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Erkal Tonkaz D, Ozpar R, Tonkaz M, Yazici Z. Efficacy of fat quantification methods used in MRI to distinguish between normal, benign, and malignant bone marrow pathologies in children. Acta Radiol 2024:2841851241247110. [PMID: 38659300 DOI: 10.1177/02841851241247110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
BACKGROUND Fat quantification methods in magnetic resonance imaging (MRI) have been studied to differentiate bone marrow pathologies in adult patients; however, scarce literature is available in pediatric patients. PURPOSE To evaluate the efficacy of the T1 signal intensity value (T1-SIV), out-of-phase/in-phase signal ratio (OP/IP SR), and fat fraction (FF) to differentiate between normal, benign, and malignant pathological processes. MATERIAL AND METHODS A total of 48 pediatric patients with lumbar and pelvic MRI were classified into three groups according to bone marrow pathology (group 1, normal; group 2, benign pathology/reconversion; group 3, malignant). The efficacy of T1-SIV, OP/IP SR, and FF values in differentiating these pathologies was evaluated using Kruskal-Wallis or analysis of variance and followed by Bonferroni or Dunn-Bonferroni tests. Cutoff values for malignant infiltration were defined using ROC analysis. RESULTS Although these values were significantly different in all three groups (P = 0.001-0.008), this difference was not sufficient to discriminate between all groups. Subgroup analyses showed significant differences in T1-SIV between groups 1-3, in OP/IP SR between groups 1-3, 2-3, and 1-2, in FF between groups 1-2 and 1-3 in various regions (P = 0.001-0.049). Cutoff values had a sensitivity and specificity of 90%-100% for OP/IP SR and FF. CONCLUSION T1-SIV, OP/IP SR, and FF may potentially distinguish normal from pathological bone marrow. OP/IP SR and FF values detected malignant infiltration with high sensitivity and specificity in this study. However, only OP/IP SR may significantly differentiate benign and malignant bone marrow pathologies which needs to be confirmed in the future study with a larger patient population.
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Affiliation(s)
| | - Rifat Ozpar
- Department of Radiology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Mehmet Tonkaz
- Department of Radiology, Gumushane State Hospital, Gumushane, Turkey
| | - Zeynep Yazici
- Department of Radiology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
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Huang M, Zhang F, Li Z, Luo Y, Li J, Wang Z, Ma L, Chen G, Hu X. Fat fraction quantification with MRI estimates tumor proliferation of hepatocellular carcinoma. Front Oncol 2024; 14:1367907. [PMID: 38665944 PMCID: PMC11044697 DOI: 10.3389/fonc.2024.1367907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Purpose To assess the utility of fat fraction quantification using quantitative multi-echo Dixon for evaluating tumor proliferation and microvascular invasion (MVI) in hepatocellular carcinoma (HCC). Methods A total of 66 patients with resection and histopathologic confirmed HCC were enrolled. Preoperative MRI with proton density fat fraction and R2* mapping was analyzed. Intratumoral and peritumoral regions were delineated with manually placed regions of interest at the maximum level of intratumoral fat. Correlation analysis explored the relationship between fat fraction and Ki67. The fat fraction and R2* were compared between high Ki67(>30%) and low Ki67 nodules, and between MVI negative and positive groups. Receiver operating characteristic (ROC) analysis was used for further analysis if statistically different. Results The median fat fraction of tumor (tFF) was higher than peritumor liver (5.24% vs 3.51%, P=0.012). The tFF was negatively correlated with Ki67 (r=-0.306, P=0.012), and tFF of high Ki67 nodules was lower than that of low Ki67 nodules (2.10% vs 4.90%, P=0.001). The tFF was a good estimator for low proliferation nodules (AUC 0.747, cut-off 3.39%, sensitivity 0.778, specificity 0.692). There was no significant difference in tFF and R2* between MVI positive and negative nodules (3.00% vs 2.90%, P=0.784; 55.80s-1 vs 49.15s-1, P=0.227). Conclusion We infer that intratumor fat can be identified in HCC and fat fraction quantification using quantitative multi-echo Dixon can distinguish low proliferative HCCs.
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Affiliation(s)
| | | | | | | | | | | | | | - Gen Chen
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xuemei Hu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Zhao F, Chen Y, Zhou T, Tang C, Huang J, Zhang H, Kannengiesser S, Long L. Application of the magnetic resonance 3D multiecho Dixon sequence for quantifying hepatic iron overload and steatosis in patients with thalassemia. Magn Reson Imaging 2024; 111:28-34. [PMID: 38492786 DOI: 10.1016/j.mri.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/02/2024] [Accepted: 03/13/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE To investigate the feasibility and diagnostic efficacy of a 3D multiecho Dixon (qDixon) research application for simultaneously quantifying the liver iron concentration (LIC) and steatosis in thalassemia patients. MATERIALS AND METHODS This prospective study enrolled participants with thalassemia who underwent 3 T MRI of the liver for the evaluation of hepatic iron overload. The imaging protocol including qDixon and conventional T2* mapping based on 2D multiecho gradient echo (ME GRE) sequences respectively. Regions of interest (ROIs) were drawn in the liver on the qDixon maps to obtain R2* and proton density fat fraction (PDFF). The reference R2* value was measured and calculated on conventional T2* mapping using the CMRtools software. Correlation analysis, Linear regression analysis, and Bland-Altman analysis were performed. RESULTS 84 patients were finally included in this study. The median R2*-ME-GRE was 366.97 (1/s), range [206.68 (1/s), 522.20 (1/s)]. 8 patients had normal hepatic iron deposition, 16 had Insignificant, 42 had mild, 18 had moderate. The median of R2*-qDixon was 376.88 (1/s) [219.33 (1/s), 491.75 (1/s)]. A strong correlation was found between the liver R2*-qDixon and the R2*-ME-GRE (r = 0.959, P < 0.001). The median value of PDFF was 1.76% (1.10%, 2.95%). 8 patients had mild fatty liver, and 1 had severe fatty liver. CONCLUSION MR qDixon research sequence can rapidly and accurately quantify liver iron overload, that highly consistent with the measured via conventional GRE sequence, and it can also simultaneously detect hepatic steatosis, this has great potential for clinical evaluation of thalassemia patients.
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Affiliation(s)
- Fanyu Zhao
- Department of Radiology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530001, China
| | - Yidi Chen
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Ting Zhou
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530001, China
| | - Cheng Tang
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530001, China
| | - Jiang Huang
- Department of Radiology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530001, China
| | - Huiting Zhang
- MR Research Collaboration, Siemens Healthineers Ltd., Wuhan, China.
| | | | - Liling Long
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530001, China.
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Haueise T, Schick F, Stefan N, Machann J. Comparison of the accuracy of commercial two-point and multi-echo Dixon MRI for quantification of fat in liver, paravertebral muscles, and vertebral bone marrow. Eur J Radiol 2024; 172:111359. [PMID: 38325186 DOI: 10.1016/j.ejrad.2024.111359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE Excess fat accumulation contributes significantly to metabolic dysfunction and diseases. This study aims to systematically compare the accuracy of commercially available Dixon techniques for quantification of fat fraction in liver, skeletal musculature, and vertebral bone marrow (BM) of healthy individuals, investigating biases and sex-specific influences. METHOD 100 healthy White individuals (50 women) underwent abdominal MRI using two-point and multi-echo Dixon sequences. Fat fraction (FF), proton density fat fraction (PDFF) and T2* values were calculated for liver, paravertebral muscles (PVM) and vertebral BM (Th8-L5). Agreement and systematic deviations were assessed using linear correlation and Bland-Altman plots. RESULTS High correlations between FF and PDFF were observed in liver (r = 0.98 for women; r = 0.96 for men), PVM (r = 0.92 for women; r = 0.93 for men) and BM (r = 0.97 for women; r = 0.95 for men). Relative deviations between FF and PDFF in liver (18.92 % for women; 13.32 % for men) and PVM (1.96 % for women; 11.62 % for men) were not significant. Relative deviations in BM were significant (38.13 % for women; 27.62 % for men). Bias correction using linear models reduced discrepancies. T2* times were significantly shorter in BM (8.72 ms for women; 7.26 ms for men) compared to PVM (13.45 ms for women; 13.62 ms for men) and liver (29.47 ms for women; 26.35 ms for men). CONCLUSION While no significant differences were observed for liver and PVM, systematic errors in BM FF estimation using two-point Dixon imaging were observed. These discrepancies - mainly resulting from organ-specific T2* times - have to be considered when applying two-point Dixon approaches for assessment of fat content. As suitable correction tools, linear models could provide added value in large-scale epidemiological cohort studies. Sex-specific differences in T2* should be considered.
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Affiliation(s)
- Tobias Haueise
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany
| | - Fritz Schick
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany; Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Norbert Stefan
- German Center for Diabetes Research (DZD), Tübingen, Germany; Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany; Department of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Tübingen, Germany
| | - Jürgen Machann
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany; Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany.
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Song S, Kim H, Choi JI, Kim DH, Kim B, Lee H, Lee J. Validity of an automated screening Dixon technique for quantifying hepatic steatosis in living liver donors. Abdom Radiol (NY) 2024; 49:406-413. [PMID: 37801142 DOI: 10.1007/s00261-023-04009-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE This retrospective study aimed to evaluate the validity of an automated screening Dixon (e-DIXON) technique for quantifying hepatic steatosis in living liver-donor patients by comparison with magnetic resonance spectroscopy (MRS) as a reference standard. METHODS A total of 285 living liver-donor candidates were examined with the e-DIXON technique and single-voxel MRS to assess hepatic steatosis and iron deposition between January 2014 and February 2019. The sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of the e-DIXON technique for hepatic steatosis were calculated. The mean fat signal fractions obtained in MRS were compared between the donors diagnosed with hepatic steatosis and the normal group. The mean R2 values of donors with or without hepatic siderosis also were compared. RESULTS The e-DIXON technique diagnosed normal in 133 (47%), fat in 124 (44%), iron in one (0.4%), and a combination of both fat and iron in 27 (10%) donors. The sensitivity, specificity, PPV, and NPV for diagnosing hepatic steatosis were 94%, 70%, 64%, and 96%, respectively. There was a significant difference in the mean fat signal fraction obtained in MRS between the steatosis and normal groups (p < 0.001), but R2 values were not significantly different between siderosis and normal groups (p = 0.11). The e-DIXON technique showed a strong correlation with MRS in fat measurement (r2 = 0.92, p < 0.001). CONCLUSION The e-DIXON technique reliably screens for hepatic steatosis but may not accurate for detecting hepatic iron deposition.
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Affiliation(s)
- Sangkeun Song
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Hokun Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
| | - Joon-Il Choi
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
- Cancer Research Institute, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, Republic of Korea
| | - Dong Hwan Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Bohyun Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Hyunsoo Lee
- Siemens Healthineers Ltd, Seoul, Republic of Korea
| | - Jiwon Lee
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea
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Kupczyk PA, Kurt D, Endler C, Luetkens JA, Kukuk GM, Fronhoffs F, Fischer HP, Attenberger UI, Pieper CC. MRI proton density fat fraction for estimation of tumor grade in steatotic hepatocellular carcinoma. Eur Radiol 2023; 33:8974-8985. [PMID: 37368108 PMCID: PMC10667464 DOI: 10.1007/s00330-023-09864-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/03/2023] [Accepted: 05/15/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVES Image-based detection of intralesional fat in focal liver lesions has been established in diagnostic guidelines as a feature indicative of hepatocellular carcinoma (HCC) and associated with a favorable prognosis. Given recent advances in MRI-based fat quantification techniques, we investigated a possible relationship between intralesional fat content and histologic tumor grade in steatotic HCCs. METHODS Patients with histopathologically confirmed HCC and prior MRI with proton density fat fraction (PDFF) mapping were retrospectively identified. Intralesional fat of HCCs was assessed using an ROI-based analysis and the median fat fraction of steatotic HCCs was compared between tumor grades G1-3 with non-parametric testing. ROC analysis was performed in case of statistically significant differences (p < 0.05). Subgroup analyses were conducted for patients with/without liver steatosis and with/without liver cirrhosis. RESULTS A total of 57 patients with steatotic HCCs (62 lesions) were eligible for analysis. The median fat fraction was significantly higher for G1 lesions (median [interquartile range], 7.9% [6.0─10.7%]) than for G2 (4.4% [3.2─6.6%]; p = .001) and G3 lesions (4.7% [2.8─7.8%]; p = .036). PDFF was a good discriminator between G1 and G2/3 lesions (AUC .81; cut-off 5.8%, sensitivity 83%, specificity 68%) with comparable results in patients with liver cirrhosis. In patients with liver steatosis, intralesional fat content was higher than in the overall sample, with PDFF performing better in distinguishing between G1 and G2/3 lesions (AUC .92; cut-off 8.8%, sensitivity 83%, specificity 91%). CONCLUSIONS Quantification of intralesional fat using MRI PDFF mapping allows distinction between well- and less-differentiated steatotic HCCs. CLINICAL RELEVANCE PDFF mapping may help optimize precision medicine as a tool for tumor grade assessment in steatotic HCCs. Further investigation of intratumoral fat content as a potential prognostic indicator of treatment response is encouraged. KEY POINTS • MRI proton density fat fraction mapping enables distinction between well- (G1) and less- (G2 and G3) differentiated steatotic hepatocellular carcinomas. • In a retrospective single-center study with 62 histologically proven steatotic hepatocellular carcinomas, G1 tumors showed a higher intralesional fat content than G2 and G3 tumors (7.9% vs. 4.4% and 4.7%; p = .004). • In liver steatosis, MRI proton density fat fraction mapping was an even better discriminator between G1 and G2/G3 steatotic hepatocellular carcinomas.
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Affiliation(s)
- Patrick Arthur Kupczyk
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
- Quantitative Imaging Lab Bonn (QILaB), Bonn, Germany.
| | - Darius Kurt
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Christoph Endler
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- Quantitative Imaging Lab Bonn (QILaB), Bonn, Germany
| | - Julian Alexander Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- Quantitative Imaging Lab Bonn (QILaB), Bonn, Germany
| | - Guido Matthias Kukuk
- Department of Radiology, Kantonsspital Graubünden, Loestrasse 170, 7000, Chur, Switzerland
| | - Florian Fronhoffs
- Institute of Pathology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Hans-Peter Fischer
- Institute of Pathology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Ulrike Irmgard Attenberger
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Claus Christian Pieper
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
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Kimita W, Ko J, Petrov MS. Relationship of Iron Intake, Ferritin, and Hepcidin with the Transverse Relaxation Rate of Water Protons in the Pancreas. Nutrients 2023; 15:3727. [PMID: 37686761 PMCID: PMC10490090 DOI: 10.3390/nu15173727] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/13/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
(1) Background: There is a paucity of markers of iron metabolism in health and disease. The aim was to investigate the associations of iron metabolism with pancreas transverse water proton relaxation rate (R2water) in healthy individuals and people after an attack of pancreatitis. (2) Methods: All participants underwent a 3.0 T magnetic resonance imaging of the abdomen on the same scanner. High-speed T2-corrected multi-echo (HISTO) acquisition at single-voxel magnetic resonance spectroscopy and inline processing were used to quantify pancreas R2water. Habitual dietary intake of iron was determined using the EPIC-Norfolk food frequency questionnaire. Circulating levels of ferritin and hepcidin were measured. Generalised additive models were used, adjusting for age, sex, body mass index, and haemoglobin A1c. (3) Results: A total of 139 individuals (47 healthy individuals, 54 individuals after acute pancreatitis, and 38 individuals after chronic pancreatitis) were included. Total dietary intake of iron was significantly associated with pancreas R2water, consistently in healthy individuals (p < 0.001), individuals after acute pancreatitis (p < 0.001), and individuals after chronic pancreatitis (p < 0.001) across all the statistical models. Ferritin was significantly associated with pancreas R2water, consistently in healthy individuals (p < 0.001), individuals after acute pancreatitis (p < 0.001), and individuals after chronic pancreatitis (p = 0.01) across all adjusted models. Hepcidin was significantly associated with pancreas R2water in individuals after acute pancreatitis (p < 0.001) and individuals after chronic pancreatitis (p = 0.04) in the most adjusted model. (4) Conclusions: Pancreas R2water, corrected for T2, is related to iron metabolism in both health and pancreatitis. This non-invasive marker could be used for automated in vivo identification of intra-pancreatic iron deposition.
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Affiliation(s)
| | | | - Maxim S. Petrov
- School of Medicine, University of Auckland, Auckland 1142, New Zealand
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Zhang J, Liu K, Sun Y, Yu J. Magnetic resonance spectroscopy for quantification of liver iron deposition in hereditary hemochromatosis of a Chinese family: Four case reports. Medicine (Baltimore) 2022; 101:e31742. [PMID: 36401425 PMCID: PMC9678622 DOI: 10.1097/md.0000000000031742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
RATIONALE Hereditary hemochromatosis (HH) is a major cause of liver iron overload. The gold standard for the diagnosis of liver iron overload is the histopathological analysis of a liver sample collected by biopsy. The biopsy procedure is both invasive and painful and carries some risks of complications. The multi-echo single-voxel magnetic resonance spectroscopy (HISTO) technique can be used for noninvasive, quantitative assessment of liver iron overload. PATIENT CONCERNS We report 4 Chinese Han men, who were relatives. Patient A was admitted with diabetes and presented with thrombocytopenia and skin hyperpigmentation. The other patients had no specific clinical presentation. DIAGNOSES Patient A was suspected of having iron in the liver on routine magnetic resonance imaging, therefore, further HISTO, laboratory testing, and liver biopsy were performed, which confirmed iron metabolic abnormalities. Furthermore, we identified hepatic iron deposition using HISTO and laboratory testing of his son and 2 brothers. Combined with symptoms, auxiliary examinations, and liver biopsy, HH was considered. INTERVENTIONS As the 4 patients had no other discomfort other than patient A who had diabetes, patient A was placed on therapy comprising the insulin pump, acarbose, and platelet booster capsule. OUTCOMES After treatment, the diabetic symptoms of patient A improved. The patient and his relatives were regularly followed-up for HH. LESSONS HH should be considered when hepatic iron deposition is suspected by routine magnetic resonance, as the HISTO sequence can quantitate liver iron deposition and leads to a promising diagnosis. HISTO is of great value in familial cases, especially in young patients requiring long-term follow-up.
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Affiliation(s)
- Jing Zhang
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Kefu Liu
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
- * Correspondence: Kefu Liu, Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, No.242, GuangJi Road, Suzhou, Jiangsu 215008, China (e-mail: )
| | - Yan Sun
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Jiafeng Yu
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
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卞 京, 陈 平, 卞 读, 贺 晓, Mutamba AK, 王 涛. [Correlation of Lipin gene expression with hepatic fat content in rats with intrauterine growth retardation]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:440-446. [PMID: 35527422 PMCID: PMC9044995 DOI: 10.7499/j.issn.1008-8830.2110130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/01/2022] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To study the correlation of the expression of Lipin1 in visceral adipose tissue and Lipin2 in liver tissue with hepatic fat content in rats with intrauterine growth retardation (IUGR). METHODS Pregnant rats were given a low-protein (10% protein) diet during pregnancy to establish a model of IUGR in neonatal rats. The pregnant rats in the control group were given a normal-protein (21% protein) diet during pregnancy. The neonatal rats were weighed and liver tissue was collected on day 1 and at weeks 3, 8, and 12 after birth, and visceral adipose tissue was collected at weeks 3, 8, and 12 after birth. The 3.0T 1H-magnetic resonance spectroscopy was used to measure hepatic fat content at weeks 3, 8, and 12 after birth. Real-time PCR was used to measure mRNA expression levels of Lipin2 in liver tissue and Lipin1 in visceral adipose tissue. Western blot was used to measure protein levels of Lipin2 in liver tissue and Lipin1 in visceral adipose tissue. A Pearson correlation analysis was performed to investigate the correlation of mRNA and protein expression of Lipin with hepatic fat content. RESULTS The IUGR group had significantly higher mRNA and protein expression levels of Lipin1 in visceral adipose tissue than the control group at weeks 3, 8, and 12 after birth (P<0.05). Compared with the control group, the IUGR group had significantly lower mRNA and protein expression levels of Lipin2 in liver tissue on day 1 after birth and significantly higher mRNA and protein expression levels of Lipin2 at weeks 1, 3, 8, and 12 after birth (P<0.05). At week 3 after birth, there was no significant difference in hepatic fat content between the IUGR and control groups (P>0.05), while at weeks 8 and 12 after birth, the IUGR group had a significantly higher hepatic fat content than the control group (P<0.05). The protein and mRNA expression levels of Lipin1 were positively correlated with hepatic fat content (r=0.628 and 0.521 respectively; P<0.05), and the protein and mRNA expression levels of Lipin2 were also positively correlated with hepatic fat content (r=0.601 and 0.524 respectively; P<0.05). CONCLUSIONS Upregulation of the mRNA and protein expression levels of Lipin1 in visceral adipose tissue and Lipin2 in liver tissue can increase hepatic fat content in rats with IUGR and may be associated with obesity in adulthood.
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Affiliation(s)
| | - 平洋 陈
- 中南大学湘雅二医院儿童医学中心新生儿专科, 湖南长沙 410011
| | | | - 晓日 贺
- 中南大学湘雅二医院儿童医学中心新生儿专科, 湖南长沙 410011
| | | | - 涛 王
- 中南大学湘雅二医院儿童医学中心新生儿专科, 湖南长沙 410011
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Trueb P, Getzmann JM, Ried E, Deininger-Czermak E, Garcia Schueler HI, Guggenberger R. Comparison of Muscle Fat Fraction Measurements in the Lower Spine Musculature with Non-Contrast-Enhanced CT and Different MR Imaging Sequences. Eur J Radiol 2022; 150:110260. [DOI: 10.1016/j.ejrad.2022.110260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 11/26/2022]
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Machann J, Hasenbalg M, Dienes J, Wagner R, Sandforth A, Fritz V, Birkenfeld AL, Nikolaou K, Kullmann S, Schick F, Heni M. Short‐Term Variability of Proton Density Fat Fraction in Pancreas and Liver Assessed by Multiecho Chemical‐Shift Encoding‐Based
MRI
at 3 T. J Magn Reson Imaging 2022; 56:1018-1026. [DOI: 10.1002/jmri.28084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 12/14/2022] Open
Affiliation(s)
- Jürgen Machann
- Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology University Hospital Tübingen Germany
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen Tübingen Germany
- German Center for Diabetes Research (DZD) Neuherberg Germany
| | - Maytee Hasenbalg
- Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology University Hospital Tübingen Germany
| | - Julia Dienes
- Department of Obstetrics and Gynecology University of Tübingen Tübingen Germany
| | - Robert Wagner
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen Tübingen Germany
- German Center for Diabetes Research (DZD) Neuherberg Germany
- Department of Diabetology, Endocrinology and Nephrology University Hospital Tübingen Germany
| | - Arvid Sandforth
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen Tübingen Germany
- German Center for Diabetes Research (DZD) Neuherberg Germany
- Department of Diabetology, Endocrinology and Nephrology University Hospital Tübingen Germany
| | - Victor Fritz
- Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology University Hospital Tübingen Germany
| | - Andreas L. Birkenfeld
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen Tübingen Germany
- German Center for Diabetes Research (DZD) Neuherberg Germany
- Department of Diabetology, Endocrinology and Nephrology University Hospital Tübingen Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology University Hospital Tübingen Germany
| | - Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen Tübingen Germany
- German Center for Diabetes Research (DZD) Neuherberg Germany
- Department of Diabetology, Endocrinology and Nephrology University Hospital Tübingen Germany
| | - Fritz Schick
- Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology University Hospital Tübingen Germany
| | - Martin Heni
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen Tübingen Germany
- German Center for Diabetes Research (DZD) Neuherberg Germany
- Department of Diabetology, Endocrinology and Nephrology University Hospital Tübingen Germany
- Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine University Hospital Tübingen Tübingen Germany
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12
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Zhao F, Chen Y, Zhang H, Li C, Long L. Multi-echo Dixon and breath-hold T2-corrected multi-echo single-voxel MRS for quantifying hepatic iron overload in rabbits. Acta Radiol 2021; 64:13-19. [PMID: 34904894 DOI: 10.1177/02841851211063007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Three-dimensional (3D) multi-echo-Dixon (ME-Dixon) and breath-hold T2-corrected multi-echo single-voxel MR spectroscopy (HISTO) can simultaneously quantify liver fat and liver iron. However, their diagnostic efficacy and application scope for quantitative iron in co-existing fatty liver have not been adequately evaluated. PURPOSE To evaluate the accuracy of ME-Dixon and HISTO for quantitative analysis of hepatic iron in rabbits with iron deposition and fatty liver using liver-iron concentration (LIC) as a reference standard. MATERIAL AND METHODS ME-Dixon, HISTO, and conventional two-dimensional multi-echo gradient echo (GRE) sequences were performed on 42 rabbits. The following parameters were calculated: R2* from ME-Dixon and GRE; proton density fat fraction (PDFF) from the ME-Dixon, HISTO (normal TE range), and HISTO-H (extended TE range); and R2_water from HISTO and HISTO-H. The LIC and liver-fat concentration (LFC) were measured through chemical analysis, and their relationship with the MRI parameters were assessed. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to evaluate the diagnostic efficiency. RESULTS LIC was significantly correlated with R2_HISTO-H, R2*_Dixon, and R2*_GRE (r = 0.858, 0.910, 0.931, respectively; P < 0.001) and weakly with R2_HISTO (r = 0.424; P = 0.008). A strong correlation was also observed between the LFC and PDFF obtained from HISTO, HISTO-H, and ME-Dixon (r = 0.776, 0.811, 0.888, respectively; P < 0.001). ME-Dixon showed the best performance with moderate iron overload (AUC = 0.983). CONCLUSION 3D ME-Dixon is useful for quantifying the LIC, especially with co-existing fatty liver. Its diagnostic performance is also superior to that of the HISTO sequence.
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Affiliation(s)
- Fanyu Zhao
- Radiology Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, PR China
| | - Yidi Chen
- Radiology Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, PR China
| | - Huiting Zhang
- MR Scientific Marketing, Siemens Healthcare Ltd, Wuhan, PR China
| | - Chenhui Li
- Radiology Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, PR China
| | - Liling Long
- Radiology Department, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, PR China
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13
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Schick F, Pieper CC, Kupczyk P, Almansour H, Keller G, Springer F, Mürtz P, Endler C, Sprinkart AM, Kaufmann S, Herrmann J, Attenberger UI. 1.5 vs 3 Tesla Magnetic Resonance Imaging: A Review of Favorite Clinical Applications for Both Field Strengths-Part 1. Invest Radiol 2021; 56:680-691. [PMID: 34324464 DOI: 10.1097/rli.0000000000000812] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
ABSTRACT Whole-body magnetic resonance imaging (MRI) systems with a field strength of 3 T have been offered by all leading manufacturers for approximately 2 decades and are increasingly used in clinical diagnostics despite higher costs. Technologically, MRI systems operating at 3 T have reached a high standard in recent years, as well as the 1.5-T devices that have been in use for a longer time. For modern MRI systems with 3 T, more complexity is required, especially for the magnet and the radiofrequency (RF) system (with multichannel transmission). Many clinical applications benefit greatly from the higher field strength due to the higher signal yield (eg, imaging of the brain or extremities), but there are also applications where the disadvantages of 3 T might outweigh the advantages (eg, lung imaging or examinations in the presence of implants). This review describes some technical features of modern 1.5-T and 3-T whole-body MRI systems, and reports on the experience of using both types of devices in different clinical settings, with all sections written by specialist radiologists in the respective fields.This first part of the review includes an overview of the general physicotechnical aspects of both field strengths and elaborates the special conditions of diffusion imaging. Many relevant aspects in the application areas of musculoskeletal imaging, abdominal imaging, and prostate diagnostics are discussed.
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Affiliation(s)
- Fritz Schick
- From the Section of Experimental Radiology, Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen
| | | | - Patrick Kupczyk
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Haidara Almansour
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Gabriel Keller
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Fabian Springer
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Petra Mürtz
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Christoph Endler
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Alois M Sprinkart
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Sascha Kaufmann
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Judith Herrmann
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Ulrike I Attenberger
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
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14
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Pasanta D, Htun KT, Pan J, Tungjai M, Kaewjaeng S, Kim H, Kaewkhao J, Kothan S. Magnetic Resonance Spectroscopy of Hepatic Fat from Fundamental to Clinical Applications. Diagnostics (Basel) 2021; 11:diagnostics11050842. [PMID: 34067193 PMCID: PMC8151733 DOI: 10.3390/diagnostics11050842] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 04/29/2021] [Accepted: 05/06/2021] [Indexed: 02/06/2023] Open
Abstract
The number of individuals suffering from fatty liver is increasing worldwide, leading to interest in the noninvasive study of liver fat. Magnetic resonance spectroscopy (MRS) is a powerful tool that allows direct quantification of metabolites in tissue or areas of interest. MRS has been applied in both research and clinical studies to assess liver fat noninvasively in vivo. MRS has also demonstrated excellent performance in liver fat assessment with high sensitivity and specificity compared to biopsy and other imaging modalities. Because of these qualities, MRS has been generally accepted as the reference standard for the noninvasive measurement of liver steatosis. MRS is an evolving technique with high potential as a diagnostic tool in the clinical setting. This review aims to provide a brief overview of the MRS principle for liver fat assessment and its application, and to summarize the current state of MRS study in comparison to other techniques.
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Affiliation(s)
- Duanghathai Pasanta
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (D.P.); (K.T.H.); (J.P.); (M.T.); (S.K.)
| | - Khin Thandar Htun
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (D.P.); (K.T.H.); (J.P.); (M.T.); (S.K.)
| | - Jie Pan
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (D.P.); (K.T.H.); (J.P.); (M.T.); (S.K.)
- Shandong Provincial Key Laboratory of Animal Resistant Biology, College of Life Sciences, Shandong Normal University, Jinan 250014, China
| | - Montree Tungjai
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (D.P.); (K.T.H.); (J.P.); (M.T.); (S.K.)
| | - Siriprapa Kaewjaeng
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (D.P.); (K.T.H.); (J.P.); (M.T.); (S.K.)
| | - Hongjoo Kim
- Department of Physics, Kyungpook National University, Daegu 41566, Korea;
| | - Jakrapong Kaewkhao
- Center of Excellence in Glass Technology and Materials Science (CEGM), Nakhon Pathom Rajabhat University, Nakhon Pathom 73000, Thailand;
| | - Suchart Kothan
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (D.P.); (K.T.H.); (J.P.); (M.T.); (S.K.)
- Correspondence: ; Tel.: +66-5394-9213
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15
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Henninger B, Plaikner M, Zoller H, Viveiros A, Kannengiesser S, Jaschke W, Kremser C. Performance of different Dixon-based methods for MR liver iron assessment in comparison to a biopsy-validated R2* relaxometry method. Eur Radiol 2020; 31:2252-2262. [PMID: 32965571 PMCID: PMC7979591 DOI: 10.1007/s00330-020-07291-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/14/2020] [Accepted: 09/14/2020] [Indexed: 01/19/2023]
Abstract
Objectives To prospectively evaluate a 3D-multiecho-Dixon sequence with inline calculation of proton density fat fraction (PDFF) and R2* (qDixon), and an improved version of it (qDixon-WIP), for the MR-quantification of hepatic iron in a clinical setting. Methods Patients with increased serum ferritin underwent 1.5-T MRI of the liver for the evaluation of hepatic iron overload. The imaging protocol for R2* quantification included as follows: (1) a validated, 2D multigradient-echo sequence (initial TE 0.99 ms, R2*-ME-GRE), (2) a 3D-multiecho-Dixon sequence with inline calculation of PDFF and R2* (initial TE 2.38 ms, R2*-qDixon), and optionally (3) a prototype (works-in-progress, WIP) version of the latter (initial TE 1.04 ms, R2*-qDixon-WIP) with improved water/fat separation and noise-corrected parameter fitting. For all sequences, three manually co-registered regions of interest (ROIs) were placed in the liver. R2* values were compared and linear regression analysis and Bland-Altman plots calculated. Results Forty-six out of 415 patients showed fat-water (F/W) swap with qDixon and were excluded. A total of 369 patients (mean age 52 years) were included; in 203/369, the optional qDixon-WIP was acquired, which showed no F/W swaps. A strong correlation was found between R2*-ME-GRE and R2*-qDixon (r2 = 0.92, p < 0.001) with Bland-Altman revealing a mean difference of − 3.82 1/s (SD = 21.26 1/s). Correlation between R2*-GRE-ME and R2*-qDixon-WIP was r2 = 0.95 (p < 0.001) with Bland-Altman showing a mean difference of − 0.125 1/s (SD = 30.667 1/s). Conclusions The 3D-multiecho-Dixon sequence is a reliable tool to quantify hepatic iron. Results are comparable with established relaxometry methods. Improvements to the original implementation eliminate occasional F/W swaps and limitations regarding maximum R2* values. Key Points • The 3D-multiecho-Dixon sequence for 1.5 T is a reliable tool to quantify hepatic iron. • Results of the 3D-multiecho-Dixon sequence are comparable with established relaxometry methods. • An improved version of the 3D-multiecho-Dixon sequence eliminates minor drawbacks.
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Affiliation(s)
- Benjamin Henninger
- Department of Radiology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Michaela Plaikner
- Department of Radiology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
| | - Heinz Zoller
- Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - André Viveiros
- Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Werner Jaschke
- Department of Radiology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Christian Kremser
- Department of Radiology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
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Chen H, Zeng WK, Shi GZ, Gao M, Wang MZ, Shen J. Liver fat accumulation measured by high-speed T2-corrected multi-echo magnetic resonance spectroscopy can predict risk of cholelithiasis. World J Gastroenterol 2020; 26:4996-5007. [PMID: 32952345 PMCID: PMC7476179 DOI: 10.3748/wjg.v26.i33.4996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/14/2020] [Accepted: 08/01/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Liver fat accumulation is associated with increased cholesterol synthesis and hypersecretion of biliary cholesterol, which may be related to the development of cholelithiasis.
AIM To investigate whether liver fat accumulation measured by high-speed T2-corrected multi-echo magnetic resonance spectroscopy (MRS) is a risk factor for cholelithiasis.
METHODS Forty patients with cholelithiasis and thirty-one healthy controls were retrospectively enrolled. The participants underwent high-speed T2-corrected multi-echo single-voxel MRS of the liver at a 3T MR scanner. The proton density fat fraction (PDFF) and R2 value were calculated. Serum parameters and waist circumference (WC) were recorded. Spearman’s correlation analysis was used to analyze the relationship between PDFF, R2, and WC values. Multivariate logistic regression analysis was carried out to determine the significant predictors of the risk of cholelithiasis. Receiver operating characteristic curve (ROC) analysis was used to evaluate the discriminative performance of significant predictors.
RESULTS Patients with cholelithiasis had higher PDFF, R2, and WC values compared with healthy controls (5.8% ± 4.2% vs 3.3% ± 2.4%, P = 0.001; 50.4 ± 24.8/s vs 38.3 ± 8.8/s, P = 0.034; 85.3 ± 9.0 cm vs 81.0 ± 6.9 cm, P = 0.030; respectively). Liver iron concentration extrapolated from R2 values was significantly higher in the cholelithiasis group (2.21 ± 2.17 mg/g dry tissue vs 1.22 ± 0.49 mg/g dry tissue, P = 0.034) than in the healthy group. PDFF was positively correlated with WC (r = 0.502, P < 0.001) and R2 (r = 0.425, P < 0.001). Multivariate logistic regression analysis showed that only PDFF was an independent risk factor for cholelithiasis (odds ratio = 1.79, 95%CI: 1.22-2.62, P = 0.003). ROC analysis showed that the area under the curve of PDFF was 0.723 for discriminating cholelithiasis from healthy controls, with a sensitivity of 55.0% and specificity of 83.9% when the cut-off value of PDFF was 4.4%.
CONCLUSION PDFF derived from high speed T2-corrected multi-echo MRS can predict the risk of cholelithiasis.
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Affiliation(s)
- Hong Chen
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China
| | - Wei-Ke Zeng
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China
| | - Guang-Zi Shi
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China
| | - Ming Gao
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China
| | - Meng-Zhu Wang
- Department of MR Scientific Marketing, Siemens Healthineers, Guangzhou 510120, Guangdong Province, China
| | - Jun Shen
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China
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17
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Abstract
There are >1.5 billion people with chronic liver disease worldwide, causing liver diseases to be a significant global health issue. Diffuse parenchymal liver diseases, including hepatic steatosis, fibrosis, metabolic diseases, and hepatitis cause chronic liver injury and may progress to fibrosis and eventually hepatocellular carcinoma. As early diagnosis and treatment of these diseases impact the progression and outcome, the need for assessment of the liver parenchyma has increased. While the current gold standard for evaluation of the hepatic parenchymal tissue, biopsy has disadvantages and limitations. Consequently, noninvasive methods have been developed based on serum biomarkers and imaging techniques. Conventional imaging modalities such as ultrasound, computed tomography scan, and magnetic resonance imaging provide noninvasive options for assessment of liver tissue. However, several recent advances in liver imaging techniques have been introduced. This review article focuses on the current status of imaging methods for diffuse parenchymal liver diseases assessment including their diagnostic accuracy, advantages and disadvantages, and comparison between different techniques.
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18
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Schneider M, Benkert T, Solomon E, Nickel D, Fenchel M, Kiefer B, Maier A, Chandarana H, Block KT. Free-breathing fat and R 2 * quantification in the liver using a stack-of-stars multi-echo acquisition with respiratory-resolved model-based reconstruction. Magn Reson Med 2020; 84:2592-2605. [PMID: 32301168 PMCID: PMC7396291 DOI: 10.1002/mrm.28280] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 01/04/2023]
Abstract
Purpose To develop a free‐breathing hepatic fat and
R2∗ quantification method by extending a previously described stack‐of‐stars model‐based fat‐water separation technique with additional modeling of the transverse relaxation rate
R2∗. Methods The proposed technique combines motion‐robust radial sampling using a stack‐of‐stars bipolar multi‐echo 3D GRE acquisition with iterative model‐based fat‐water separation. Parallel‐Imaging and Compressed‐Sensing principles are incorporated through modeling of the coil‐sensitivity profiles and enforcement of total‐variation (TV) sparsity on estimated water, fat, and
R2∗ parameter maps. Water and fat signals are used to estimate the confounder‐corrected proton‐density fat fraction (PDFF). Two strategies for handling respiratory motion are described: motion‐averaged and motion‐resolved reconstruction. Both techniques were evaluated in patients (n = 14) undergoing a hepatobiliary research protocol at 3T. PDFF and
R2∗ parameter maps were compared to a breath‐holding Cartesian reference approach. Results Linear regression analyses demonstrated strong (r > 0.96) and significant (P ≪ .01) correlations between radial and Cartesian PDFF measurements for both the motion‐averaged reconstruction (slope: 0.90; intercept: 0.07%) and the motion‐resolved reconstruction (slope: 0.90; intercept: 0.11%). The motion‐averaged technique overestimated hepatic
R2∗ values (slope: 0.35; intercept: 30.2 1/s) compared to the Cartesian reference. However, performing a respiratory‐resolved reconstruction led to better
R2∗ value consistency (slope: 0.77; intercept: 7.5 1/s). Conclusions The proposed techniques are promising alternatives to conventional Cartesian imaging for fat and
R2∗ quantification in patients with limited breath‐holding capabilities. For accurate
R2∗ estimation, respiratory‐resolved reconstruction should be used.
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Affiliation(s)
- Manuel Schneider
- Pattern Recognition Lab, Department of Computer Science, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany.,MR Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Thomas Benkert
- MR Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Eddy Solomon
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Dominik Nickel
- MR Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Matthias Fenchel
- MR R&D Collaborations, Siemens Medical Solutions, New York, NY, USA
| | - Berthold Kiefer
- MR Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Andreas Maier
- Pattern Recognition Lab, Department of Computer Science, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany
| | - Hersh Chandarana
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Kai Tobias Block
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University School of Medicine, New York, NY, USA
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