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Simultaneous Multiparameter Mapping of the Liver in a Single Breath-Hold or Respiratory-Triggered Acquisition Using
Mary Kate Manhard1,2, Anandh Kilpattu Ramaniharan1, Jean A Tkach1,2
1Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Background:
Quantitative parametric mapping is an increasingly important tool for noninvasive assessment of chronic liver disease. Conventional parametric mapping techniques require multiple breath-held acquisitions and provide limited anatomic coverage.
Purpose:
To investigate a multi-inversion spin and gradient echo (MI-SAGE) technique for simultaneous estimation of T1, T2, and T2* of the liver.
Study Type:
Prospective.
Subjects:
Sixteen research participants, both adult and pediatric (age 17.5 ± 4.6 years, eight male), with and without known liver disease (seven asymptomatic healthy controls, two fibrotic liver disease, five steatotic liver disease, and two fibrotic and steatotic liver disease).
Field Strength/Sequence:
1.5 T, single breath-hold and respiratory triggered MI-SAGE, breath-hold modified Look-Locker inversion recovery (MOLLI, T1 mapping), breath-hold gradient and spin echo (GRASE, T2 mapping), and multiple gradient echo (mGRE, T2* mapping) sequences.
Assessment:
Agreement between hepatic T1, T2, and T2* estimated using MI-SAGE and conventional parametric mapping sequences was evaluated. Repeatability and reproducibility of MI-SAGE were evaluated using a same-session acquisition and second-session acquisition.
Statistical Tests:
Bland-Altman analysis with bias assessment and limits of agreement (LOA) and intraclass correlation coefficients (ICC).
Results:
Hepatic T1, T2, and T2* estimates obtained using the MI-SAGE technique had mean biases of 72 (LOA: -22 to 166) msec, -3 (LOA: -10 to 5) msec, and 2 (LOA: -5 to 8) msec (single breath-hold) and 36 (LOA: -43 to 120) msec, -3 (LOA: -17 to 11) msec, and 4 (LOA: -3 to 11) msec (respiratory triggered), respectively, in comparison to conventional acquisitions using MOLLI, GRASE, and mGRE. All MI-SAGE estimates had strong repeatability and reproducibility (ICC > 0.72).
Data Conclusion:
Hepatic T1, T2, and T2* estimates obtained using an MI-SAGE technique were comparable to conventional methods, although there was a 12%/6% for breath-hold/respiratory triggered underestimation of T1 values compared to MOLLI. Both respiratory triggered and breath-hold MI-SAGE parameter maps demonstrated strong repeatability and reproducibility.
Level Of Evidence:
1 TECHNICAL EFFICACY: Stage 2.
