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Hernando D, Zhao R, Yuan Q, Aliyari Ghasabeh M, Ruschke S, Miao X, Karampinos DC, Mao L, Harris DT, Mattison RJ, Jeng MR, Pedrosa I, Kamel IR, Vasanawala S, Yokoo T, Reeder SB. Multicenter Reproducibility of Liver Iron Quantification with 1.5-T and 3.0-T MRI. Radiology 2023; 306:e213256. [PMID: 36194113 PMCID: PMC9885339 DOI: 10.1148/radiol.213256] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 07/22/2022] [Accepted: 08/08/2022] [Indexed: 01/26/2023]
Abstract
Background MRI is a standard of care tool to measure liver iron concentration (LIC). Compared with regulatory-approved R2 MRI, R2* MRI has superior speed and is available in most MRI scanners; however, the cross-vendor reproducibility of R2*-based LIC estimation remains unknown. Purpose To evaluate the reproducibility of LIC via single-breath-hold R2* MRI at both 1.5 T and 3.0 T with use of a multicenter, multivendor study. Materials and Methods Four academic medical centers using MRI scanners from three different vendors (three 1.5-T scanners, one 2.89-T scanner, and two 3.0-T scanners) participated in this prospective cross-sectional study. Participants with known or suspected liver iron overload were recruited to undergo multiecho gradient-echo MRI for R2* mapping at 1.5 T and 3.0 T (2.89 T or 3.0 T) on the same day. R2* maps were reconstructed from the multiecho images and analyzed at a single center. Reference LIC measurements were obtained with a commercial R2 MRI method performed using standardized 1.5-T spin-echo imaging. R2*-versus-LIC calibrations were generated across centers and field strengths using linear regression and compared using F tests. Receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic performance of R2* MRI in the detection of clinically relevant LIC thresholds. Results A total of 207 participants (mean age, 38 years ± 20 [SD]; 117 male participants) were evaluated between March 2015 and September 2019. A linear relationship was confirmed between R2* and LIC. All calibrations within the same field strength were highly reproducible, showing no evidence of statistically significant center-specific differences (P > .43 across all comparisons). Calibrations for 1.5 T and 3.0 T were generated, as follows: for 1.5 T, LIC (in milligrams per gram [dry weight]) = -0.16 + 2.603 × 10-2 R2* (in seconds-1); for 2.89 T, LIC (in milligrams per gram) = -0.03 + 1.400 × 10-2 R2* (in seconds-1); for 3.0 T, LIC (in milligrams per gram) = -0.03 + 1.349 × 10-2 R2* (in seconds-1). Liver R2* had high diagnostic performance in the detection of clinically relevant LIC thresholds (area under the ROC curve, >0.98). Conclusion R2* MRI enabled accurate and reproducible quantification of liver iron overload over clinically relevant ranges of liver iron concentration (LIC). The data generated in this study provide the necessary calibrations for broad clinical dissemination of R2*-based LIC quantification. ClinicalTrials.gov registration no.: NCT02025543 © RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Diego Hernando
- From the Departments of Radiology (D.H., R.Z., D.T.H., S.B.R.),
Medical Physics (D.H., R.Z., S.B.R.), Statistics (X.M.), Biostatistics and
Medical Informatics (L.M.), Medicine (R.J.M.), Biomedical Engineering (S.B.R.),
Medicine (S.B.R.), and Emergency Medicine, University of
Wisconsin–Madison, 1111 Highland Ave, WIMR2, Room 2472, Madison, WI 53705
(S.B.R.); Department of Radiology (Q.Y., I.P., T.Y.) and Advanced Imaging
Research Center (I.P., T.Y.), University of Texas Southwestern Medical Center,
Dallas, Tex; Department of Radiology, The Johns Hopkins University, Baltimore,
Md (M.A.G., I.R.K.); Department of Diagnostic and Interventional Radiology,
School of Medicine, Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany (S.R., D.C.K.); and Departments of Pediatrics (M.R.J.) and
Radiology (S.V.), Stanford University, Palo Alto, Calif
| | - Ruiyang Zhao
- From the Departments of Radiology (D.H., R.Z., D.T.H., S.B.R.),
Medical Physics (D.H., R.Z., S.B.R.), Statistics (X.M.), Biostatistics and
Medical Informatics (L.M.), Medicine (R.J.M.), Biomedical Engineering (S.B.R.),
Medicine (S.B.R.), and Emergency Medicine, University of
Wisconsin–Madison, 1111 Highland Ave, WIMR2, Room 2472, Madison, WI 53705
(S.B.R.); Department of Radiology (Q.Y., I.P., T.Y.) and Advanced Imaging
Research Center (I.P., T.Y.), University of Texas Southwestern Medical Center,
Dallas, Tex; Department of Radiology, The Johns Hopkins University, Baltimore,
Md (M.A.G., I.R.K.); Department of Diagnostic and Interventional Radiology,
School of Medicine, Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany (S.R., D.C.K.); and Departments of Pediatrics (M.R.J.) and
Radiology (S.V.), Stanford University, Palo Alto, Calif
| | - Qing Yuan
- From the Departments of Radiology (D.H., R.Z., D.T.H., S.B.R.),
Medical Physics (D.H., R.Z., S.B.R.), Statistics (X.M.), Biostatistics and
Medical Informatics (L.M.), Medicine (R.J.M.), Biomedical Engineering (S.B.R.),
Medicine (S.B.R.), and Emergency Medicine, University of
Wisconsin–Madison, 1111 Highland Ave, WIMR2, Room 2472, Madison, WI 53705
(S.B.R.); Department of Radiology (Q.Y., I.P., T.Y.) and Advanced Imaging
Research Center (I.P., T.Y.), University of Texas Southwestern Medical Center,
Dallas, Tex; Department of Radiology, The Johns Hopkins University, Baltimore,
Md (M.A.G., I.R.K.); Department of Diagnostic and Interventional Radiology,
School of Medicine, Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany (S.R., D.C.K.); and Departments of Pediatrics (M.R.J.) and
Radiology (S.V.), Stanford University, Palo Alto, Calif
| | - Mounes Aliyari Ghasabeh
- From the Departments of Radiology (D.H., R.Z., D.T.H., S.B.R.),
Medical Physics (D.H., R.Z., S.B.R.), Statistics (X.M.), Biostatistics and
Medical Informatics (L.M.), Medicine (R.J.M.), Biomedical Engineering (S.B.R.),
Medicine (S.B.R.), and Emergency Medicine, University of
Wisconsin–Madison, 1111 Highland Ave, WIMR2, Room 2472, Madison, WI 53705
(S.B.R.); Department of Radiology (Q.Y., I.P., T.Y.) and Advanced Imaging
Research Center (I.P., T.Y.), University of Texas Southwestern Medical Center,
Dallas, Tex; Department of Radiology, The Johns Hopkins University, Baltimore,
Md (M.A.G., I.R.K.); Department of Diagnostic and Interventional Radiology,
School of Medicine, Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany (S.R., D.C.K.); and Departments of Pediatrics (M.R.J.) and
Radiology (S.V.), Stanford University, Palo Alto, Calif
| | - Stefan Ruschke
- From the Departments of Radiology (D.H., R.Z., D.T.H., S.B.R.),
Medical Physics (D.H., R.Z., S.B.R.), Statistics (X.M.), Biostatistics and
Medical Informatics (L.M.), Medicine (R.J.M.), Biomedical Engineering (S.B.R.),
Medicine (S.B.R.), and Emergency Medicine, University of
Wisconsin–Madison, 1111 Highland Ave, WIMR2, Room 2472, Madison, WI 53705
(S.B.R.); Department of Radiology (Q.Y., I.P., T.Y.) and Advanced Imaging
Research Center (I.P., T.Y.), University of Texas Southwestern Medical Center,
Dallas, Tex; Department of Radiology, The Johns Hopkins University, Baltimore,
Md (M.A.G., I.R.K.); Department of Diagnostic and Interventional Radiology,
School of Medicine, Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany (S.R., D.C.K.); and Departments of Pediatrics (M.R.J.) and
Radiology (S.V.), Stanford University, Palo Alto, Calif
| | - Xinran Miao
- From the Departments of Radiology (D.H., R.Z., D.T.H., S.B.R.),
Medical Physics (D.H., R.Z., S.B.R.), Statistics (X.M.), Biostatistics and
Medical Informatics (L.M.), Medicine (R.J.M.), Biomedical Engineering (S.B.R.),
Medicine (S.B.R.), and Emergency Medicine, University of
Wisconsin–Madison, 1111 Highland Ave, WIMR2, Room 2472, Madison, WI 53705
(S.B.R.); Department of Radiology (Q.Y., I.P., T.Y.) and Advanced Imaging
Research Center (I.P., T.Y.), University of Texas Southwestern Medical Center,
Dallas, Tex; Department of Radiology, The Johns Hopkins University, Baltimore,
Md (M.A.G., I.R.K.); Department of Diagnostic and Interventional Radiology,
School of Medicine, Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany (S.R., D.C.K.); and Departments of Pediatrics (M.R.J.) and
Radiology (S.V.), Stanford University, Palo Alto, Calif
| | - Dimitrios C. Karampinos
- From the Departments of Radiology (D.H., R.Z., D.T.H., S.B.R.),
Medical Physics (D.H., R.Z., S.B.R.), Statistics (X.M.), Biostatistics and
Medical Informatics (L.M.), Medicine (R.J.M.), Biomedical Engineering (S.B.R.),
Medicine (S.B.R.), and Emergency Medicine, University of
Wisconsin–Madison, 1111 Highland Ave, WIMR2, Room 2472, Madison, WI 53705
(S.B.R.); Department of Radiology (Q.Y., I.P., T.Y.) and Advanced Imaging
Research Center (I.P., T.Y.), University of Texas Southwestern Medical Center,
Dallas, Tex; Department of Radiology, The Johns Hopkins University, Baltimore,
Md (M.A.G., I.R.K.); Department of Diagnostic and Interventional Radiology,
School of Medicine, Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany (S.R., D.C.K.); and Departments of Pediatrics (M.R.J.) and
Radiology (S.V.), Stanford University, Palo Alto, Calif
| | - Lu Mao
- From the Departments of Radiology (D.H., R.Z., D.T.H., S.B.R.),
Medical Physics (D.H., R.Z., S.B.R.), Statistics (X.M.), Biostatistics and
Medical Informatics (L.M.), Medicine (R.J.M.), Biomedical Engineering (S.B.R.),
Medicine (S.B.R.), and Emergency Medicine, University of
Wisconsin–Madison, 1111 Highland Ave, WIMR2, Room 2472, Madison, WI 53705
(S.B.R.); Department of Radiology (Q.Y., I.P., T.Y.) and Advanced Imaging
Research Center (I.P., T.Y.), University of Texas Southwestern Medical Center,
Dallas, Tex; Department of Radiology, The Johns Hopkins University, Baltimore,
Md (M.A.G., I.R.K.); Department of Diagnostic and Interventional Radiology,
School of Medicine, Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany (S.R., D.C.K.); and Departments of Pediatrics (M.R.J.) and
Radiology (S.V.), Stanford University, Palo Alto, Calif
| | - David T. Harris
- From the Departments of Radiology (D.H., R.Z., D.T.H., S.B.R.),
Medical Physics (D.H., R.Z., S.B.R.), Statistics (X.M.), Biostatistics and
Medical Informatics (L.M.), Medicine (R.J.M.), Biomedical Engineering (S.B.R.),
Medicine (S.B.R.), and Emergency Medicine, University of
Wisconsin–Madison, 1111 Highland Ave, WIMR2, Room 2472, Madison, WI 53705
(S.B.R.); Department of Radiology (Q.Y., I.P., T.Y.) and Advanced Imaging
Research Center (I.P., T.Y.), University of Texas Southwestern Medical Center,
Dallas, Tex; Department of Radiology, The Johns Hopkins University, Baltimore,
Md (M.A.G., I.R.K.); Department of Diagnostic and Interventional Radiology,
School of Medicine, Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany (S.R., D.C.K.); and Departments of Pediatrics (M.R.J.) and
Radiology (S.V.), Stanford University, Palo Alto, Calif
| | - Ryan J. Mattison
- From the Departments of Radiology (D.H., R.Z., D.T.H., S.B.R.),
Medical Physics (D.H., R.Z., S.B.R.), Statistics (X.M.), Biostatistics and
Medical Informatics (L.M.), Medicine (R.J.M.), Biomedical Engineering (S.B.R.),
Medicine (S.B.R.), and Emergency Medicine, University of
Wisconsin–Madison, 1111 Highland Ave, WIMR2, Room 2472, Madison, WI 53705
(S.B.R.); Department of Radiology (Q.Y., I.P., T.Y.) and Advanced Imaging
Research Center (I.P., T.Y.), University of Texas Southwestern Medical Center,
Dallas, Tex; Department of Radiology, The Johns Hopkins University, Baltimore,
Md (M.A.G., I.R.K.); Department of Diagnostic and Interventional Radiology,
School of Medicine, Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany (S.R., D.C.K.); and Departments of Pediatrics (M.R.J.) and
Radiology (S.V.), Stanford University, Palo Alto, Calif
| | - Michael R. Jeng
- From the Departments of Radiology (D.H., R.Z., D.T.H., S.B.R.),
Medical Physics (D.H., R.Z., S.B.R.), Statistics (X.M.), Biostatistics and
Medical Informatics (L.M.), Medicine (R.J.M.), Biomedical Engineering (S.B.R.),
Medicine (S.B.R.), and Emergency Medicine, University of
Wisconsin–Madison, 1111 Highland Ave, WIMR2, Room 2472, Madison, WI 53705
(S.B.R.); Department of Radiology (Q.Y., I.P., T.Y.) and Advanced Imaging
Research Center (I.P., T.Y.), University of Texas Southwestern Medical Center,
Dallas, Tex; Department of Radiology, The Johns Hopkins University, Baltimore,
Md (M.A.G., I.R.K.); Department of Diagnostic and Interventional Radiology,
School of Medicine, Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany (S.R., D.C.K.); and Departments of Pediatrics (M.R.J.) and
Radiology (S.V.), Stanford University, Palo Alto, Calif
| | - Ivan Pedrosa
- From the Departments of Radiology (D.H., R.Z., D.T.H., S.B.R.),
Medical Physics (D.H., R.Z., S.B.R.), Statistics (X.M.), Biostatistics and
Medical Informatics (L.M.), Medicine (R.J.M.), Biomedical Engineering (S.B.R.),
Medicine (S.B.R.), and Emergency Medicine, University of
Wisconsin–Madison, 1111 Highland Ave, WIMR2, Room 2472, Madison, WI 53705
(S.B.R.); Department of Radiology (Q.Y., I.P., T.Y.) and Advanced Imaging
Research Center (I.P., T.Y.), University of Texas Southwestern Medical Center,
Dallas, Tex; Department of Radiology, The Johns Hopkins University, Baltimore,
Md (M.A.G., I.R.K.); Department of Diagnostic and Interventional Radiology,
School of Medicine, Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany (S.R., D.C.K.); and Departments of Pediatrics (M.R.J.) and
Radiology (S.V.), Stanford University, Palo Alto, Calif
| | - Ihab R. Kamel
- From the Departments of Radiology (D.H., R.Z., D.T.H., S.B.R.),
Medical Physics (D.H., R.Z., S.B.R.), Statistics (X.M.), Biostatistics and
Medical Informatics (L.M.), Medicine (R.J.M.), Biomedical Engineering (S.B.R.),
Medicine (S.B.R.), and Emergency Medicine, University of
Wisconsin–Madison, 1111 Highland Ave, WIMR2, Room 2472, Madison, WI 53705
(S.B.R.); Department of Radiology (Q.Y., I.P., T.Y.) and Advanced Imaging
Research Center (I.P., T.Y.), University of Texas Southwestern Medical Center,
Dallas, Tex; Department of Radiology, The Johns Hopkins University, Baltimore,
Md (M.A.G., I.R.K.); Department of Diagnostic and Interventional Radiology,
School of Medicine, Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany (S.R., D.C.K.); and Departments of Pediatrics (M.R.J.) and
Radiology (S.V.), Stanford University, Palo Alto, Calif
| | - Shreyas Vasanawala
- From the Departments of Radiology (D.H., R.Z., D.T.H., S.B.R.),
Medical Physics (D.H., R.Z., S.B.R.), Statistics (X.M.), Biostatistics and
Medical Informatics (L.M.), Medicine (R.J.M.), Biomedical Engineering (S.B.R.),
Medicine (S.B.R.), and Emergency Medicine, University of
Wisconsin–Madison, 1111 Highland Ave, WIMR2, Room 2472, Madison, WI 53705
(S.B.R.); Department of Radiology (Q.Y., I.P., T.Y.) and Advanced Imaging
Research Center (I.P., T.Y.), University of Texas Southwestern Medical Center,
Dallas, Tex; Department of Radiology, The Johns Hopkins University, Baltimore,
Md (M.A.G., I.R.K.); Department of Diagnostic and Interventional Radiology,
School of Medicine, Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany (S.R., D.C.K.); and Departments of Pediatrics (M.R.J.) and
Radiology (S.V.), Stanford University, Palo Alto, Calif
| | - Takeshi Yokoo
- From the Departments of Radiology (D.H., R.Z., D.T.H., S.B.R.),
Medical Physics (D.H., R.Z., S.B.R.), Statistics (X.M.), Biostatistics and
Medical Informatics (L.M.), Medicine (R.J.M.), Biomedical Engineering (S.B.R.),
Medicine (S.B.R.), and Emergency Medicine, University of
Wisconsin–Madison, 1111 Highland Ave, WIMR2, Room 2472, Madison, WI 53705
(S.B.R.); Department of Radiology (Q.Y., I.P., T.Y.) and Advanced Imaging
Research Center (I.P., T.Y.), University of Texas Southwestern Medical Center,
Dallas, Tex; Department of Radiology, The Johns Hopkins University, Baltimore,
Md (M.A.G., I.R.K.); Department of Diagnostic and Interventional Radiology,
School of Medicine, Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany (S.R., D.C.K.); and Departments of Pediatrics (M.R.J.) and
Radiology (S.V.), Stanford University, Palo Alto, Calif
| | - Scott B. Reeder
- From the Departments of Radiology (D.H., R.Z., D.T.H., S.B.R.),
Medical Physics (D.H., R.Z., S.B.R.), Statistics (X.M.), Biostatistics and
Medical Informatics (L.M.), Medicine (R.J.M.), Biomedical Engineering (S.B.R.),
Medicine (S.B.R.), and Emergency Medicine, University of
Wisconsin–Madison, 1111 Highland Ave, WIMR2, Room 2472, Madison, WI 53705
(S.B.R.); Department of Radiology (Q.Y., I.P., T.Y.) and Advanced Imaging
Research Center (I.P., T.Y.), University of Texas Southwestern Medical Center,
Dallas, Tex; Department of Radiology, The Johns Hopkins University, Baltimore,
Md (M.A.G., I.R.K.); Department of Diagnostic and Interventional Radiology,
School of Medicine, Klinikum rechts der Isar, Technical University of Munich,
Munich, Germany (S.R., D.C.K.); and Departments of Pediatrics (M.R.J.) and
Radiology (S.V.), Stanford University, Palo Alto, Calif
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