Spectroscopy-based multi-parametric quantification in subjects with liver iron overload at 1.5T and 3T

Area of Science:

• Magnetic Resonance Imaging
• Medical Diagnostics
• Biomarker Discovery

Background:

• Chronic liver disease (CLD) in patients with iron overload requires accurate assessment of liver health.
• Magnetic Resonance Spectroscopy (MRS) offers quantitative biomarkers for CLD, but its precision and inter-biomarker relationships need thorough evaluation.
• Quantitative STEAM-MRS (stimulated echo acquisition mode magnetic resonance spectroscopy) is a promising technique for non-invasive assessment.

Purpose of the Study:

• To evaluate the precision (repeatability and reproducibility) of quantitative STEAM-MRS.
• To determine the relationships between multiple MR biomarkers of CLD in subjects with iron overload.
• To assess these parameters at both 1.5 Tesla (T) and 3T field strengths.

Main Methods:

• Acquired MRS data from 56 subjects with known or suspected liver iron overload at 1.5T and 3T.
• Utilized two STEAM-MRS sequences (multi-TE and multi-TE-TR) with test-retest acquisitions.
• Assessed precision using intraclass correlation coefficients, linear regression, and Bland-Altman analyses; evaluated multi-parametric relationships.

Main Results:

• Both STEAM-MRS sequences demonstrated good-to-excellent precision (ICC ≥ 0.81) for quantifying R1, R2, FWHM, and proton density fat fraction at 1.5T and 3T.
• Observed moderate to high correlations (R² = 0.50 to ≥ 0.70) between biomarkers across field strengths and with liver iron concentration.
• Achieved precise quantification of key MR biomarkers in iron overload patients.

Conclusions:

• Quantitative STEAM-MRS enables rapid and precise measurement of multiple CLD biomarkers across a broad range of liver iron concentrations.
• Evaluating multi-parametric relationships advances comprehensive MRS-based assessment of CLD.
• This work may help establish robust MRS biomarkers for chronic liver disease diagnosis and monitoring.