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3D Multiecho Dixon for the Evaluation of Hepatic Iron and Fat in a Clinical Setting
Author(s) -
Henninger Benjamin,
Zoller Heinz,
Kannengiesser Stephan,
Zhong Xiaodong,
Jaschke Werner,
Kremser Christian
Publication year - 2017
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25630
Subject(s) - nuclear medicine , medicine , voxel , limits of agreement , magnetic resonance imaging , bland–altman plot , correlation , nuclear magnetic resonance , mathematics , radiology , physics , geometry
Purpose To prospectively evaluate a new 3D‐multiecho‐Dixon (3D‐ME‐Dixon) sequence for the quantification of hepatic iron and fat in a clinical setting. Materials and Methods In all, 120 patients underwent 1.5T magnetic resonance imaging of the liver between December 2013 and June 2015 including the following three sequences: 3D‐ME‐Dixon with inline calculation of R2* and proton‐density fat‐fraction (PDFF) maps, single‐voxel‐spectroscopy (SVS), 2D multigradient‐echo sequence (2D‐ME‐GRE). SVS and 2D‐ME‐GRE were used as reference for PDFF and R2*, respectively. R2*‐ and PDFF‐values from 3D‐ME‐Dixon were compared with those of the reference. Linear regression analysis, Bland–Altman plots, and agreement parameters were calculated. Results In total, 103 patients were finally included (87 men and 16 women; mean age, 50.51 years); 17/120 were excluded due to fat/water‐swaps or R2*‐values exceeding the constraint of 400 1/s for 3D‐ME‐Dixon. A strong correlation ( r = 0.992, P < 0.001) between R2* of 3D‐ME‐Dixon and the reference 2D‐ME‐GRE was found. Bland–Altman analysis revealed systematically lower values for 3D‐ME‐Dixon (16.499%). Using an adapted threshold of 57 1/s, 3D‐ME‐Dixon obtained a positive/negative percentage agreement (PPA/NPA) of 84.4%/91.4% for detecting hepatic iron overload. For hepatic fat the correlation between 3D‐ME‐Dixon and the reference SVS was strong ( r = 0.957, P < 0.001); PPA/NPA was 88.3%/91.4%. Conclusion The 3D‐ME‐Dixon sequence is a valuable tool for the evaluation of hepatic iron and fat in a clinical setting. Fat/water‐swaps remain a drawback requiring improvements to the implementation and making it necessary to have proven conventional sequences at hand in case of an eventual occurrence. Level of Evidence : 1. Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:793–800