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Complex confounder-corrected R2* mapping for liver iron quantification with MRI.

Diego Hernando1,2, Rachel J Cook3,4, Naila Qazi5,6

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Summary

Complex confounder-corrected R2* mapping reliably quantifies liver iron concentration (LIC) across MRI protocols and field strengths. This method demonstrates high reproducibility and predictive ability for iron overload assessment.

Keywords:
BiomarkersIron overloadLiverMagnetic resonance imaging

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Area of Science:

  • Magnetic Resonance Imaging (MRI)
  • Medical Physics
  • Radiology

Background:

  • MRI-based R2* mapping offers potential for rapid and reliable liver iron concentration (LIC) quantification.
  • The performance and reproducibility of R2* mapping across various acquisition protocols and magnetic field strengths remain underexplored.

Purpose of the Study:

  • To evaluate the performance and reproducibility of complex confounder-corrected R2* mapping.
  • To assess R2* mapping across different acquisition protocols at both 1.5 T and 3.0 T field strengths.

Main Methods:

  • Prospective study involving 40 patients with suspected iron overload and 10 healthy controls.
  • MRI acquisitions at 1.5 T and 3.0 T using four distinct R2* mapping protocols per field strength.
  • Comparison with an FDA-approved R2-based method for LIC reference; R2* maps corrected for noise and fat signal.

Main Results:

  • R2* mapping demonstrated high reproducibility across acquisition protocols (p > 0.05 for 96/108 comparisons) and field strengths (ICC > 0.91).
  • High predictive ability for clinically relevant LIC thresholds was observed (AUC > 0.95).
  • Calibration equations for R2* to LIC were established for both 1.5 T and 3.0 T.

Conclusions:

  • Complex confounder-corrected R2* mapping provides reproducible LIC quantification across diverse MRI acquisition protocols.
  • The method is effective at both 1.5 T and 3.0 T, correlating highly with established R2-based LIC quantification.
  • This study determined the calibration between confounder-corrected R2* and LIC at both field strengths.