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Published on: January 31, 2022
Comparison of R2* and FerriScan liver iron concentration (LIC) quantification in the clinical classification of Iron
Marshall S Sussman1, Stephan A R Kannengiesser2, Shopnil Prasla1
1Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital, and Women's College Hospital, University of Toronto, Toronto, ON, Canada.
Purpose:
This study assessed the clinical classification performance of an R2*-based MRI technique for LIC quantification relative to FerriScan, with intra-patient FerriScan LIC uncertainty taken into account. The variabilities of R2* and FerriScan LIC were also assessed.
Materials And Methods:
This was an ethics approved retrospective study, performed on patients undergoing chelation treatment for iron overload. 126 patients (69 women, 57 men), with an age of 42 +/- 16 years (range 19-86 years) were included. FerriScan and R2* MRI at 1.5 T were performed as part of a routine liver iron assessment protocol. For R2* MRI, a commercially available pulse sequence and reconstruction implementation was used, together with a previously derived calibration curve to convert R2* to LIC. Clinical classifications arising from R2*-derived LIC estimates were compared to those based on FerriScan. The accuracy and precision of the R2* technique was calculated. The variabilities of FerriScan- and R2*-derived estimates of LIC were compared with a Wilcoxon Signed Rank test. Significance was set at the 95% confidence level.
Results:
The precision of R2* ranged from 0.59 to 0.92, with an overall accuracy of 72%. When intra-patient FerriScan LIC uncertainty was considered, precision and accuracy increased to >94% and 97% respectively. The R2*-LIC variability (=17%) was significantly lower than the FerriScan-LIC variability (34%) at the 95% confidence level (p < 10-3).
Conclusion:
MRI R2*-based LIC estimates provided a similar clinical classification as FerriScan. The intra-patient uncertainty of R2*-based LIC estimates was significantly lower than FerriScan.
