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Updated: Jun 12, 2025
Author Spotlight: Advancing Hepatic Fibrosis Diagnosis Using Magnetic Resonance Elastography and AI
Published on: July 21, 2023
Liver R2* threshold to predict the failure of MR elastography at 3T: SE-EPI versus GRE sequences
Thi Hien Trang Chau1, Elise Bannier2,3, Edouard Bardou-Jacquet4
1NUMECAN, INSERM U1099, Rennes University Hospital, Rennes, France.
Abstract:
BackgroundLiver iron overload is the most common cause of magnetic resonance elastography (MRE) failure.PurposeTo determine a threshold of R2*, a surrogate of liver iron concentration (LIC), which predicts the failure of liver MRE for either 2D gradient-recalled echo (GRE) or spin-echo echo-planar imaging (SE-EPI) MRE sequence at 3 T.Material and MethodsThis single-center retrospective study included 247 patients who underwent GRE MRE, SE-EPI MRE sequences for fibrosis evaluation and 2D multi-echo GRE sequence for R2* quantification using MRQuantif software. The ability of R2* to predict the failed MRE related to liver iron accumulation was estimated by the area under the receiver operating characteristic curve (AUC).ResultsAfter excluding 26 exams for technical failure, we evaluated 221 patients (52 women; mean age = 56 ± 13) with R2* values in the range of 37-1665 s-1. The iron-related failure rates of GRE MRE and SE-EPI MRE were 62.9% (139/221) and 10.0% (22/221), respectively. The best cutoff of R2* to predict failure exam due to liver iron deposition with GRE MRE was 101 s-1 with a sensitivity of 79.1% and specificity of 97.6% (AUC = 0.97; 95% confidence interval [CI] = 0.95-0.99). This cutoff for SE-EPI MRE was 289 s-1 with a sensitivity of 82.8% and specificity of 99.5% (AUC = 0.89; 95% CI = 0.78-1).ConclusionLiver R2* is a good predictor of MRE examination failure related to iron deposition for MRE at 3 T.
Insights
Liver iron overload commonly causes magnetic resonance elastography (MRE) failure. This study identified R2* thresholds predicting MRE failure due to iron deposition for GRE and SE-EPI sequences at 3 T.
Area of Science:
- Radiology
- Medical Imaging
- Hepatology
Background:
- Liver iron overload is a primary cause of magnetic resonance elastography (MRE) failure.
- Accurate MRE is crucial for liver fibrosis assessment.
- Identifying predictors of MRE failure is essential for reliable diagnosis.
Purpose of the Study:
- To establish R2* thresholds that predict MRE failure in the presence of liver iron overload.
- To evaluate these thresholds for both 2D gradient-recalled echo (GRE) and spin-echo echo-planar imaging (SE-EPI) MRE sequences at 3 Tesla.
Main Methods:
- Retrospective analysis of 221 patients undergoing GRE MRE, SE-EPI MRE, and R2* quantification.
- R2* values, a surrogate for liver iron concentration (LIC), were measured.
- Receiver operating characteristic (ROC) curve analysis determined the predictive ability of R2* for MRE failure.
Main Results:
- Iron-related MRE failure rates were 62.9% for GRE MRE and 10.0% for SE-EPI MRE.
- An R2* cutoff of 101 s⁻¹ predicted GRE MRE failure (AUC=0.97).
- An R2* cutoff of 289 s⁻¹ predicted SE-EPI MRE failure (AUC=0.89).
Conclusions:
- Liver R2* effectively predicts MRE examination failure caused by iron deposition at 3 T.
- Specific R2* thresholds can differentiate between MRE success and failure due to iron overload for different MRE sequences.
