State-of-the-Art Quantification of Liver Iron With MRI-Vendor Implementation and Available Tools

Area of Science:

• Radiology
• Medical Imaging
• Biophysics

Background:

• Magnetic Resonance Imaging (MRI) is crucial for estimating liver iron concentration (LIC) in patients with iron overload.
• Standardization of MRI-based LIC quantification is limited by multiple existing techniques.

Purpose of the Study:

• To review established and emerging MRI techniques for LIC estimation.
• To discuss protocols, calibrations, software, and clinical implications for MRI-based LIC quantification.

Main Methods:

• Review of signal intensity ratio (SIR), R2, and R2* relaxometry methods for LIC estimation at 1.5T and 3T.
• Discussion of acquisition protocols, analysis, calibration, vendor implementations, and software.

Main Results:

• Both R2 and R2* relaxometry can accurately estimate LIC with validated protocols.
• R2*-MRI is increasingly endorsed as the most accurate and reproducible method over the Ferriscan R2 method.
• Emerging R2*-MRI techniques show promise with improved motion compensation and dynamic range.

Conclusions:

• R2*-MRI is positioned to become the standard for LIC quantification.
• Standardized MRI-based LIC measurements will improve clinical decision-making in iron overload management.