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Liver R2*is affected by both iron and fat: A dual biopsy-validated study of chronic liver disease
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Gastroentorology.
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).ORCID iD: 0000-0002-4111-1693
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics. Linköping University, Center for Medical Image Science and Visualization (CMIV).ORCID iD: 0000-0003-4630-6550
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2019 (English)In: Journal of Magnetic Resonance Imaging, ISSN 1053-1807, E-ISSN 1522-2586, Vol. 50, no 1, p. 325-333Article in journal (Refereed) Published
Abstract [en]

Background Liver iron content (LIC) in chronic liver disease (CLD) is currently determined by performing an invasive liver biopsy. MRI using R2* relaxometry is a noninvasive alternative for estimating LIC. Fat accumulation in the liver, or proton density fat fraction (PDFF), may be a possible confounder of R2* measurements. Previous studies of the effect of PDFF on R2* have not used quantitative LIC measurement. Purpose To assess the associations between R2*, LIC, PDFF, and liver histology in patients with suspected CLD. Study Type Prospective. Population Eighty-one patients with suspected CLD. Field Strength/Sequence 1.5 T. Multiecho turbo field echo to quantify R2*. PRESS MRS to quantify PDFF. Assessment Each patient underwent an MR examination, followed by two needle biopsies immediately following the MR examination. The first biopsy was used for conventional histological assessment of LIC, whereas the second biopsy was used to quantitatively measure LIC using mass spectrometry. R2* was correlated with both LIC and PDFF. A correction for the influence of fat on R2* was calculated. Statistical Tests Pearson correlation, linear regression, and area under the receiver operating curve. Results There was a positive linear correlation between R2* and PDFF (R = 0.69), after removing data from patients with elevated iron levels, as defined by LIC. R2*, corrected for PDFF, was the best method for identifying patients with elevated iron levels, with a correlation of R = 0.87 and a sensitivity and specificity of 87.5% and 98.6%, respectively. Data Conclusion PDFF increases R2*. Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:325-333.

Place, publisher, year, edition, pages
WILEY , 2019. Vol. 50, no 1, p. 325-333
Keywords [en]
liver iron content; liver fat; R2*; PDFF; iron overload
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:liu:diva-158842DOI: 10.1002/jmri.26601ISI: 000471831600033PubMedID: 30637926OAI: oai:DiVA.org:liu-158842DiVA, id: diva2:1337519
Note

Funding Agencies|Region Ostergotland; Medical Research council of Southeast Sweden [FORSS #12621]; Swedish Research Council [VR/NT #2014-6157, VR/MH, #2007-2884]; Forskningsradet i Sydostra Sverige; Linkoping University; Linkoping University Hospital Research Foundations; Vinnova [#2013-01314]; Vetenskapsradet

Available from: 2019-07-15 Created: 2019-07-15 Last updated: 2019-09-19

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Karlsson, MarkusEkstedt, MattiasDahlström, NilsForsgren, MikaelIgnatova, SimoneNorén, BengtDahlqvist Leinhard, OlofKechagias, StergiosLundberg, Peter
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Division of Radiological SciencesFaculty of Medicine and Health SciencesDivision of Cardiovascular MedicineDepartment of GastroentorologyDepartment of Radiology in LinköpingCenter for Medical Image Science and Visualization (CMIV)Department of Radiation PhysicsDivison of NeurobiologyClinical pathologyMedical radiation physics
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