations in accurately assessing these metrics in infants due to motion artifacts.
- Developing non-invasive methods is crucial for pediatric research.
Purpose of the Study:
- To compare image quality between free-breathing 3-D stack-of-radial MRI and 3-D Cartesian MRI in infant livers.
- To assess the feasibility of using free-breathing radial MRI for quantifying body composition and hepatic proton-density fat fraction (PDFF) in infants.
Main Methods:
- Ten infants (2-7 months) underwent both free-breathing radial and Cartesian MRI.
- Image quality was assessed by a radiologist using a 3-point scale.
- Body composition (VAT, SAT, BAT) and hepatic PDFF were measured using free-breathing radial MRI.
Main Results:
- Free-breathing radial MRI yielded significantly higher liver image quality scores than Cartesian MRI (P=0.01).
- The technique demonstrated feasibility for quantifying visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), brown adipose tissue (BAT), and hepatic PDFF.
- Repeatability of hepatic PDFF measurements was good (coefficient of repeatability <2.0%).
Conclusions:
- Free-breathing radial MRI offers superior liver image quality in infants compared to Cartesian MRI.
- This novel MRI technique is feasible and effective for quantifying body composition and hepatic fat in infants.
Background:
Body composition and hepatic fat correlate with future risk for metabolic syndrome. In children, many conventional techniques for quantifying body composition and hepatic fat have limitations. MRI is a noninvasive research tool to study body composition and hepatic fat in infants; however, conventional Cartesian MRI is sensitive to motion, particularly in the abdomen because of respiration. Therefore we developed a free-breathing MRI technique to quantify body composition and hepatic fat in infants.
Objective:
In infants, we aimed to (1) compare the image quality between free-breathing 3-D stack-of-radial MRI (free-breathing radial) and 3-D Cartesian MRI in the liver and (2) determine the feasibility of using free-breathing radial MRI to quantify body composition and hepatic proton-density fat fraction (PDFF).
Materials And Methods:
Ten infants ages 2-7 months were scanned with free-breathing radial (two abdominal; one head and chest) and Cartesian (one abdominal) MRI sequences. The median preparation and scan times were reported. To assess feasibility for hepatic PDFF quantification, a radiologist masked to the MRI technique scored abdominal scans for motion artifacts in the liver using a 3-point scale (1, or non-diagnostic, to 3, or no artifacts). Median visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and brown adipose tissue (BAT) volume and PDFF, and hepatic PDFF were measured using free-breathing radial MRI. We assessed repeatability of free-breathing radial hepatic PDFF (coefficient of repeatability) between back-to-back scans. We determined differences in the distribution of image-quality scores using McNemar-Bowker tests. P<0.05 was considered significant.
Results:
Nine infants completed the entire study (90% completion). For ten infants, the median preparation time was 32 min and scan time was 24 min. Free-breathing radial MRI demonstrated significantly higher image-quality scores compared to Cartesian MRI in the liver (radial scan 1 median = 2 and radial scan 2 median = 3 vs. Cartesian median = 1; P=0.01). Median measurements using free-breathing radial were VAT=52.0 cm3, VAT-PDFF=42.2%, SAT=267.7 cm3, SAT-PDFF=87.1%, BAT=1.4 cm3, BAT-PDFF=26.1% and hepatic PDFF=3.4% (coefficient of repeatability <2.0%).
Conclusion:
In this study, free-breathing radial MRI in infants achieved significantly improved liver image quality compared to Cartesian MRI. It is feasible to use free-breathing radial MRI to quantify body composition and hepatic fat in infants.
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