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Assessment of a truncation-based R2* fitting technique for quantifying high liver iron concentration (LIC).

Marshall S Sussman1, Bryan Buckley1, Stephan A R Kannengiesser2

  • 1Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital, and Women's College Hospital, University of Toronto, Toronto, ON, Canada.

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Summary

A new R2* magnetic resonance imaging (MRI) technique accurately measures liver iron concentration (LIC) in patients with iron overload. This truncation-based R2* fitting method improves accuracy across all LIC levels compared to standard methods.

Keywords:
FerriScanLiver Iron quantificationMRIR2* fittingTruncation

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Area of Science:

  • Medical Imaging
  • Radiology
  • Biophysics

Background:

  • R2*-based MRI offers advantages for liver iron concentration (LIC) quantification.
  • However, existing methods show reduced accuracy in high iron overload states, limiting clinical utility.

Purpose of the Study:

  • To develop and validate a novel R2* fitting technique using truncation to enhance LIC estimation accuracy.
  • The study hypothesizes that this truncation-based method will provide accurate LIC estimates across the full spectrum of iron overload, as defined by FerriScan.

Main Methods:

  • A retrospective analysis of 170 patients with iron overload undergoing chelation therapy was performed.
  • R2* MRI and FerriScan were conducted during the same examination using 1.5 T field strength with specific pulse sequences for each method.
  • LIC was calculated using both non-truncated and truncated R2* fits and compared to FerriScan reference values.

Main Results:

  • Truncated R2* fits demonstrated accurate LIC estimates, matching FerriScan results across all measured iron levels.
  • Non-truncated R2* fits showed deviations from FerriScan for LIC values exceeding 28 mg Fe/g dry weight liver.
  • The precision of LIC estimates was superior with the truncated R2* fitting method compared to non-truncated fits.

Conclusions:

  • The developed truncation R2*-fitting method enables accurate liver iron concentration characterization over the entire range of values assessed by FerriScan.
  • This technique improves the reliability of R2*-based MRI for managing patients with significant iron overload.