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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.
Background:
R2*-based MRI liver iron concentration (LIC) quantification has several advantages. However, lower accuracies can impact utility in high iron overload states.
Purpose:
To develop and characterize an R2* fitting technique based on truncation. Unlike other truncation methods, this approach maximizes the accuracy of LIC estimates at the possible cost of precision, rather than the converse. The hypothesis of this study is that the truncation-based method can provide accurate LIC estimates over the full range of LICs characterized by FerriScan.
Study Type:
RETROSPECTIVE SUBJECTS: 170 patients undergoing chelation treatment for iron overload had undergone FerriScan and R2* MRI during the same exam.
Field Strength/Sequence:
Field strength was 1.5 T. Pulse sequences included 2D multi-slice spin-echo for FerriScan, and 3D 5-echo gradient echo for R2* mapping.
Assessment:
LIC was calculated for both non- and truncated R2* fits using a previously-derived calibration curve. The resulting LIC values were compared to those from the reference FerriScan technique. Precision was also assessed for LIC estimates.
Statistical Tests:
LIC values were compared using a Wilcoxon signed rank test. Statistical significance was set at the 95 % confidence level.
Results:
LIC estimates from truncated R2* fits were equal to FerriScan at all LIC values, while those from non-truncated fits deviated for LIC > 28 mg Fe / g dw liver. The precision of the truncated fits was better than the non-truncated fits.
Data Conclusion:
The truncation R2*-fitting method developed in this study permits accurate characterization of LIC over the full range of LICs characterized by FerriScan.
