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Improved free-breathing liver fat and iron quantification using a 2D chemical shift–encoded MRI with flip angle modulation and motion-corrected averaging.

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Title: Improved free-breathing liver fat and iron quantification using a 2D chemical shift–encoded MRI with flip angle modulation and motion-corrected averaging.
Authors: Starekova, Jitka1 (AUTHOR), Zhao, Ruiyang1,2 (AUTHOR), Colgan, Timothy J.1 (AUTHOR), Johnson, Kevin M.1,2 (AUTHOR), Rehm, Jennifer L.3 (AUTHOR), Wells, Shane A.1,4 (AUTHOR), Reeder, Scott B.1,2,5,6,7 (AUTHOR), Hernando, Diego1,2 (AUTHOR) dhernando@wisc.edu
Source: European Radiology. Aug2022, Vol. 32 Issue 8, p5458-5467. 10p.
Subjects: Magnetic resonance imaging, Fatty liver, Image stabilization, Adipose tissues, Iron in the body, Diagnostic imaging
Abstract: Objectives: 3D chemical shift–encoded (CSE) MRI enables accurate and precise quantification of proton density fat fraction (PDFF) and R2*, biomarkers of hepatic fat and iron deposition. Unfortunately, 3D CSE-MRI requires reliable breath-holding. Free-breathing 2D CSE-MRI with sequential radiofrequency excitation is a motion-robust alternative but suffers from low signal-to-noise-ratio (SNR). To overcome this limitation, this work explores the combination of flip angle–modulated (FAM) 2D CSE imaging with a non-local means (NLM) motion-corrected averaging technique. Methods: In this prospective study, 35 healthy subjects (27 children/8 adults) were imaged on a 3T MRI-system. Multi-echo 3D CSE ("3D") and 2D CSE FAM ("FAM") images were acquired during breath-hold and free-breathing, respectively, to obtain PDFF and R2* maps of the liver. Multi-repetition FAM was postprocessed with direct averaging (DA)– and NLM-based averaging and compared to 3D CSE using Bland-Altmann and regression analysis. Image qualities of PDFF and R2* maps were reviewed by two radiologists using a Likert-like scale (score 1–5, 5 = best). Results: Compared to 3D CSE, multi-repetition FAM-NLM showed excellent agreement (regression slope = 1.0, R2 = 0.996) for PDFF and good agreement (regression slope 1.08–1.15, R2 ≥ 0.899) for R2*. Further, multi-repetition FAM-NLM PDFF and R2* maps had fewer artifacts (score 3.8 vs. 3.2, p < 0.0001 for PDFF; score 3.2 vs. 2.6, p < 0.001 for R2*) and better overall image quality (score 4.0 vs. 3.5, p < 0.0001 for PDFF; score 3.4 vs. 2.7, p < 0.0001 for R2*). Conclusions: Free-breathing FAM-NLM provides superior image quality of the liver compared to the conventional breath-hold 3D CSE-MRI, while minimizing bias for PDFF and R2* quantification. Key Points: • 2D CSE FAM-NLM is a free-breathing method for liver fat and iron quantification and viable alternative for patients unable to hold their breath. • 2D CSE FAM-NLM is a feasible alternative to breath-hold 3D CSE methods, with low bias in proton density fat fraction (PDFF) and no clinically significant bias in R2*. • Quantitatively, multiple repetitions in 2D CSE FAM-NLM lead to improved SNR. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Improved free-breathing liver fat and iron quantification using a 2D chemical shift–encoded MRI with flip angle modulation and motion-corrected averaging.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Starekova%2C+Jitka%22&quot;&gt;Starekova, Jitka&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Zhao%2C+Ruiyang%22&quot;&gt;Zhao, Ruiyang&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Colgan%2C+Timothy+J%2E%22&quot;&gt;Colgan, Timothy J.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Johnson%2C+Kevin+M%2E%22&quot;&gt;Johnson, Kevin M.&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Rehm%2C+Jennifer+L%2E%22&quot;&gt;Rehm, Jennifer L.&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Wells%2C+Shane+A%2E%22&quot;&gt;Wells, Shane A.&lt;/searchLink&gt;&lt;relatesTo&gt;1,4&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Reeder%2C+Scott+B%2E%22&quot;&gt;Reeder, Scott B.&lt;/searchLink&gt;&lt;relatesTo&gt;1,2,5,6,7&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hernando%2C+Diego%22&quot;&gt;Hernando, Diego&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; dhernando@wisc.edu&lt;/i&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22European+Radiology%22&quot;&gt;European Radiology&lt;/searchLink&gt;. Aug2022, Vol. 32 Issue 8, p5458-5467. 10p.
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  Data: Objectives: 3D chemical shift–encoded (CSE) MRI enables accurate and precise quantification of proton density fat fraction (PDFF) and R2*, biomarkers of hepatic fat and iron deposition. Unfortunately, 3D CSE-MRI requires reliable breath-holding. Free-breathing 2D CSE-MRI with sequential radiofrequency excitation is a motion-robust alternative but suffers from low signal-to-noise-ratio (SNR). To overcome this limitation, this work explores the combination of flip angle–modulated (FAM) 2D CSE imaging with a non-local means (NLM) motion-corrected averaging technique. Methods: In this prospective study, 35 healthy subjects (27 children/8 adults) were imaged on a 3T MRI-system. Multi-echo 3D CSE (&quot;3D&quot;) and 2D CSE FAM (&quot;FAM&quot;) images were acquired during breath-hold and free-breathing, respectively, to obtain PDFF and R2* maps of the liver. Multi-repetition FAM was postprocessed with direct averaging (DA)– and NLM-based averaging and compared to 3D CSE using Bland-Altmann and regression analysis. Image qualities of PDFF and R2* maps were reviewed by two radiologists using a Likert-like scale (score 1–5, 5 = best). Results: Compared to 3D CSE, multi-repetition FAM-NLM showed excellent agreement (regression slope = 1.0, R2 = 0.996) for PDFF and good agreement (regression slope 1.08–1.15, R2 ≥ 0.899) for R2*. Further, multi-repetition FAM-NLM PDFF and R2* maps had fewer artifacts (score 3.8 vs. 3.2, p &lt; 0.0001 for PDFF; score 3.2 vs. 2.6, p &lt; 0.001 for R2*) and better overall image quality (score 4.0 vs. 3.5, p &lt; 0.0001 for PDFF; score 3.4 vs. 2.7, p &lt; 0.0001 for R2*). Conclusions: Free-breathing FAM-NLM provides superior image quality of the liver compared to the conventional breath-hold 3D CSE-MRI, while minimizing bias for PDFF and R2* quantification. Key Points: • 2D CSE FAM-NLM is a free-breathing method for liver fat and iron quantification and viable alternative for patients unable to hold their breath. • 2D CSE FAM-NLM is a feasible alternative to breath-hold 3D CSE methods, with low bias in proton density fat fraction (PDFF) and no clinically significant bias in R2*. • Quantitatively, multiple repetitions in 2D CSE FAM-NLM lead to improved SNR. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1007/s00330-022-08682-x
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        Type: general
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      – SubjectFull: Image stabilization
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      – SubjectFull: Adipose tissues
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              Text: Aug2022
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