Practical Application of Multivendor MRI-Based R2* Mapping for Liver Iron Quantification at 1.5 T and 3.0 T

Gregory Simchick; Ruiyang Zhao; Qing Yuan; Mounes Aliyari Ghasabeh; Stefan Ruschke; Dimitrios C Karampinos; David T Harris; Raphael do Vale Souza; Ryan J Mattison; Michael R Jeng; Ivan Pedrosa; Ihab R Kamel; Shreyas Vasanawala; Takeshi Yokoo; Scott B Reeder; Diego Hernando

doi:10.1002/jmri.29401

Practical Application of Multivendor MRI-Based R2* Mapping for Liver Iron Quantification at 1.5 T and 3.0 T

J Magn Reson Imaging. 2024 Apr 25. doi: 10.1002/jmri.29401. Online ahead of print.

Authors

Gregory Simchick¹, Ruiyang Zhao^{1

2}, Qing Yuan³, Mounes Aliyari Ghasabeh⁴, Stefan Ruschke⁵, Dimitrios C Karampinos⁵, David T Harris¹, Raphael do Vale Souza¹, Ryan J Mattison⁶, Michael R Jeng⁷, Ivan Pedrosa^{3

8}, Ihab R Kamel⁴, Shreyas Vasanawala⁹, Takeshi Yokoo^{3

8}, Scott B Reeder^{1

2

6

10

11}, Diego Hernando^{1

2}

Affiliations

¹ Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.
² Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA.
³ Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
⁴ Radiology, Johns Hopkins University, Baltimore, Maryland, USA.
⁵ Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
⁶ Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA.
⁷ Pediatrics - Hematology & Oncology, Stanford University, Palo Alto, California, USA.
⁸ Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
⁹ Radiology, Stanford University, Palo Alto, California, USA.
¹⁰ Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA.
¹¹ Emergency Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA.

PMID: 38662618
DOI: 10.1002/jmri.29401

Abstract

Background: Recent multicenter, multivendor MRI-based R2* vs. liver iron concentration (LIC) calibrations (i.e., MCMV calibrations) may facilitate broad clinical dissemination of R2*-based LIC quantification. However, these calibrations are based on a centralized offline R2* reconstruction, and their applicability with vendor-provided R2* maps is unclear.

Purpose: To determine R2* ranges of agreement between the centralized and three MRI vendors' R2* reconstructions.

Study type: Prospective.

Subjects: Two hundred and seven subjects (mean age 37.6 ± 19.6 years; 117 male) with known or suspected iron overload from four academic medical centers.

Field strength/sequence: Standardized multiecho spoiled gradient echo sequence at 1.5 T and 3.0 T for R2* mapping and a multiple spin-echo sequence at 1.5 T for LIC quantification. MRI vendors: GE Healthcare, Philips Healthcare, and Siemens Healthineers.

Assessment: R2* maps were generated using both the centralized and vendor reconstructions, and ranges of agreement were determined. R2*-LIC linear calibrations were determined for each site, field strength, and reconstruction and compared with the MCMV calibrations.

Statistical tests: Bland-Altman analysis to determine ranges of agreement. Linear regression, analysis of covariance F tests, and Tukey's multiple comparison testing to assess reproducibility of calibrations across sites and vendors. A P value <0.05 was considered significant.

Results: The upper limits of R2* ranges of agreement were approximately 500, 375, and 330 s^-1 for GE, Philips, and Siemens reconstructions, respectively, at 1.5 T and approximately 700 and 800 s^-1 for GE and Philips, respectively, at 3.0 T. Within the R2* ranges of agreement, vendor R2*-LIC calibrations demonstrated high reproducibility (no significant differences between slopes or intercepts; P ≥ 0.06) and agreed with the MCMV calibrations (overlapping 95% confidence intervals).

Data conclusion: Based on the determined upper limits, R2* measurements obtained from vendor-provided R2* maps may be reliably and practically used to quantify LIC less than approximately 8-13 mg/g using the MCMV calibrations and similar acquisition parameters as this study.

Evidence level: 1 TECHNICAL EFFICACY: Stage 3.

Keywords: iron overload; liver; liver iron concentration; quantitative MRI.

Abstract

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