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- Open Access
Fat Content Effect in the Measurement of T2* for Iron Quantification in the Liver in Patients With Suspected Myocardial Iron Overload
© Junqueira et al. 2016
- Published: 27 January 2016
- Iron Overload
- Liver Iron
- Liver Iron Concentration
- Myocardial Iron
- Liver Iron Content
Iron quantification using T2* has become a routine non-invasive procedure for assessment of myocardium and liver in patients with regular transfusions. Cardiologists and cardiovascular radiologists are progressively measuring iron overload in the liver associated with myocardial overload. It is currently unknown if potential interference of high fat content in the liver may result in discrepant iron estimations. We sought to evaluate whether the use of regular T2* sequences would be confounded by fat in comparison to a commercial software with fat-water separation.
Twenty-six patients with clinical indication for liver and myocardial iron assessment were studied using a 1.5T scanner (GE Optima 450). In all patients, an axial image of the liver was acquired using a multi-echo single breath-hold GRE sequence with 10 TEs and fat saturation followed by an image using a three-dimensional volumetric imaging sequence (IDEAL-IQ, GE Healthcare) with six echo times. For the T2* GRE sequence, a region of interest (ROI) was drawn through the right lobe of the liver and the mean signal intensity for each echo time used to fit the T2* decay curve with the formula SI = Ke-TE/T2* with nonlinear fit and truncation to correct for high iron levels. For the commercial sequence, automatic R2* and fat-fraction maps were created automatically by the software and a ROI was traced on these maps to obtain R2* (1/T2*) and fat fraction (FF) percentage values. Patients were divided according to FF (abnormal >10%) and liver iron concentration (abnormal if T2* <15.4 ms). A comparison of T2* values using both softwares was performed and analyzed according to fat and iron concentrations.
With traditional GRE-T2* sequences, fat content of the liver will not significantly affect usual T2* measurements in patient with either low fat content (FF < 10%) or abnormal iron stores (T2* < 15.4 ms). In patients with normal liver iron concentrations and high fat content, GRE-T2* underestimates the liver T2* values.
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