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Sawh MC, Newton KP, Goyal NP, Angeles JE, Harlow K, Bross C, Schlein AN, Hooker JC, Sy EZ, Glaser KJ, Yin M, Ehman RL, Sirlin CB, Schwimmer JB. Normal range for MR elastography measured liver stiffness in children without liver disease. J Magn Reson Imaging 2019; 51:919-927. [PMID: 31452280 DOI: 10.1002/jmri.26905] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 08/05/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Magnetic resonance elastography (MRE) can determine the presence and stage of liver fibrosis. Data on normative MRE values, while reported in adults, are limited in children. PURPOSE To determine the distribution of MRE-measured liver stiffness in children without liver disease. STUDY TYPE Prospective, observational. POPULATION Eighty-one healthy children (mean 12.6 ± 2.6 years, range 8-17 years). FIELD STRENGTH/SEQUENCE 3.0T Signa HDxt, General Electric MR Scanner; 2D GRE MRE sequence. ASSESSMENT History, examination, laboratory evaluation, and (MR) exams (proton density fat fraction, PDFF, and MRE) were performed. MR elastograms were analyzed manually at two reading centers and compared with each other for agreement and with published values in healthy adults and thresholds for fibrosis in adult and pediatric patients. STATISTICAL TESTS Descriptive statistics, Bland-Altman analysis, t-test to compare hepatic stiffness values with reference standards. RESULTS Stiffness values obtained at both reading centers were similar, without significant bias (P = 0.362) and with excellent correlation (intraclass correlation coefficient [ICC] = 0.782). Mean hepatic stiffness value for the study population was 2.45 ± 0.35 kPa (95th percentile 3.19 kPa), which was significantly higher than reported values for healthy adult subjects (2.10 ± 0.23 kPa, P < 0.001). In all, 74-85% of subjects had stiffness measurements suggestive of no fibrosis. DATA CONCLUSION Mean liver stiffness measured with MRE in this cohort was significantly higher than that reported in healthy adults. Despite rigorous screening, some healthy children had stiffness measurements suggestive of liver fibrosis using current published thresholds. Although MRE has the potential to provide noninvasive assessment in patients with suspected hepatic disease, further refinement of this technology will help advance its use as a diagnostic tool for evidence of fibrosis in pediatric populations. LEVEL OF EVIDENCE 1 Technical Efficacy: 5 J. Magn. Reson. Imaging 2020;51:919-927.
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Affiliation(s)
- Mary Catherine Sawh
- The Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of California San Diego School of Medicine, La Jolla, California, USA.,Department of Gastroenterology, Rady Children's Hospital, San Diego, California, USA
| | - Kimberly P Newton
- The Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of California San Diego School of Medicine, La Jolla, California, USA.,Department of Gastroenterology, Rady Children's Hospital, San Diego, California, USA
| | - Nidhi P Goyal
- The Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of California San Diego School of Medicine, La Jolla, California, USA.,Department of Gastroenterology, Rady Children's Hospital, San Diego, California, USA
| | - Jorge Eduardo Angeles
- The Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of California San Diego School of Medicine, La Jolla, California, USA
| | - Kathryn Harlow
- The Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of California San Diego School of Medicine, La Jolla, California, USA.,Department of Gastroenterology, Rady Children's Hospital, San Diego, California, USA
| | - Craig Bross
- The Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of California San Diego School of Medicine, La Jolla, California, USA
| | - Alexandra N Schlein
- Liver Imaging Group, Department of Radiology, University of California San Diego School of Medicine, La Jolla, California, USA
| | - Jonathan C Hooker
- Liver Imaging Group, Department of Radiology, University of California San Diego School of Medicine, La Jolla, California, USA
| | - Ethan Z Sy
- Liver Imaging Group, Department of Radiology, University of California San Diego School of Medicine, La Jolla, California, USA
| | - Kevin J Glaser
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Meng Yin
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Richard L Ehman
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Claude B Sirlin
- Liver Imaging Group, Department of Radiology, University of California San Diego School of Medicine, La Jolla, California, USA
| | - Jeffrey B Schwimmer
- The Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of California San Diego School of Medicine, La Jolla, California, USA.,Department of Gastroenterology, Rady Children's Hospital, San Diego, California, USA
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152
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Agreement and Reproducibility of Proton Density Fat Fraction Measurements Using Commercial MR Sequences Across Different Platforms. Invest Radiol 2019; 54:517-523. [DOI: 10.1097/rli.0000000000000561] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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153
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Zhu A, Hernando D, Johnson KM, Reeder SB. Characterizing a short T 2 * signal component in the liver using ultrashort TE chemical shift-encoded MRI at 1.5T and 3.0T. Magn Reson Med 2019; 82:2032-2045. [PMID: 31270858 DOI: 10.1002/mrm.27876] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 05/08/2019] [Accepted: 05/30/2019] [Indexed: 01/19/2023]
Abstract
PURPOSE Recent studies have suggested the presence of short-T2 * signals in the liver, which may confound chemical shift-encoded (CSE) fat quantification when using short echo times (TEs). The purpose of this study was to characterize the liver signal at short echo times and to determine its impact on liver fat quantification. METHODS An ultrashort echo time (UTE) chemical shift-encoded MRI (CSE-MRI) technique and a multicomponent reconstruction were developed to characterize short-T2 * liver signals. Subsequently, liver fat fraction was quantified using a short-TE (first TE = 0.7 ms) and UTE CSE-MRI acquisitions and compared with a standard CSE-MRI (first TE = 1.2 ms). RESULTS Short-T2 * signals were consistently observed in the liver of all healthy volunteers imaged at both 1.5T and 3.0T. At 3.0T, short-T2 * signal fractions of 9.6 ± 1.5%, 7.0 ± 1.7%, and 7.4 ± 1.7% with T2 * of 0.23 ± 0.05 ms, 0.20 ± 0.05 ms, and 0.10 ± 0.02 ms were measured in healthy volunteers, patients with liver cirrhotic disease, and patients with hepatic steatosis (but no cirrhosis), respectively. For proton density fat fraction (PDFF) estimation, 1.7% (P < .01) and 3.4% (P < .01) biases were observed in subjects imaged using short-TE CSE-MRI and using UTE CSE-MRI at 1.5T, respectively. The biases were reduced to 0.4% and -0.7%, respectively, by excluding short echoes less than 1 ms. A 3.2% bias (P < .01) was observed in subjects imaged using UTE CSE-MRI at 3.0T, which was reduced to 0.1% by excluding short echoes <1 ms. CONCLUSIONS A liver short-T2 * signal component was consistently observed and was shown to confound liver fat quantification when short echo times were used with CSE-MRI.
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Affiliation(s)
- Ante Zhu
- Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin
- Department of Radiology, University of Wisconsin, Madison, Wisconsin
| | - Diego Hernando
- Department of Radiology, University of Wisconsin, Madison, Wisconsin
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin
| | - Kevin M Johnson
- Department of Radiology, University of Wisconsin, Madison, Wisconsin
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin
| | - Scott B Reeder
- Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin
- Department of Radiology, University of Wisconsin, Madison, Wisconsin
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin
- Department of Medicine, University of Wisconsin, Madison, Wisconsin
- Department of Emergency Medicine, University of Wisconsin, Madison, Wisconsin
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154
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Zhao Y, Yan X, Zhang Z, Zhao W, Liu Z, Li J. Self-adapting multi-peak water-fat reconstruction for the removal of lipid artifacts in chemical exchange saturation transfer (CEST) imaging. Magn Reson Med 2019; 82:1700-1712. [PMID: 31241219 DOI: 10.1002/mrm.27859] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/23/2019] [Accepted: 05/21/2019] [Indexed: 12/26/2022]
Abstract
PURPOSE Artifacts caused by strong lipid signals pose challenges in body chemical exchange saturation transfer (CEST) imaging. This study aimed to develop an accurate water-fat reconstruction method based on the multi-echo Dixon technique to remove lipid artifacts in CEST imaging. THEORY AND METHODS It is well known that fat has multiple spectral peaks. Furthermore, RF pulses in CEST preparation saturate each fat peak at different levels, complicating fat modeling. Therefore, a self-adapting multi-peak model (SMPM) is proposed to update relative amplitudes of fat peaks using numerical calculation. With the SMPM-based updating, nonlinear least-squares fitting combined with IDEAL (Iterative Decomposition of water and fat with Echo Asymmetry and Least-squares estimation) algorithms was used for water-fat reconstruction and B0 mapping. The proposed method was compared with the reported 3-point Dixon method and the fixed multi-peak model in a phantom study using a fat-free Z-spectrum obtained from MR spectroscopy acquisition as the ground truth. This method was also validated by in vivo experiments on human breast. RESULTS In the phantom experiments, the Z-spectrum from the SMPM-based method agreed well with the fat-free Z-spectrum from CEST-PRESS (point-resolved spectroscopy), validating the effective removal of lipid artifacts, while a decrease or a rise that appeared at -3.5 ppm was observed in the Z-spectrum from the 3-point method and the FMPM-based method, respectively. In the in vivo experiments, no lipid artifacts were observed in the Z-spectrum or the amide CEST map from the SMPM-based method in the fibro-glandular region of the breast with high fat fractions. CONCLUSION The SMPM-based method successfully removes lipid artifacts and significantly improves the accuracy of CEST contrast.
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Affiliation(s)
- Yu Zhao
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Materials Science, East China Normal University, Shanghai, China
| | - Xu Yan
- MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China
| | | | - Weiwei Zhao
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Materials Science, East China Normal University, Shanghai, China
| | - Zhenzhi Liu
- Molecular Imaging Program at Stanford, Department of Radiology, Stanford University, Stanford, California
| | - Jianqi Li
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Materials Science, East China Normal University, Shanghai, China
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Dietary Glycotoxins Impair Hepatic Lipidemic Profile in Diet-Induced Obese Rats Causing Hepatic Oxidative Stress and Insulin Resistance. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:6362910. [PMID: 31341532 PMCID: PMC6614994 DOI: 10.1155/2019/6362910] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 04/22/2019] [Indexed: 02/06/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is caused by excessive liver lipid accumulation, but insulin resistance is specifically associated with impaired lipid saturation, oxidation, and storage (esterification), besides increased de novo lipogenesis. We hypothesized that dietary glycotoxins could impair hepatic lipid metabolism in obesity contributing to lipotoxicity-driven insulin resistance and thus to the onset of nonalcoholic steatohepatitis (NASH). In diet-induced obese rats with methylglyoxal-induced glycation, magnetic resonance spectroscopy, mass spectrometry, and gas chromatography were used to assess liver composition in fatty acyl chains and phospholipids. High-fat diet-induced obesity increased liver lipid fraction and suppressed de novo lipogenesis but did not change fatty acid esterification and saturation or insulin sensitivity. Despite a similar increase in total lipid fraction when supplementing the high-fat diet with dietary glycotoxins, impairment in the suppression of de novo lipogenesis and decreased fatty acid unsaturation and esterification were observed. Moreover, glycotoxins also decreased polyunsaturated cardiolipins and caused oxidative stress, portal inflammation, and insulin resistance in high-fat diet-induced obese rats. Dietary glycated products do not change total lipid levels in the liver of obese rats but dramatically modify the lipidemic profile, leading to oxidative stress, hepatic lipotoxicity, and insulin resistance in obesity and thus contribute to the onset of NASH.
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156
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Colgan TJ, Van Pay AJ, Sharma SD, Mao L, Reeder SB. Diurnal Variation of Proton Density Fat Fraction in the Liver Using Quantitative Chemical Shift Encoded MRI. J Magn Reson Imaging 2019; 51:407-414. [PMID: 31168893 DOI: 10.1002/jmri.26814] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Whole-organ, noninvasive techniques for the detection and quantification of nonalcoholic fatty liver disease features have clinical and research applications. However, the effect of time of day, hydration status, and meals are unknown factors with potential to impact bias, precision, reproducibility, and repeatability of chemical shift-encoded MRI (CSE-MRI) to quantify liver proton density fat fraction (PDFF). PURPOSE To assess the effect of diurnal variation on PDFF using CSE-MRI, including the effect of time of day, the effect of meals and hydration status, as well as the day to day variability. STUDY TYPE Prospective. SUBJECTS Eleven healthy subjects and nine patients with observed hepatic steatosis. FIELD STRENGTH/SEQUENCES A commercial quantitative confounder-corrected CSE-MRI sequence (IDEAL IQ) and an MR spectroscopy (MRS) sequence (multiecho STEAM) were acquired at 1.5T. ASSESSMENT MRI-PDFF and MRS-PDFF estimates were compared across six visits (before and after a controlled breakfast, before and after an uncontrolled lunch, at approximately 4 pm, and then before breakfast on the following day) with three repeated measures for a total of 360 MRI-PDFF and MRS-PDFF measurements. STATISTICAL TESTS Linear regression, Bland-Altman analysis, and mixed effect models were used to determine the bias, precision, and repeatability of PDFF measurements. RESULTS No statistically significant linear trend was observed across visits for either MRI-PDFF or MRS-PDFF (P = 0.31 and 0.37, respectively). The repeatability was measured to be 0.86% for MRI-PDFF and 1.1% for MRS-PDFF over all six visits. For MRI-PDFF, the variability between all six visits (0.94%) was only slightly higher than within each visit (0.66%), with P < 0.001. For MRS-PDFF, the variability between all six visits was 1.29%, compared with 0.87% within each visit (P < 0.001). DATA CONCLUSION Our results may indicate that it is not necessary to control for the time of day or the fasting/fed state of the patient when measuring PDFF using CSE-MRI. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:407-414.
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Affiliation(s)
- Timothy J Colgan
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
| | - Andrew J Van Pay
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
| | - Samir D Sharma
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
| | - Lu Mao
- Departments of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin, USA
| | - Scott B Reeder
- Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA.,Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA.,Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin, USA.,Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA.,Department of Emergency Medicine, University of Wisconsin, Madison, Wisconsin, USA
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157
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Quantitative Mapping of Triacylglycerol Chain Length and Saturation Using Broadband CARS Microscopy. Biophys J 2019; 116:2346-2355. [PMID: 31153590 DOI: 10.1016/j.bpj.2019.04.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 03/25/2019] [Accepted: 04/25/2019] [Indexed: 01/15/2023] Open
Abstract
Lipid droplets (LDs), present in many cell types, are highly dynamic organelles that store neutral lipids, primarily triacylglycerols (TAGs). With the discovery of new LD functions (e.g., in immune response, protein clearage, and occurrence with disease), new methods to study LD chemical composition in situ are necessary. We present an approach for in situ, quantitative TAG analysis using label-free, coherent Raman microscopy that allows deciphering LD TAG composition in different biochemically complex samples with submicrometer spatial resolution. Employing a set of standard TAGs, we generate a spectral training matrix capturing the variation caused in Raman-like spectra by TAG backbone, chain length, and number of double bonds per chain, as well as the presence of proteins or other diluting molecules. Comparing our fitting approach to gas chromatography measurements for mixtures of standard TAGs and food oils, we find the root mean-square error for the prediction of TAG chemistry to be 0.69 CH2 and 0.15 #C=C. When progressing to more complex samples such as oil emulsions and LDs in various eukaryotic cells, we find good agreement with bulk gas chromatography measurements. For differentiated adipocytes, we find a significant increase in the number of double bonds in small LDs (below 2 μm in diameter) compared to large LDs (above 2 μm in diameter). Coupled with a relatively limited sample preparation requirement, this approach should enable rapid and accurate TAG LD analysis for a variety of cell biology and technological applications.
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158
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Fazeli Dehkordy S, Fowler KJ, Mamidipalli A, Wolfson T, Hong CW, Covarrubias Y, Hooker JC, Sy EZ, Schlein AN, Cui JY, Gamst AC, Hamilton G, Reeder SB, Sirlin CB. Hepatic steatosis and reduction in steatosis following bariatric weight loss surgery differs between segments and lobes. Eur Radiol 2019; 29:2474-2480. [PMID: 30547206 PMCID: PMC6483076 DOI: 10.1007/s00330-018-5894-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/22/2018] [Accepted: 11/14/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The purpose of this study was to (1) evaluate proton density fat fraction (PDFF) distribution across liver segments at baseline and (2) compare longitudinal segmental PDFF changes across time points in adult patients undergoing a very low-calorie diet (VLCD) and subsequent bariatric weight loss surgery (WLS). METHODS We performed a secondary analysis of data from 118 morbidly obese adult patients enrolled in a VLCD-WLS program. PDFF was estimated using magnitude-based confounder-corrected chemical-shift-encoded (CSE) MRI in each hepatic segment and lobe at baseline (visit 1), after completion of VLCD (visit 2), and at 1, 3, and 6 months (visits 3-5) following WLS. Linear regressions were used to estimate the rate of PDFF change across visits. Lobar and segmental rates of change were compared pairwise. RESULTS Baseline PDFF was significantly higher in the right lobe compared to the left lobe (p < 0.0001). Lobar and segmental PDFF declined by 3.9-4.5% per month between visits 1 and 2 (preoperative period) and by 4.3-4.8% per month between visits 1 and 3 (perioperative period), but no significant pairwise differences were found in slope between segments and lobes. For visits 3-5 (postoperative period), lobar and segmental PDFF reduction was much less overall (0.4-0.8% PDFF per month) and several pairwise differences were significant; in each case, a right-lobe segment had greater decline than a left-lobe segment. CONCLUSIONS Baseline and longitudinal changes in fractional fat content in the 5-month postoperative period following WLS vary across segments, with right-lobe segments having higher PDFF at baseline and more rapid reduction in liver fat content. KEY POINTS • Baseline and longitudinal changes in liver fat following bariatric weight loss surgery vary across liver segments. • Methods that do not provide whole liver fat assessment, such as liver biopsy, may be unreliable in monitoring longitudinal changes in liver fat following weight loss interventions.
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Affiliation(s)
- Soudabeh Fazeli Dehkordy
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W. Arbor Drive #8756, San Diego, CA, 92103-8756, USA.
| | - Kathryn J Fowler
- Department of Radiology, Washington University, Saint Louis, MO, USA
| | - Adrija Mamidipalli
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W. Arbor Drive #8756, San Diego, CA, 92103-8756, USA
| | - Tanya Wolfson
- Computational and Applied Statistics Laboratory, University of California San Diego, San Diego, CA, USA
| | - Cheng William Hong
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W. Arbor Drive #8756, San Diego, CA, 92103-8756, USA
| | - Yesenia Covarrubias
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W. Arbor Drive #8756, San Diego, CA, 92103-8756, USA
| | - Jonathan C Hooker
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W. Arbor Drive #8756, San Diego, CA, 92103-8756, USA
| | - Ethan Z Sy
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W. Arbor Drive #8756, San Diego, CA, 92103-8756, USA
| | - Alexandra N Schlein
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W. Arbor Drive #8756, San Diego, CA, 92103-8756, USA
| | - Jennifer Y Cui
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W. Arbor Drive #8756, San Diego, CA, 92103-8756, USA
| | - Anthony C Gamst
- Computational and Applied Statistics Laboratory, University of California San Diego, San Diego, CA, USA
| | - Gavin Hamilton
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W. Arbor Drive #8756, San Diego, CA, 92103-8756, USA
| | - Scott B Reeder
- Department of Radiology, Medical Physics, Biomedical Engineering, Medicine, and Emergency Medicine, University of Wisconsin Madison, Madison, WI, USA
| | - Claude B Sirlin
- Liver Imaging Group, Department of Radiology, University of California San Diego, 200 W. Arbor Drive #8756, San Diego, CA, 92103-8756, USA
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159
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Substrate utilization and metabolic profile in response to overfeeding with a high-fat diet in South Asian and white men: a sedentary lifestyle study. Int J Obes (Lond) 2019; 44:136-146. [PMID: 31040398 DOI: 10.1038/s41366-019-0368-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 02/02/2019] [Accepted: 03/10/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND For the same BMI, South Asians have a higher body fat percentage, a higher liver fat content and a more adverse metabolic profile than whites. South Asians may have a lower fat oxidation than whites, which could result in an unfavorable metabolic profile when exposed to increased high-fat foods consumption and decreased physical activity as in current modern lifestyle. OBJECTIVE To determine substrate partitioning, liver fat accumulation and metabolic profile in South Asian and white men in response to overfeeding with high-fat diet under sedentary conditions in a respiration chamber. DESIGN Ten South Asian men (BMI, 18-29 kg/m2) and 10 white men (BMI, 22-33 kg/m2), matched for body fat percentage, aged 20-40 year were included. A weight maintenance diet (30% fat, 55% carbohydrate, and 15% protein) was given for 3 days. Thereafter, a baseline measurement of liver fat content (1H-MRS) and blood parameters was performed. Subsequently, subjects were overfed (150% energy requirement) with a high-fat diet (60% fat, 25% carbohydrate, and 15% protein) over 3 consecutive days while staying in a respiration chamber mimicking a sedentary lifestyle. Energy expenditure and substrate use were measured for 3 × 24-h. Liver fat and blood parameters were measured again after the subjects left the chamber. RESULTS The 24-h fat oxidation as a percentage of total energy expenditure did not differ between ethnicities (P = 0.30). Overfeeding increased liver fat content (P = 0.02), but the increase did not differ between ethnicities (P = 0.64). In South Asians, overfeeding tended to increase LDL-cholesterol (P = 0.08), tended to decrease glucose clearance (P = 0.06) and tended to elevate insulin response (P = 0.07) slightly more than whites. CONCLUSIONS Despite a similar substrate partitioning and similar accretion of liver fat, overfeeding with high-fat under sedentary conditions tended to have more adverse effects on the lipid profile and insulin sensitivity in South Asians.
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160
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Andersson J, Ahlström H, Kullberg J. Separation of water and fat signal in whole-body gradient echo scans using convolutional neural networks. Magn Reson Med 2019; 82:1177-1186. [PMID: 31033022 PMCID: PMC6618066 DOI: 10.1002/mrm.27786] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/20/2019] [Accepted: 04/07/2019] [Indexed: 12/11/2022]
Abstract
Purpose To perform and evaluate water–fat signal separation of whole‐body gradient echo scans using convolutional neural networks. Methods Whole‐body gradient echo scans of 240 subjects, each consisting of 5 bipolar echoes, were used. Reference fat fraction maps were created using a conventional method. Convolutional neural networks, more specifically 2D U‐nets, were trained using 5‐fold cross‐validation with 1 or several echoes as input, using the squared difference between the output and the reference fat fraction maps as the loss function. The outputs of the networks were assessed by the loss function, measured liver fat fractions, and visually. Training was performed using a graphics processing unit (GPU). Inference was performed using the GPU as well as a central processing unit (CPU). Results The loss curves indicated convergence, and the final loss of the validation data decreased when using more echoes as input. The liver fat fractions could be estimated using only 1 echo, but results were improved by use of more echoes. Visual assessment found the quality of the outputs of the networks to be similar to the reference even when using only 1 echo, with slight improvements when using more echoes. Training a network took at most 28.6 h. Inference time of a whole‐body scan took at most 3.7 s using the GPU and 5.8 min using the CPU. Conclusion It is possible to perform water–fat signal separation of whole‐body gradient echo scans using convolutional neural networks. Separation was possible using only 1 echo, although using more echoes improved the results.
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Affiliation(s)
- Jonathan Andersson
- Section of Radiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Håkan Ahlström
- Section of Radiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.,Antaros Medical, Mölndal, Sweden
| | - Joel Kullberg
- Section of Radiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.,Antaros Medical, Mölndal, Sweden
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161
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Castera L, Friedrich-Rust M, Loomba R. Noninvasive Assessment of Liver Disease in Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology 2019; 156:1264-1281.e4. [PMID: 30660725 PMCID: PMC7505052 DOI: 10.1053/j.gastro.2018.12.036] [Citation(s) in RCA: 849] [Impact Index Per Article: 169.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 12/02/2018] [Accepted: 12/24/2018] [Indexed: 02/07/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is estimated to afflict approximately 1 billion individuals worldwide. In a subset of NAFLD patients, who have the progressive form of NAFLD termed nonalcoholic steatohepatitis (NASH), it can progress to advanced fibrosis, cirrhosis, hepatocellular carcinoma, and liver-related morbidity and mortality. NASH is typically characterized by a specific pattern on liver histology, including steatosis, lobular inflammation, and ballooning with or without peri-sinusoidal fibrosis. Thus, key issues in NAFLD patients are the differentiation of NASH from simple steatosis and identification of advanced hepatic fibrosis. Until now, liver biopsy has been the gold standard for identifying these 2 critical end points, but has well-known limitations, including invasiveness; rare but potentially life-threatening complications; poor acceptability; sampling variability; and cost. Furthermore, due to the epidemic proportion of individuals with NAFLD worldwide, liver biopsy evaluation is impractical, and noninvasive assessment for the diagnosis of NASH and fibrosis is needed. Although much of the work remains to be done in establishing cost-effective strategies for screening for NASH, advanced fibrosis, and cirrhosis, in this review, we summarize the current state of the noninvasive assessment of liver disease in NAFLD, and we provide an expert synthesis of how these noninvasive tools could be utilized in clinical practice. Finally, we also list the key areas of research priorities in this area to move forward clinical practice.
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Affiliation(s)
- Laurent Castera
- Department of Hepatology, Hôpital Beaujon, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 1149, University of Paris-VII, Clichy, France.
| | - Mireen Friedrich-Rust
- Department of Internal Medicine 1, Division of Gastroenterology, Hepatology, Goethe University Hospital, Frankfurt, Germany
| | - Rohit Loomba
- Nonalcoholic Fatty Liver Disease Research Center, Division of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, California
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Triay Bagur A, Hutton C, Irving B, Gyngell ML, Robson MD, Brady M. Magnitude-intrinsic water-fat ambiguity can be resolved with multipeak fat modeling and a multipoint search method. Magn Reson Med 2019; 82:460-475. [PMID: 30874334 PMCID: PMC6593794 DOI: 10.1002/mrm.27728] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/16/2019] [Accepted: 02/15/2019] [Indexed: 12/21/2022]
Abstract
Purpose To develop a postprocessing algorithm for multiecho chemical‐shift encoded water–fat separation that estimates proton density fat fraction (PDFF) maps over the full dynamic range (0‐100%) using multipeak fat modeling and multipoint search optimization. To assess its accuracy, reproducibility, and agreement with state‐of‐the‐art complex‐based methods, and to evaluate its robustness to artefacts in abdominal PDFF maps. Methods We introduce MAGO (MAGnitude‐Only), a magnitude‐based reconstruction that embodies multipeak liver fat spectral modeling and multipoint optimization, and which is compatible with asymmetric echo acquisitions. MAGO is assessed first for accuracy and reproducibility on publicly available phantom data. Then, MAGO is applied to N = 178 UK Biobank cases, in which its liver PDFF measures are compared using Bland‐Altman analysis with those from a version of the hybrid iterative decomposition of water and fat with echo asymmetry and least squares estimation (IDEAL) algorithm, LiverMultiScan IDEAL (LMS IDEAL, Perspectum Diagnostics Ltd, Oxford, UK). Finally, MAGO is tested on a succession of high field challenging cases for which LMS IDEAL generated artefacts in the PDFF maps. Results Phantom data showed accurate, reproducible MAGO PDFF values across manufacturers, field strengths, and acquisition protocols. Moreover, we report excellent agreement between MAGO and LMS IDEAL for 6‐echo, 1.5 tesla human acquisitions (bias = −0.02% PDFF, 95% confidence interval = ±0.13% PDFF). When tested on 12‐echo, 3 tesla cases from different manufacturers, MAGO was shown to be more robust to artefacts compared to LMS IDEAL. Conclusion MAGO resolves the water–fat ambiguity over the entire fat fraction dynamic range without compromising accuracy, therefore enabling robust PDFF estimation where phase data is inaccessible or unreliable and complex‐based and hybrid methods fail.
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Affiliation(s)
| | - Chloe Hutton
- Perspectum Diagnostics Ltd, Oxford, United Kingdom
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Deibert P, Lazaro A, Schaffner D, Berg A, Koenig D, Kreisel W, Baumstark MW, Steinmann D, Buechert M, Lange T. Comprehensive lifestyle intervention vs soy protein-based meal regimen in non-alcoholic steatohepatitis. World J Gastroenterol 2019; 25:1116-1131. [PMID: 30862999 PMCID: PMC6406181 DOI: 10.3748/wjg.v25.i9.1116] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 02/15/2019] [Accepted: 02/16/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Non-alcoholic steatohepatitis (NASH) has become one of the leading causes of liver disease in the western world. In obese patients weight reduction is recommended. Up to now there are no specific guidelines for weight loss in order to reduce hepatic fat content.
AIM To investigate the effects of a 24-wk guided lifestyle intervention program compared to a meal replacement regimen based on soy protein.
METHODS Twenty-six subjects with NASH participated in a randomized single-center study. They were randomly assigned to either meal replacement group (MR-G) with soy-yogurt-honey preparation or to guided lifestyle change group (LC-G) with endurance activity and nutrition counselling. Serum alanine transaminase (ALT), aspartate transaminase (AST), lipid parameters, and adipokines were measured. Liver fat content and lipid composition were determined by magnetic resonance imaging and magnetic resonance spectroscopy. Body fat mass and lean body mass were assessed using Bod Pod® device. Pre- and post-intervention monitoring of parameters was performed. Statistical analyses were conducted with SPSS software, results were expressed as median (interquartile range).
RESULTS Twenty-two subjects (MR-G, n = 11 and LC-G, n = 11) completed the study (9 women, 13 men; age 52.1 (15.0) years, body mass index (BMI) 32.3 (3.3) kg/m²). In both groups a significant weight loss was achieved (MR-G: -6.4 (3.6) kg, P < 0.01; LC-G: -9.1 (10.4) kg, P < 0.01). BMI dropped in both groups (MR-G: -2.3 (1.5) kg/m2, P = 0.003; LC-G: -3.0 (3.4) kg/m2, P = 0.006). Internal fat and hepatic lipid content were markedly reduced in both groups in comparable amount. There was a strong correlation between reduction in liver fat and decrease in ALT. Likewise, both groups showed an improvement in glycemic control and lipid profile. Changes in adipokines, particularly in adiponectin and leptin were closely related to intrahepatic lipid changes.
CONCLUSION Comprehensive lifestyle intervention and meal replacement regimen have comparable effects on body and liver fat, as well as decrease in markers of hepatic inflammation among NASH patients.
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Affiliation(s)
- Peter Deibert
- Faculty of Medicine, Department of Medicine, Institute of Exercise and Occupational Medicine, Medical Center, University of Freiburg, Freiburg D-79106, Germany
| | - Adhara Lazaro
- Faculty of Medicine, Department of Medicine, Institute of Exercise and Occupational Medicine, Medical Center, University of Freiburg, Freiburg D-79106, Germany
| | - Denise Schaffner
- Faculty of Medicine, Department of Medicine, Institute of Exercise and Occupational Medicine, Medical Center, University of Freiburg, Freiburg D-79106, Germany
| | - Aloys Berg
- Department of Nutrition, Institute for Sports and Sports Science, University of Freiburg, Freiburg D-79106, Germany
| | - Daniel Koenig
- Department of Nutrition, Institute for Sports and Sports Science, University of Freiburg, Freiburg D-79106, Germany
| | - Wolfgang Kreisel
- Faculty of Medicine, Department of Medicine, Division of Gastroenterology, Hepatology, Endocrinology and Infectious Diseases, Medical Center, University of Freiburg, Freiburg D-79106, Germany
| | - Manfred W Baumstark
- Faculty of Medicine, Department of Medicine, Institute of Exercise and Occupational Medicine, Medical Center, University of Freiburg, Freiburg D-79106, Germany
| | - Daniel Steinmann
- University Hospital of Freiburg, Occupational Medicine, Freiburg 79110, Germany
| | - Martin Buechert
- Faculty of Medicine, Department of Radiology - Medical Physics, Medical Center, University of Freiburg, Freiburg D-79106, Germany
| | - Thomas Lange
- Faculty of Medicine, Department of Radiology - Medical Physics, Medical Center, University of Freiburg, Freiburg D-79106, Germany
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Tipirneni-Sajja A, Krafft AJ, Loeffler RB, Song R, Bahrami A, Hankins JS, Hillenbrand CM. Autoregressive moving average modeling for hepatic iron quantification in the presence of fat. J Magn Reson Imaging 2019; 50:1620-1632. [PMID: 30761652 DOI: 10.1002/jmri.26682] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 01/28/2019] [Accepted: 01/29/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Measuring hepatic R2* by fitting a monoexponential model to the signal decay of a multigradient-echo (mGRE) sequence noninvasively determines hepatic iron content (HIC). Concurrent hepatic steatosis introduces signal oscillations and confounds R2* quantification with standard monoexponential models. PURPOSE To evaluate an autoregressive moving average (ARMA) model for accurate quantification of HIC in the presence of fat using biopsy as the reference. STUDY TYPE Phantom study and in vivo cohort. POPULATION Twenty iron-fat phantoms covering clinically relevant R2* (30-800 s-1 ) and fat fraction (FF) ranges (0-40%), and 10 patients (four male, six female, mean age 18.8 years). FIELD STRENGTH/SEQUENCE 2D mGRE acquisitions at 1.5 T and 3 T. ASSESSMENT Phantoms were scanned at both field strengths. In vivo data were analyzed using the ARMA model to determine R2* and FF values, and compared with biopsy results. STATISTICAL TESTS Linear regression analysis was used to compare ARMA R2* and FF results with those obtained using a conventional monoexponential model, complex-domain nonlinear least squares (NLSQ) fat-water model, and biopsy. RESULTS In phantoms and in vivo, all models produced R2* and FF values consistent with expected values in low iron and low/high fat conditions. For high iron and no fat phantoms, monoexponential and ARMA models performed excellently (slopes: 0.89-1.07), but NLSQ overestimated R2* (slopes: 1.14-1.36) and produced false FFs (12-17%) at 1.5 T; in high iron and fat phantoms, NLSQ (slopes: 1.02-1.16) outperformed monoexponential and ARMA models (slopes: 1.23-1.88). The results with NLSQ and ARMA improved in phantoms at 3 T (slopes: 0.96-1.04). In patients, mean R2*-HIC estimates for monoexponential and ARMA models were close to biopsy-HIC values (slopes: 0.90-0.95), whereas NLSQ substantially overestimated HIC (slope 1.4) and produced false FF values (4-28%) with very high SDs (15-222%) in patients with high iron overload and no steatosis. DATA CONCLUSION ARMA is superior in quantifying R2* and FF under high iron and no fat conditions, whereas NLSQ is superior for high iron and concurrent fat at 1.5 T. Both models give improved R2* and FF results at 3 T. LEVEL OF EVIDENCE 2 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:1620-1632.
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Affiliation(s)
- Aaryani Tipirneni-Sajja
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.,Department of Biomedical Engineering, University of Memphis, Memphis, Tennessee, USA
| | - Axel J Krafft
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.,Department of Radiology, Medical Physics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ralf B Loeffler
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Ruitian Song
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Armita Bahrami
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Jane S Hankins
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Claudia M Hillenbrand
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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Inter-reader agreement of magnetic resonance imaging proton density fat fraction and its longitudinal change in a clinical trial of adults with nonalcoholic steatohepatitis. Abdom Radiol (NY) 2019; 44:482-492. [PMID: 30128694 DOI: 10.1007/s00261-018-1745-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To determine the inter-reader agreement of magnetic resonance imaging proton density fat fraction (PDFF) and its longitudinal change in a clinical trial of adults with nonalcoholic steatohepatitis (NASH). STUDY TYPE We performed a secondary analysis of a placebo-controlled randomized clinical trial of a bile acid sequestrant in 45 adults with NASH. A six-echo spoiled gradient-recalled-echo magnitude-based fat quantification technique was performed at 3 T. Three independent readers measured MRI-PDFF by placing one primary and two additional regions of interest (ROIs) in each segment at both time points. Cross-sectional agreement between the three readers was evaluated using intra-class correlation coefficients (ICCs) and coefficients of variation (CV). Additionally, we used Bland-Altman analyses to examine pairwise agreement between the three readers at baseline, end of treatment (EOT), and for longitudinal change. RESULTS Using all ROIs by all readers, mean PDFF at baseline, at EOT, and mean change in PDFF was 16.1%, 16.0%, and 0.07%, respectively. The 27-ROI PDFF measurements had 0.998 ICC and 1.8% CV at baseline, 0.998 ICC and 1.8% CV at EOT, and 0.997 ICC for longitudinal change. The 9-ROI PDFF measurements had corresponding values of 0.997 and 2.6%, 0.996 and 2.4%, and 0.994. Using 27 ROIs, the magnitude of the bias between readers for whole-liver PDFF measurement ranged from 0.03% to 0.06% points at baseline, 0.01% to 0.07% points at EOT, and 0.01% to 0.02% points for longitudinal change. CONCLUSION Inter-reader agreement for measuring whole-liver PDFF and its longitudinal change is high. 9-ROI measurements have only slightly lower agreement than 27-ROI measurements.
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Mozes FE, Tunnicliffe EM, Moolla A, Marjot T, Levick CK, Pavlides M, Robson MD. Mapping tissue water T 1 in the liver using the MOLLI T 1 method in the presence of fat, iron and B 0 inhomogeneity. NMR IN BIOMEDICINE 2019; 32:e4030. [PMID: 30462873 PMCID: PMC6492199 DOI: 10.1002/nbm.4030] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 09/11/2018] [Accepted: 09/20/2018] [Indexed: 05/11/2023]
Abstract
Modified Look-Locker inversion recovery (MOLLI) T1 mapping sequences can be useful in cardiac and liver tissue characterization, but determining underlying water T1 is confounded by iron, fat and frequency offsets. This article proposes an algorithm that provides an independent water MOLLI T1 (referred to as on-resonance water T1 ) that would have been measured if a subject had no fat and normal iron, and imaging had been done on resonance. Fifteen NiCl2 -doped agar phantoms with different peanut oil concentrations and 30 adults with various liver diseases, nineteen (63.3%) with liver steatosis, were scanned at 3 T using the shortened MOLLI (shMOLLI) T1 mapping, multiple-echo spoiled gradient-recalled echo and 1 H MR spectroscopy sequences. An algorithm based on Bloch equations was built in MATLAB, and water shMOLLI T1 values of both phantoms and human participants were determined. The quality of the algorithm's result was assessed by Pearson's correlation coefficient between shMOLLI T1 values and spectroscopically determined T1 values of the water, and by linear regression analysis. Correlation between shMOLLI and spectroscopy-based T1 values increased, from r = 0.910 (P < 0.001) to r = 0.998 (P < 0.001) in phantoms and from r = 0.493 (for iron-only correction; P = 0.005) to r = 0.771 (for iron, fat and off-resonance correction; P < 0.001) in patients. Linear regression analysis revealed that the determined water shMOLLI T1 values in patients were independent of fat and iron. It can be concluded that determination of on-resonance water (sh)MOLLI T1 independent of fat, iron and macroscopic field inhomogeneities was possible in phantoms and human subjects.
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Affiliation(s)
- Ferenc E. Mozes
- The University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe HospitalOxfordUK
| | - Elizabeth M. Tunnicliffe
- The University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe HospitalOxfordUK
| | - Ahmad Moolla
- The University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe HospitalOxfordUK
- Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM)University of Oxford, Churchill HospitalOxfordUK
| | - Thomas Marjot
- Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM)University of Oxford, Churchill HospitalOxfordUK
| | - Christina K. Levick
- The University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe HospitalOxfordUK
- Translational Gastroenterology UnitUniversity of Oxford, John Radcliffe HospitalOxfordUK
| | - Michael Pavlides
- The University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe HospitalOxfordUK
- Translational Gastroenterology UnitUniversity of Oxford, John Radcliffe HospitalOxfordUK
- Oxford NIHR Biomedical Research CentreOxfordUK
| | - Matthew D. Robson
- The University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe HospitalOxfordUK
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167
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Goldfarb JW, Craft J, Cao JJ. Water-fat separation and parameter mapping in cardiac MRI via deep learning with a convolutional neural network. J Magn Reson Imaging 2019; 50:655-665. [DOI: 10.1002/jmri.26658] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 11/08/2022] Open
Affiliation(s)
- James W. Goldfarb
- Department of Research and Education; Saint Francis Hospital; Roslyn New York USA
| | - Jason Craft
- Department of Research and Education; Saint Francis Hospital; Roslyn New York USA
| | - J. Jane Cao
- Department of Research and Education; Saint Francis Hospital; Roslyn New York USA
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168
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Franz D, Diefenbach MN, Treibel F, Weidlich D, Syväri J, Ruschke S, Wu M, Holzapfel C, Drabsch T, Baum T, Eggers H, Rummeny EJ, Hauner H, Karampinos DC. Differentiating supraclavicular from gluteal adipose tissue based on simultaneous PDFF and T 2 * mapping using a 20-echo gradient-echo acquisition. J Magn Reson Imaging 2019; 50:424-434. [PMID: 30684282 PMCID: PMC6767392 DOI: 10.1002/jmri.26661] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 01/15/2023] Open
Abstract
Background Adipose tissue (AT) can be classified into white and brown/beige subtypes. Chemical shift encoding‐based water–fat MRI‐techniques allowing simultaneous mapping of proton density fat fraction (PDFF) and T2* result in a lower PDFF and a shorter T2* in brown compared with white AT. However, AT T2* values vary widely in the literature and are primarily based on 6‐echo data. Increasing the number of echoes in a multiecho gradient‐echo acquisition is expected to increase the precision of AT T2* mapping. Purpose 1) To mitigate issues of current T2*‐measurement techniques through experimental design, and 2) to investigate gluteal and supraclavicular AT T2* and PDFF and their relationship using a 20‐echo gradient‐echo acquisition. Study Type Prospective. Subjects Twenty‐one healthy subjects. Field Strength/Sequence Assessment First, a ground truth signal evolution was simulated from a single‐T2* water–fat model. Second, a time‐interleaved 20‐echo gradient‐echo sequence with monopolar gradients of neck and abdomen/pelvis at 3 T was performed in vivo to determine supraclavicular and gluteal PDFF and T2*. Complex‐based water–fat separation was performed for the first 6 echoes and the full 20 echoes. AT depots were segmented. Statistical Tests Mann‐Whitney test, Wilcoxon signed‐rank test and simple linear regression analysis. Results Both PDFF and T2* differed significantly between supraclavicular and gluteal AT with 6 and 20 echoes (PDFF: P < 0.0001 each, T2*: P = 0.03 / P < 0.0001 for 6/20 echoes). 6‐echo T2* demonstrated higher standard deviations and broader ranges than 20‐echo T2*. Regression analyses revealed a strong relationship between PDFF and T2* values per AT compartment (R2 = 0.63 supraclavicular, R2 = 0.86 gluteal, P < 0.0001 each). Data Conclusion The present findings suggest that an increase in the number of sampled echoes beyond 6 does not affect AT PDFF quantification, whereas AT T2* is considerably affected. Thus, a 20‐echo gradient‐echo acquisition enables a multiparametric analysis of both AT PDFF and T2* and may therefore improve MR‐based differentiation between white and brown fat. Level of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:424–434.
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Affiliation(s)
- Daniela Franz
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Maximilian N Diefenbach
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Franziska Treibel
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Dominik Weidlich
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jan Syväri
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Stefan Ruschke
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Mingming Wu
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Christina Holzapfel
- Institute for Nutritional Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Theresa Drabsch
- Institute for Nutritional Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | | | - Ernst J Rummeny
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Hans Hauner
- Institute for Nutritional Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Curtis WA, Fraum TJ, An H, Chen Y, Shetty AS, Fowler KJ. Quantitative MRI of Diffuse Liver Disease: Current Applications and Future Directions. Radiology 2019; 290:23-30. [DOI: 10.1148/radiol.2018172765] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- William A. Curtis
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Tyler J. Fraum
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Hongyu An
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Yasheng Chen
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Anup S. Shetty
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
| | - Kathryn J. Fowler
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110
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Xavier A, Zacconi F, Gainza C, Cabrera D, Arrese M, Uribe S, Sing-Long C, Andia ME. Intrahepatic fatty acids composition as a biomarker of NAFLD progression from steatosis to NASH by using1H-MRS. RSC Adv 2019; 9:42132-42139. [PMID: 35542850 PMCID: PMC9076551 DOI: 10.1039/c9ra08914d] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 12/10/2019] [Indexed: 12/30/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the world and it is becoming one of the most frequent cause of liver transplantation. Unfortunately, the only available method that can reliably determine the stage of this disease is liver biopsy, however, it is invasive and risky for patients. The purpose of this study is to investigate changes in the intracellular composition of the liver fatty acids during the progression of the NAFLD in a mouse model fed with Western diet, with the aim of identify non-invasive biomarkers of NAFLD progression based in 1H-MRS. Our results showed that the intracellular liver fatty acid composition changes as NAFLD progresses from simple steatosis to steatohepatitis (NASH). Using principal component analysis with a clustering method, it was possible to identify the three most relevant clinical groups: normal, steatosis and NASH by using 1H-MRS. These results showed a good agreement with the results obtained by GC-MS and histology. Our results suggest that it would be possible to detect the progression of simple steatosis to NASH using 1H-MRS, that has the potential to be used routinely in clinical application for screening high-risk patients. Our results suggest that it would be possible to detect the progression of simple steatosis to NASH using 1H-MRS.![]()
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Affiliation(s)
- Aline Xavier
- Biomedical Imaging Center
- Pontificia Universidad Católica de Chile
- Chile
- Millennium Nucleus for Cardiovascular Magnetic Resonance
- Chile
| | - Flavia Zacconi
- Faculty of Chemistry and Pharmacy
- Pontificia Universidad Católica de Chile
- Chile
- Research Center for Nanotechnology and Advanced Materials CIEN-UC
- Pontificia Univesidad Católica de Chile
| | - Constanza Gainza
- Institute for Mathematical and Computational Engineering
- Pontificia Universidad Católica de Chile
- Chile
| | - Daniel Cabrera
- Gastroenterology Department
- School of Medicine
- Pontificia Universidad Católica de Chile
- Chile
- Department of Chemical and Biological Sciences
| | - Marco Arrese
- Gastroenterology Department
- School of Medicine
- Pontificia Universidad Católica de Chile
- Chile
| | - Sergio Uribe
- Biomedical Imaging Center
- Pontificia Universidad Católica de Chile
- Chile
- Millennium Nucleus for Cardiovascular Magnetic Resonance
- Chile
| | - Carlos Sing-Long
- Biomedical Imaging Center
- Pontificia Universidad Católica de Chile
- Chile
- Millennium Nucleus for Cardiovascular Magnetic Resonance
- Chile
| | - Marcelo E. Andia
- Biomedical Imaging Center
- Pontificia Universidad Católica de Chile
- Chile
- Millennium Nucleus for Cardiovascular Magnetic Resonance
- Chile
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171
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Pino AM, Rodríguez JP. Is fatty acid composition of human bone marrow significant to bone health? Bone 2019; 118:53-61. [PMID: 29258874 DOI: 10.1016/j.bone.2017.12.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 12/15/2017] [Indexed: 12/31/2022]
Abstract
The bone marrow adipose tissue (BMAT) is a conserved component of the marrow microenvironment, providing storage and release of energy and stabilizing the marrow extent. Also, it is recognized both the amount and quality of BMAT are relevant to preserve the functional relationships between BMAT, bone, and blood cell production. In this article we ponder the information supporting the tenet that the quality of BMAT is relevant to bone health. In the human adult the distribution of BMAT is heterogeneous over the entire skeleton, and both BMAT accumulation and bone loss come about with aging in healthy populations. But some pathological conditions which increase BMAT formation lead to bone impairment and fragility. Analysis in vivo of the relative content of saturated and unsaturated fatty acids (FA) in BMAT indicates site-related bone marrow fat composition and an association between increased unsaturation index (UI) and bone health. With aging some impairment ensues in the regulation of bone marrow cells and systemic signals leading to local chronic inflammation. Most of the bone loss diseases which evolve altered BMAT composition have as common factors aging and/or chronic inflammation. Both saturated and unsaturated FAs originate lipid species which are active mediators in the inflammation process. Increased free saturated FAs may lead to lipotoxicity of bone marrow cells. The pro-inflammatory, anti-inflammatory or resolving actions of compounds derived from long chain poly unsaturated FAs (PUFA) on bone cells is varied, and depending on the metabolism of the parent n:3 or n:6 PUFAs series. Taking together the evidence substantiate that marrow adipocyte function is fundamental for an efficient link between systemic and marrow fatty acids to accomplish specific energy or regulatory needs of skeletal and marrow cells. Further, they reveal marrow requirements of PUFAs.
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Affiliation(s)
- Ana María Pino
- Laboratorio de Biología Celular, INTA, Universidad de Chile, Chile
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Pasanta D, Tungjai M, Chancharunee S, Sajomsang W, Kothan S. Body mass index and its effects on liver fat content in overweight and obese young adults by proton magnetic resonance spectroscopy technique. World J Hepatol 2018; 10:924-933. [PMID: 30631397 PMCID: PMC6323521 DOI: 10.4254/wjh.v10.i12.924] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 08/03/2018] [Accepted: 08/21/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the association between liver fat content (LFC) and weight status in young adults using proton magnetic resonance spectroscopy (1H MRS) technique.
METHODS Seventy-eight healthy young adults, between 19-30 years of age participated in this study. This group was then separated into a control of 39 subjects and an overweight/obese group (OW/OB group) consisting of 39 subjects. Blood biochemical quantity and 1H MRS was performed for LFC assessment.
RESULTS LFC was found to be almost three times higher in OW/OB group when compared to the control group. A 48.7% incidence of non-alcoholic fatty liver disease in the OW/OB group was found. Blood biochemical measurements showed statistically higher low-density lipoproteins and triglyceride, lower high-density lipoproteins, and increased glycosylated hemoglobin and fasting glucose in the OW/OB group. Body mass index was a significant independent predictor for LFC after adjusting for age and sex (multiple linear regression; β = 0.459, P < 0.001).
CONCLUSION Due to the prevalence of high LFC in the OW/OB group, it can be proposed that weight gain and obesity are sensitive indicators of high hepatic fat content.
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Affiliation(s)
- Duanghathai Pasanta
- Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Montree Tungjai
- Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Sirirat Chancharunee
- Department of Chemistry, Faculty of Science, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Warayuth Sajomsang
- National Nanotechnology Center, National Science and Technology Development Agency, Thailand Science Park, Pathum Thani 12120, Thailand
| | - Suchart Kothan
- Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
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173
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Martel D, Leporq B, Saxena A, Belmont HM, Turyan G, Honig S, Regatte RR, Chang G. 3T chemical shift-encoded MRI: Detection of altered proximal femur marrow adipose tissue composition in glucocorticoid users and validation with magnetic resonance spectroscopy. J Magn Reson Imaging 2018; 50:490-496. [PMID: 30548522 DOI: 10.1002/jmri.26586] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/07/2018] [Accepted: 11/08/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Osteoporosis (OP) results in weak bone and can ultimately lead to fracture. Drugs such as glucocorticoids can also induce OP (glucocorticoid-induced osteoporosis [GIO]). Bone marrow adipose tissue composition and quantity may play a role in OP pathophysiology, but has not been thoroughly studied in GIO compared to primary OP. PURPOSE/HYPOTHESIS Chemical shift-encoded (CSE) MRI allows detection of subregional differences in bone marrow adipose tissue composition and quantity in the proximal femur of GIO compared to OP subjects and has high agreement with the reference standard of magnetic resonance spectroscopy (MRS). STUDY TYPE Prospective. SUBJECTS In all, 18 OP and 13 GIO subjects. FIELDS STRENGTH 3T. SEQUENCE Multiple gradient-echo, stimulated echo acquisition mode (STEAM). ASSESSMENT Subjects underwent CSE-MRI in the proximal femurs, and for each parametric map regions of interest (ROIs) were assessed in the femoral head (fHEAD), femoral neck (fNECK), Ward's triangle (fTRIANGLE), and the greater trochanter (GTROCH). In addition, we compared CSE-MRI against the reference standard of MRS performed in the femoral neck and Ward's triangle. STATISTICAL TESTS Differences between OP/GIO were investigated using the Mann-Whitney nonparametric test. Bland-Altman methodology was used to assess measurement agreement between CSE-MRI and MRS. RESULTS GIO compared with OP subjects demonstrated: decreased monounsaturated fat fraction (MUFA) (-2.1%, P < 0.05) in fHEAD; decreased MUFA (-3.8%, P < 0.05), increased saturated fat fraction (SFA) (5.5%, P < 0.05), and decreased T 2 * (-3.8 msec, P < 0.05) in fNECK; decreased proton density fat fraction (PDFF) (-15.1%, P < 0.05), MUFA (-9.8%, P < 0.05), polyunsaturated fat fraction (PUFA) (-1.8%, P < 0.01), increased SFA (11.6%, P < 0.05), and decreased T 2 * (-5.4 msec, P < 0.05) in fTRIANGLE; and decreased T 2 * (-1.5 msec, P < 0.05) in GTROCH. There was high measurement agreement between MRI and MRS using the Bland-Altman test. DATA CONCLUSION 3T CSE-MRI may allow reliable assessment of subregional bone marrow adipose tissue (bMAT) quantity and composition in the proximal femur in a clinically reasonable scan time. Glucocorticoids may alter the lipid profile of bMAT and potentially result in reduced bone quality. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:490-496.
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Affiliation(s)
- Dimitri Martel
- New York Langone Health, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Benjamin Leporq
- Université de Lyon, CREATIS CNRS UMR 5220, Inserm U1206, INSA-Lyon, UCBL Lyon 1, Lyon, France
| | - Amit Saxena
- New York Langone Health, Division of Rheumatology, Hospital for Joint Diseases, New York, New York, USA
| | - H Michael Belmont
- New York Langone Health, Division of Rheumatology, Hospital for Joint Diseases, New York, New York, USA
| | - Gabrielle Turyan
- New York Langone Health, Osteoporosis Center, Hospital for Joint Diseases, New York, New York, USA
| | - Stephen Honig
- New York Langone Health, Osteoporosis Center, Hospital for Joint Diseases, New York, New York, USA
| | - Ravinder R Regatte
- New York Langone Health, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Gregory Chang
- New York Langone Health, Department of Radiology, New York University School of Medicine, New York, New York, USA
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174
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Kim HJ, Cho HJ, Kim B, You MW, Lee JH, Huh J, Kim JK. Accuracy and precision of proton density fat fraction measurement across field strengths and scan intervals: A phantom and human study. J Magn Reson Imaging 2018; 50:305-314. [PMID: 30430684 DOI: 10.1002/jmri.26575] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/27/2018] [Accepted: 10/29/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Complex-based chemical shift imaging-based magnetic resonance imaging (CSE-MRI) is emerging as a preferred method for noninvasively quantifying proton density fat fraction (PDFF), a promising quantitative imaging biomarker (QIB) for longitudinal hepatic steatosis measurement. PURPOSE To determine linearity, bias, repeatability, and reproducibility of the PDFF measurement using CSE-MRI (CSE-PDFF) across scan intervals, MR field strengths, and readers in phantom and nonalcoholic fatty liver disease (NAFLD) patients. STUDY TYPE Institutional Review Board (IRB)-approved prospective. SUBJECTS Fat-water phantom and 20 adult patients. FIELD STRENGTH/SEQUENCE 1.5 T and 3.0 T MR systems and a commercially available CSE-MRI sequence (IDEAL-IQ). ASSESSMENT Two independent readers measured CSE-PDFF of fat-water phantom and NAFLD patients across two field strengths and scan intervals (same-day and 2-week) each and in a combination of both. MR spectroscopy-based PDFF (MRS-PDFF) was used as the reference standard for phantom PDFF. STATISTICAL TESTS Linearity and bias of measurement were evaluated by linear regression analysis and Bland-Altman plots, respectively. Repeatability and reproducibility were assessed by coefficient of variance and repeatability / reproducibility coefficients (RC). The intraclass correlation coefficient was used to validate intra- and interobserver agreements. RESULTS CSE-PDFF showed high linearity and small bias (-0.6-0.4 PDFF%) with 95% limits of agreement within ±2.9 PDFF% across field strengths, 2-week interscan period, and readers in the clinical scans. CSE-PDFF was highly repeatable and reproducible both in phantom and clinical scans, with the largest observed RC across field strengths and 2-week interscan period being 3 PDFF%. DATA CONCLUSION CSE-PDFF is a robust QIB with high linearity, small bias, and excellent repeatability/reproducibility. A change of more than 3 PDFF% across field strengths within 2 weeks of scan interval likely reflects a true change, which is well within the clinically acceptable range. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:305-314.
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Affiliation(s)
- Hye Jin Kim
- Department of Radiology, Ajou University School of Medicine, Ajou University Hospital, Suwon, South Korea
| | - Hyo Jung Cho
- Department of Gastroenterology, Ajou University School of Medicine, Ajou University Hospital, Suwon, South Korea
| | - Bohyun Kim
- Department of Radiology, Ajou University School of Medicine, Ajou University Hospital, Suwon, South Korea
| | - Myung-Won You
- Department of Radiology, Kyung Hee University Hospital, Seoul, South Korea
| | - Jei Hee Lee
- Department of Radiology, Ajou University School of Medicine, Ajou University Hospital, Suwon, South Korea
| | - Jimi Huh
- Department of Radiology, Ajou University School of Medicine, Ajou University Hospital, Suwon, South Korea
| | - Jai Keun Kim
- Department of Radiology, Ajou University School of Medicine, Ajou University Hospital, Suwon, South Korea
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175
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Simchick G, Liu Z, Nagy T, Xiong M, Zhao Q. Assessment of MR-based R2* and quantitative susceptibility mapping for the quantification of liver iron concentration in a mouse model at 7T. Magn Reson Med 2018; 80:2081-2093. [PMID: 29575047 PMCID: PMC6107404 DOI: 10.1002/mrm.27173] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 01/19/2023]
Abstract
PURPOSE To assess the feasibility of quantifying liver iron concentration (LIC) using R2* and quantitative susceptibility mapping (QSM) at a high field strength of 7 Tesla (T). METHODS Five different concentrations of Fe-dextran were injected into 12 mice to produce various degrees of liver iron overload. After mice were sacrificed, blood and liver samples were harvested. Ferritin enzyme-linked immunosorbent assay (ELISA) and inductively coupled plasma mass spectrometry were performed to quantify serum ferritin concentration and LIC. Multiecho gradient echo MRI was conducted to estimate R2* and the magnetic susceptibility of each liver sample through complex nonlinear least squares fitting and a morphology enabled dipole inversion method, respectively. RESULTS Average estimates of serum ferritin concentration, LIC, R2*, and susceptibility all show good linear correlations with injected Fe-dextran concentration; however, the standard deviations in the estimates of R2* and susceptibility increase with injected Fe-dextran concentration. Both R2* and susceptibility measurements also show good linear correlations with LIC (R2 = 0.78 and R2 = 0.91, respectively), and a susceptibility-to-LIC conversion factor of 0.829 ppm/(mg/g wet) is derived. CONCLUSION The feasibility of quantifying LIC using MR-based R2* and QSM at a high field strength of 7T is demonstrated. Susceptibility quantification, which is an intrinsic property of tissues and benefits from being field-strength independent, is more robust than R2* quantification in this ex vivo study. A susceptibility-to-LIC conversion factor is presented that agrees relatively well with previously published QSM derived results obtained at 1.5T and 3T.
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Affiliation(s)
- Gregory Simchick
- Physics and Astronomy, University of Georgia, Athens, GA, United States
- Bio-Imaging Research Center, University of Georgia, Athens, GA, United States
| | - Zhi Liu
- Pharmaceutical & Biomedical Sciences, University of Georgia, Athens, GA United States
| | - Tamas Nagy
- Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA United States
| | - May Xiong
- Pharmaceutical & Biomedical Sciences, University of Georgia, Athens, GA United States
| | - Qun Zhao
- Physics and Astronomy, University of Georgia, Athens, GA, United States
- Bio-Imaging Research Center, University of Georgia, Athens, GA, United States
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176
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Schneider M, Janas G, Lugauer F, Hoppe E, Nickel D, Dale BM, Kiefer B, Maier A, Bashir MR. Accurate fatty acid composition estimation of adipose tissue in the abdomen based on bipolar multi‐echo MRI. Magn Reson Med 2018; 81:2330-2346. [DOI: 10.1002/mrm.27557] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/18/2018] [Accepted: 09/11/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Manuel Schneider
- Pattern Recognition Lab, Department of Computer Science Friedrich‐Alexander‐Universität Erlangen‐Nürnberg Erlangen Germany
| | - Gemini Janas
- Radiology Duke University Medical Center Durham North Carolina
- Center for Advanced Magnetic Resonance Development Duke University Medical Center Durham North Carolina
| | - Felix Lugauer
- Pattern Recognition Lab, Department of Computer Science Friedrich‐Alexander‐Universität Erlangen‐Nürnberg Erlangen Germany
| | - Elisabeth Hoppe
- Pattern Recognition Lab, Department of Computer Science Friedrich‐Alexander‐Universität Erlangen‐Nürnberg Erlangen Germany
| | - Dominik Nickel
- MR Applications Predevelopment Siemens Healthcare GmbH Erlangen Germany
| | - Brian M. Dale
- MR R&D Collaborations Siemens Healthineers Cary North Carolina
| | - Berthold Kiefer
- MR Applications Predevelopment Siemens Healthcare GmbH Erlangen Germany
| | - Andreas Maier
- Pattern Recognition Lab, Department of Computer Science Friedrich‐Alexander‐Universität Erlangen‐Nürnberg Erlangen Germany
| | - Mustafa R. Bashir
- Radiology Duke University Medical Center Durham North Carolina
- Center for Advanced Magnetic Resonance Development Duke University Medical Center Durham North Carolina
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177
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Su GY, Wang CB, Hu H, Liu J, Ding HY, Xu XQ, Wu FY. Effect of laterality, gender, age and body mass index on the fat fraction of salivary glands in healthy volunteers: assessed using iterative decomposition of water and fat with echo asymmetry and least-squares estimation method. Dentomaxillofac Radiol 2018; 48:20180263. [PMID: 30306806 DOI: 10.1259/dmfr.20180263] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES: To evaluate the effect of laterality, gender, age and body mass index (BMI) on fat fraction (FF) measurements of both parotid glands (PGs) and submandibular glands (SMGs) by using: Iterative decomposition of water and fat with echo asymmetry and least-squares estimation method (IDEAL-IQ). METHODS: A total of 87 healthy participants were enrolled in our study. IDEAL-IQ image was scanned using a 3.0 T scanner. Paired t test was performed to compare the difference on FF of both PGs and SMGs between left and right side. The FF of two glands between male and female healthy participants were compared using an unpaired t-test. The correlation between the FF of two glands and participant age or BMI were analyzed by Pearson's correlation. RESULTS: Excellent inter- and intrareader agreements were obtained during the measurements of FF by IDEAL-IQ method (ICC, 0.952-0.981). FF values correlated positively with the age and BMI in both left and right PGs and SMGs (p < 0.05). No significant difference was found on FF between left and right PGs and SMGs (p > 0.05). There was also no difference on FF between male and female healthy participants (p > 0.05). CONCLUSIONS: FFs of PGs and SMGs were age- and BMI- dependent, but not laterality- and gender-dependent. The effect of age and BMI need to be considered in further studies using Ideal-IQ technology to evaluate FFs of salivary gland diseases.
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Affiliation(s)
- Guo-Yi Su
- 1 Department of Radiology, The First Affiliated Hospital of Nanjing Medical University , Nanjing , China
| | - Chuan-Bing Wang
- 1 Department of Radiology, The First Affiliated Hospital of Nanjing Medical University , Nanjing , China
| | - Hao Hu
- 1 Department of Radiology, The First Affiliated Hospital of Nanjing Medical University , Nanjing , China
| | - Jun Liu
- 1 Department of Radiology, The First Affiliated Hospital of Nanjing Medical University , Nanjing , China
| | - Hong-Yuan Ding
- 1 Department of Radiology, The First Affiliated Hospital of Nanjing Medical University , Nanjing , China
| | - Xiao-Quan Xu
- 1 Department of Radiology, The First Affiliated Hospital of Nanjing Medical University , Nanjing , China
| | - Fei-Yun Wu
- 1 Department of Radiology, The First Affiliated Hospital of Nanjing Medical University , Nanjing , China
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178
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Bashir MR, Wolfson T, Gamst AC, Fowler KJ, Ohliger M, Shah SN, Alazraki A, Trout AT, Behling C, Allende DS, Loomba R, Sanyal A, Schwimmer J, Lavine JE, Shen W, Tonascia J, Van Natta ML, Mamidipalli A, Hooker J, Kowdley KV, Middleton MS, Sirlin CB. Hepatic R2* is more strongly associated with proton density fat fraction than histologic liver iron scores in patients with nonalcoholic fatty liver disease. J Magn Reson Imaging 2018; 49:1456-1466. [PMID: 30318834 DOI: 10.1002/jmri.26312] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/09/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The liver R2* value is widely used as a measure of liver iron but may be confounded by the presence of hepatic steatosis and other covariates. PURPOSE To identify the most influential covariates for liver R2* values in patients with nonalcoholic fatty liver disease (NAFLD). STUDY TYPE Retrospective analysis of prospectively acquired data. POPULATION Baseline data from 204 subjects enrolled in NAFLD/NASH (nonalcoholic steatohepatitis) treatment trials. FIELD STRENGTH 1.5T and 3T; chemical-shift encoded multiecho gradient echo. ASSESSMENT Correlation between liver proton density fat fraction and R2*; assessment for demographic, metabolic, laboratory, MRI-derived, and histological covariates of liver R2*. STATISTICAL TESTS Pearson's and Spearman's correlations; univariate analysis; gradient boosting machines (GBM) multivariable machine-learning method. RESULTS Hepatic proton density fat fraction (PDFF) was the most strongly correlated covariate for R2* at both 1.5T (r = 0.652, P < 0.0001) and at 3T (r = 0.586, P < 0.0001). In the GBM analysis, hepatic PDFF was the most influential covariate for hepatic R2*, with relative influences (RIs) of 61.3% at 1.5T and 47.5% at 3T; less influential covariates had RIs of up to 11.5% at 1.5T and 16.7% at 3T. Nonhepatocellular iron was weakly associated with R2* at 3T only (RI 6.7%), and hepatocellular iron was not associated with R2* at either field strength. DATA CONCLUSION Hepatic PDFF is the most influential covariate for R2* at both 1.5T and 3T; nonhepatocellular iron deposition is weakly associated with liver R2* at 3T only. LEVEL OF EVIDENCE 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1456-1466.
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Affiliation(s)
- Mustafa R Bashir
- Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA.,Center for Advanced Magnetic Resonance Development (CAMRD), Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA.,Division of Gastroenterology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Tanya Wolfson
- Computational and Applied Statistics Laboratory (CASL), San Diego Supercomputing Center (SDSC), University of California-San Diego, San Diego, California, USA
| | - Anthony C Gamst
- Computational and Applied Statistics Laboratory (CASL), San Diego Supercomputing Center (SDSC), University of California-San Diego, San Diego, California, USA
| | - Kathryn J Fowler
- Department of Radiology, Washington University, St. Louis, Missouri, USA
| | - Michael Ohliger
- Departments of Radiology and Biomedical Engineering, University of California-San Francisco, San Francisco, California, USA
| | - Shetal N Shah
- Section of Abdominal Imaging and Nuclear Medicine Department, Imaging Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Adina Alazraki
- Departments of Radiology and Pediatrics, Emory University School of Medicine/Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Andrew T Trout
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Cynthia Behling
- Department of Pathology, University of California-San Diego, La Jolla, California, USA
| | | | - Rohit Loomba
- NAFLD Research Center, Division of Gastroenterology, Department of Medicine, University of California-San Diego, La Jolla, California, USA
| | - Arun Sanyal
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jeffrey Schwimmer
- Department of Pediatrics, University of California-San Diego, San Diego, California, USA
| | - Joel E Lavine
- Department of Pediatrics, Columbia College of Physicians and Surgeons, New York, New York, USA
| | - Wei Shen
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics and the Institute of Human Nutrition, Columbia University Medical Center, New York, New York, USA
| | - James Tonascia
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mark L Van Natta
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Adrija Mamidipalli
- Liver Imaging Group, Department of Radiology, University of California, San Diego, San Diego, California, USA
| | - Jonathan Hooker
- Liver Imaging Group, Department of Radiology, University of California, San Diego, San Diego, California, USA
| | - Kris V Kowdley
- Liver Care Network and Organ Care Research, Swedish Medical Center, Seattle, Washington, USA
| | - Michael S Middleton
- Liver Imaging Group, Department of Radiology, University of California, San Diego, San Diego, California, USA
| | - Claude B Sirlin
- Liver Imaging Group, Department of Radiology, University of California, San Diego, San Diego, California, USA
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- Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA
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Stinson EG, Trzasko JD, Campeau NG, Glockner JF, Huston J, Young PM, Riederer SJ. Time-resolved contrast-enhanced MR angiography with single-echo Dixon fat suppression. Magn Reson Med 2018; 80:1556-1567. [PMID: 29488251 PMCID: PMC6097950 DOI: 10.1002/mrm.27152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 01/26/2018] [Accepted: 02/05/2018] [Indexed: 01/07/2023]
Abstract
PURPOSE Dixon-based fat suppression has recently gained interest for dynamic contrast-enhanced MRI, but multi-echo techniques require longer scan times and reduce temporal resolution compared to single-echo alternatives without fat suppression. The purpose of this work is to demonstrate accelerated single-echo Dixon imaging with high spatial and temporal resolution. THEORY AND METHODS Real-valued water and fat images can be obtained from a single measurement if the shared initial phase and that due to ΔB0 are assumed known a priori. An expression for simultaneous sensitivity encoding (SENSE) unfolding and fat-water separation is derived for the general undersampling case, and simplified under the special case of uniform Cartesian undersampling. In vivo experiments were performed in extremities and brain with SENSE acceleration factors of up to R = 8. RESULTS Single-echo Dixon reconstruction of highly undersampled data was successfully demonstrated. Dynamic contrast-enhanced water and fat images provided high spatial and temporal resolution dynamic images with image update times shorter than previous single-echo Dixon work. CONCLUSION Time-resolved contrast-enhanced MRI with single-echo Dixon fat suppression shows high image quality, improved vessel delineation, and reduced sensitivity to motion when compared to time-subtraction methods.
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Affiliation(s)
| | | | | | | | - John Huston
- Mayo Clinic, Department of Radiology, Rochester, MN, USA
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180
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Hutton C, Gyngell ML, Milanesi M, Bagur A, Brady M. Validation of a standardized MRI method for liver fat and T2* quantification. PLoS One 2018; 13:e0204175. [PMID: 30235288 PMCID: PMC6147490 DOI: 10.1371/journal.pone.0204175] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/03/2018] [Indexed: 01/01/2023] Open
Abstract
Purpose Several studies have demonstrated the accuracy, precision, and reproducibility of proton density fat fraction (PDFF) quantification using vendor-specific image acquisition protocols and PDFF estimation methods. The purpose of this work is to validate a confounder-corrected, cross-vendor, cross field-strength, in-house variant LMS IDEAL of the IDEAL method licensed from the University of Wisconsin, which has been developed for routine clinical use. Methods LMS IDEAL is implemented using a combination of patented and/or published acquisition and some novel model fitting methods required to correct confounds which result from the imaging and estimation processes, including: water-fat ambiguity; T2* relaxation; multi-peak fat modelling; main field inhomogeneity; T1 and noise bias; bipolar readout gradients; and eddy currents. LMS IDEAL has been designed to use image acquisition protocols that can be installed on most MRI scanners and cloud-based image processing to provide fast, standardized clinical results. Publicly available phantom data were used to validate LMS IDEAL PDFF calculations against results from originally published IDEAL methodology. LMS PDFF and T2* measurements were also compared with an independent technique in human volunteer data (n = 179) acquired as part of the UK Biobank study. Results We demonstrate excellent agreement of LMS IDEAL across vendors, field strengths, and over a wide range of PDFF and T2* values in the phantom study. The performance of LMS IDEAL was then assessed in vivo against widely accepted PDFF and T2* estimation methods (LMS Dixon and LMS T2*, respectively), demonstrating the robustness of LMS IDEAL to potential sources of error. Conclusion The development and clinical validation of the LMS IDEAL algorithm as a chemical shift-encoded MRI method for PDFF and T2* estimation contributes towards robust, unbiased applications for quantification of hepatic steatosis and iron overload, which are key features of chronic liver disease.
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Affiliation(s)
- Chloe Hutton
- Perspectum Diagnostics, Oxford, United Kingdom
- * E-mail:
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181
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Nemeth A, Segrestin B, Leporq B, Coum A, Gambarota G, Seyssel K, Laville M, Beuf O, Ratiney H. Comparison of MRI-derived vs. traditional estimations of fatty acid composition from MR spectroscopy signals. NMR IN BIOMEDICINE 2018; 31:e3991. [PMID: 30040156 DOI: 10.1002/nbm.3991] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 05/29/2018] [Accepted: 06/07/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION The composition of fatty acids in the body is gaining increasing interest, and can be followed up noninvasively by quantitative magnetic resonance spectroscopy (MRS). However, current MRS quantification methods have been shown to provide different quantitative results in terms of lipid signals, with possible varying outcomes for a given biological examination. Quantitative magnetic resonance imaging using multigradient echo sequence (MGE-MRI) has recently been added to MRS approaches. In contrast, these methods fit the undersampled magnetic resonance temporal signal with a simplified model function (expressing the triglyceride [TG] spectrum with only three TG parameters), specific implementations and prior knowledge. In this study, an adaptation of an MGE-MRI method to MRS lipid quantification is proposed. METHODS Several versions of the method - with time data fully or undersampled, including or excluding the spectral peak T2 knowledge in the fitting - were compared theoretically and on Monte Carlo studies with a time-domain, peak-fitting approach. Robustness, repeatability and accuracy were also inspected on in vitro oil acquisitions and test-retest in vivo subcutaneous adipose tissue acquisitions, adding results from the reference LCModel method. RESULTS On simulations, the proposed method provided TG parameter estimates with the smallest variability, but with a possible bias, which was mitigated by fitting on undersampled data and considering peak T2 values. For in vitro measurements, estimates for all approaches were correlated with theoretical values and the best concordance was found for the usual MRS method (LCModel and peak fitting). Limited in vivo test-retest variability was found (4.1% for PUFAindx, 0.6% for MUFAindx and 3.6% for SFAindx), as for LCModel (7.6% for PUFAindx, 7.8% for MUFAindx and 3.0% for SFAindx). CONCLUSION This study shows that fitting the three TG parameters directly on MRS data is one valuable solution to circumvent the poor conditioning of the MRS quantification problem.
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Affiliation(s)
- Angeline Nemeth
- Université Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
| | - Bérénice Segrestin
- Centre de Recherche en Nutrition Humaine Rhône-Alpes (CRNH-RA), Centre Hospitalier Lyon Sud, Pierre-Bénite, Lyon, France
| | - Benjamin Leporq
- Université Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
| | - Amandine Coum
- INSERM, UMR 1099, Rennes, France
- Université Rennes 1, LTSI, Rennes, France
| | - Giulio Gambarota
- INSERM, UMR 1099, Rennes, France
- Université Rennes 1, LTSI, Rennes, France
| | - Kevin Seyssel
- Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Martine Laville
- Centre de Recherche en Nutrition Humaine Rhône-Alpes (CRNH-RA), Centre Hospitalier Lyon Sud, Pierre-Bénite, Lyon, France
| | - Olivier Beuf
- Université Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
| | - Hélène Ratiney
- Université Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, Lyon, France
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Zhang YN, Fowler KJ, Hamilton G, Cui JY, Sy EZ, Balanay M, Hooker JC, Szeverenyi N, Sirlin CB. Liver fat imaging-a clinical overview of ultrasound, CT, and MR imaging. Br J Radiol 2018; 91:20170959. [PMID: 29722568 PMCID: PMC6223150 DOI: 10.1259/bjr.20170959] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Hepatic steatosis is a frequently encountered imaging finding that may indicate chronic liver disease, the most common of which is non-alcoholic fatty liver disease. Non-alcoholic fatty liver disease is implicated in the development of systemic diseases and its progressive phenotype, non-alcoholic steatohepatitis, leads to increased liver-specific morbidity and mortality. With the rising obesity epidemic and advent of novel therapeutics aimed at altering metabolism, there is a growing need to quantify and monitor liver steatosis. Imaging methods for assessing steatosis range from simple and qualitative to complex and highly accurate metrics. Ultrasound may be appropriate in some clinical instances as a screening modality to identify the presence of abnormal liver morphology. However, it lacks sufficient specificity and sensitivity to constitute a diagnostic modality for instigating and monitoring therapy. Newer ultrasound techniques such as quantitative ultrasound show promise in turning qualitative assessment of steatosis on conventional ultrasound into quantitative measurements. Conventional unenhanced CT is capable of detecting and quantifying moderate to severe steatosis but is inaccurate at diagnosing mild steatosis and involves the use of radiation. Newer CT techniques, like dual energy CT, show potential in expanding the role of CT in quantifying steatosis. MRI proton-density fat fraction is currently the most accurate and precise imaging biomarker to quantify liver steatosis. As such, proton-density fat fraction is the most appropriate noninvasive end point for steatosis reduction in clinical trials and therapy response assessment.
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Affiliation(s)
- Yingzhen N Zhang
- Department of Radiology, Liver Imaging Group, University of California San Diego, San Diego, CA, USA
| | - Kathryn J Fowler
- Department of Radiology, Washington University School of Medicine, Washington University, St. Louis, MO, USA
| | - Gavin Hamilton
- Department of Radiology, Liver Imaging Group, University of California San Diego, San Diego, CA, USA
| | - Jennifer Y Cui
- Department of Radiology, Liver Imaging Group, University of California San Diego, San Diego, CA, USA
| | - Ethan Z Sy
- Department of Radiology, Liver Imaging Group, University of California San Diego, San Diego, CA, USA
| | - Michelle Balanay
- Department of Radiology, Liver Imaging Group, University of California San Diego, San Diego, CA, USA
| | - Jonathan C Hooker
- Department of Radiology, Liver Imaging Group, University of California San Diego, San Diego, CA, USA
| | - Nikolaus Szeverenyi
- Department of Radiology, Liver Imaging Group, University of California San Diego, San Diego, CA, USA
| | - Claude B Sirlin
- Department of Radiology, Liver Imaging Group, University of California San Diego, San Diego, CA, USA
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183
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Roberts NT, Hernando D, Holmes JH, Wiens CN, Reeder SB. Noise properties of proton density fat fraction estimated using chemical shift-encoded MRI. Magn Reson Med 2018; 80:685-695. [PMID: 29322549 PMCID: PMC5910302 DOI: 10.1002/mrm.27065] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 02/06/2023]
Abstract
PURPOSE The purpose of this work is to characterize the noise distribution of proton density fat fraction (PDFF) measured using chemical shift-encoded MRI, and to provide alternative strategies to reduce bias in PDFF estimation. THEORY We derived the probability density function for PDFF estimated using chemical shift-encoded MRI, and found it to exhibit an asymmetric noise distribution that contributes to signal-to-noise-ratio dependent bias. METHODS To study PDFF noise bias, we performed (at 1.5 T) numerical simulations, phantom acquisitions, and a retrospective in vivo experiment. In each experiment, we compared the performance of three statistics (mean, median, and maximum likelihood estimator) in estimating the PDFF in a region of interest. RESULTS We demonstrated the presence of the asymmetric noise distribution in simulations, phantoms, and in vivo. In each experiment we demonstrated that both the median and proposed maximum likelihood estimator statistics outperformed the mean statistic in mitigating noise-related bias for low signal-to-noise-ratio acquisitions. CONCLUSIONS Characterization of the noise distribution of PDFF estimated using chemical shift-encoded MRI enabled new strategies based on median and maximum likelihood estimator statistics to mitigate noise-related bias for accurate PDFF measurement from a region of interest. Such strategies are important for quantitative chemical shift-encoded MRI applications that typically operate in low signal-to-noise-ratio regimes. Magn Reson Med 80:685-695, 2018. © 2018 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Nathan T Roberts
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Electrical and Computer Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Diego Hernando
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - James H Holmes
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Curtis N Wiens
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Scott B Reeder
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Emergency Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
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184
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Santarelli MF, Meloni A, De Marchi D, Pistoia L, Quarta A, Spasiano A, Landini L, Pepe A, Positano V. Estimation of pancreatic R2* for iron overload assessment in the presence of fat: a comparison of different approaches. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2018; 31:757-769. [PMID: 30043125 DOI: 10.1007/s10334-018-0695-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 06/13/2018] [Accepted: 07/18/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To propose a method for estimating pancreatic relaxation rate, R2*, from conventional multi-echo MRI, based on the nonlinear fitting of the acquired magnitude signal decay to MR signal models that take into account both the signal oscillations induced by fat and the different R2* values of pancreatic parenchyma and fat. MATERIALS AND METHODS Single-peak fat (SPF) and multi-peak fat (MPF) models were introduced. Single-R2* and dual-R2* assumptions were considered as well. Analyses were conducted on simulated data and 20 thalassemia major patients. RESULTS Simulations revealed the ability of the MPF model to correctly estimate the R2* value in a large range of fat fractions and R2* values. From the comparison between the results obtained with a single R2* value for water and fat and the dual-R2* approach, the latter is more accurate in both water R2* and fat fraction estimation. In patient's data analysis, a strong concordance was found between SPF and MPF estimated data with measurements done with manual signal correction and from fat-saturated images. The MPF method showed better reproducibility. CONCLUSION The MPF dual-R2* approach improves reproducibility and reduces image analysis time in the assessment of pancreatic R2* value in patients with iron overload.
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Affiliation(s)
| | - Antonella Meloni
- Fondazione CNR Regione Toscana "G. Monasterio", Via Moruzzi, 1, 56124, Pisa, Italy
| | - Daniele De Marchi
- Fondazione CNR Regione Toscana "G. Monasterio", Via Moruzzi, 1, 56124, Pisa, Italy
| | - Laura Pistoia
- Fondazione CNR Regione Toscana "G. Monasterio", Via Moruzzi, 1, 56124, Pisa, Italy
| | | | - Anna Spasiano
- UOS Malattie Rare Del Globulo Rosso, AORN Cardarelli, Naples, Italy
| | - Luigi Landini
- Fondazione CNR Regione Toscana "G. Monasterio", Via Moruzzi, 1, 56124, Pisa, Italy
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | - Alessia Pepe
- Fondazione CNR Regione Toscana "G. Monasterio", Via Moruzzi, 1, 56124, Pisa, Italy
| | - Vincenzo Positano
- Fondazione CNR Regione Toscana "G. Monasterio", Via Moruzzi, 1, 56124, Pisa, Italy.
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185
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Abstract
Fatty liver disease is characterized histologically by hepatic steatosis, the abnormal accumulation of lipid in hepatocytes. It is classified into alcoholic fatty liver disease and nonalcoholic fatty liver disease, and is an increasingly important cause of chronic liver disease and cirrhosis. Assessing the severity of hepatic steatosis in these conditions is important for diagnostic and prognostic purposes, as hepatic steatosis is potentially reversible if diagnosed early. The criterion standard for assessing hepatic steatosis is liver biopsy, which is limited by sampling error, its invasive nature, and associated morbidity. As such, noninvasive imaging-based methods of assessing hepatic steatosis are needed. Ultrasound and computed tomography are able to suggest the presence of hepatic steatosis based on imaging features, but are unable to accurately quantify hepatic fat content. Since Dixon's seminal work in 1984, magnetic resonance imaging has been used to compute the signal fat fraction from chemical shift-encoded imaging, commonly implemented as out-of-phase and in-phase imaging. However, signal fat fraction is confounded by several factors that limit its accuracy and reproducibility. Recently, advanced chemical shift-encoded magnetic resonance imaging methods have been developed that address these confounders and are able to measure the proton density fat fraction, a standardized, accurate, and reproducible biomarker of fat content. The use of these methods in the liver, as well as in other abdominal organs such as the pancreas, adrenal glands, and adipose tissue will be discussed in this review.
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186
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Martel D, Leporq B, Bruno M, Regatte RR, Honig S, Chang G. Chemical shift-encoded MRI for assessment of bone marrow adipose tissue fat composition: Pilot study in premenopausal versus postmenopausal women. Magn Reson Imaging 2018; 53:148-155. [PMID: 30006022 DOI: 10.1016/j.mri.2018.07.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 07/03/2018] [Accepted: 07/05/2018] [Indexed: 12/27/2022]
Abstract
OBJECT To quantify and compare subregional proximal femur bone marrow fat composition in premenopausal and postmenopausal women using chemical shift-encoded-MRI (CSE-MRI). MATERIALS AND METHODS A multi gradient-echo sequence at 3 T was used to scan both hips of premenopausal (n = 9) and postmenopausal (n = 18) women. Subregional fat composition (saturation, poly-unsaturation, mono-unsaturation) was quantitatively assessed in the femoral head, femoral neck, Ward's triangle, greater trochanter, and proximal shaft in bone marrow adipose tissue and separately within red and yellow marrow adipose tissue. RESULTS Significant differences in fat composition in postmenopausal compared to premenopausal women, which varied depending on the subregion analyzed, were found. Within both whole and yellow marrow adipose tissue, postmenopausal women demonstrated higher saturation (+14.7% to +43.3%), lower mono- (-11.4% to -33%) and polyunsaturation (-52 to -83%) (p < 0.05). Within red marrow adipose tissue, postmenopausal women demonstrated lower fat quantity (-16% to -24%) and decreased polyunsaturation (-80 to -120%) in the femoral neck, greater trochanter, and Ward's triangle (p < 0.05). CONCLUSION CSE-MRI can be used to detect subregional differences in proximal femur marrow adipose tissue composition between pre- and post-menopausal women in clinically feasible scan times.
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Affiliation(s)
- Dimitri Martel
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York City, NY, USA.
| | - Benjamin Leporq
- University of Lyon, Laboratoire CREATIS, CNRS UMR 5220, Inserm U1206, INSA-Lyon, UJM Saint-Etienne, UCBL Lyon 1, Lyon, France
| | - Mary Bruno
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York City, NY, USA
| | - Ravinder R Regatte
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York City, NY, USA
| | - Stephen Honig
- Osteoporosis Center, Hospital for Joint Diseases, New York University School of Medicine, New York City, NY, USA
| | - Gregory Chang
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York City, NY, USA
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187
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Simchick G, Yin A, Yin H, Zhao Q. Fat spectral modeling on triglyceride composition quantification using chemical shift encoded magnetic resonance imaging. Magn Reson Imaging 2018; 52:84-93. [PMID: 29928937 DOI: 10.1016/j.mri.2018.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/14/2018] [Accepted: 06/17/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE To explore, at a high field strength of 7T, the performance of various fat spectral models on the quantification of triglyceride composition and proton density fat fraction (PDFF) using chemical-shift encoded MRI (CSE-MRI). METHODS MR data was acquired from CSE-MRI experiments for various fatty materials, including oil and butter samples and in vivo brown and white adipose mouse tissues. Triglyceride composition and PDFF were estimated using various a priori 6- or 9-peak fat spectral models. To serve as references, NMR spectroscopy experiments were conducted to obtain material specific fat spectral models and triglyceride composition estimates for the same fatty materials. Results obtained using the spectroscopy derived material specific models were compared to results obtained using various published fat spectral models. RESULTS Using a 6-peak fat spectral model to quantify triglyceride composition may lead to large biases at high field strengths. When using a 9-peak model, triglyceride composition estimations vary greatly depending on the relative amplitudes of the chosen a priori spectral model, while PDFF estimations show small variations across spectral models. Material specific spectroscopy derived spectral models produce estimations that better correlate with NMR spectroscopy estimations in comparison to those obtained using non-material specific models. CONCLUSION At a high field strength of 7T, a material specific 9-peak fat spectral model, opposed to a widely accepted or generic human liver model, is necessary to accurately quantify triglyceride composition when using CSE-MRI estimation methods that assume the spectral model to be known as a priori information. CSE-MRI allows for the quantification of the spatial distribution of triglyceride composition for certain in vivo applications. Additionally, PDFF quantification is shown to be independent of the chosen a priori spectral model, which agrees with previously reported results obtained at lower field strengths (e.g. 3T).
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Affiliation(s)
- Gregory Simchick
- Physics and Astronomy, University of Georgia, Athens, GA, United States; Bio-Imaging Research Center, University of Georgia, Athens, GA, United States
| | - Amelia Yin
- Biochemistry and Molecular Biology, University of Georgia, Athens, GA, United States; Center for Molecular Medicine, University of Georgia, Athens, GA, United States
| | - Hang Yin
- Biochemistry and Molecular Biology, University of Georgia, Athens, GA, United States; Center for Molecular Medicine, University of Georgia, Athens, GA, United States
| | - Qun Zhao
- Physics and Astronomy, University of Georgia, Athens, GA, United States; Bio-Imaging Research Center, University of Georgia, Athens, GA, United States.
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188
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Chalasani N, Vuppalanchi R, Rinella M, Middleton MS, Siddiqui MS, Barritt AS, Kolterman O, Flores O, Alonso C, Iruarrizaga‐Lejarreta M, Gil‐Redondo R, Sirlin CB, Zemel MB. Randomised clinical trial: a leucine-metformin-sildenafil combination (NS-0200) vs placebo in patients with non-alcoholic fatty liver disease. Aliment Pharmacol Ther 2018; 47:1639-1651. [PMID: 29696666 PMCID: PMC6001629 DOI: 10.1111/apt.14674] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 02/24/2018] [Accepted: 03/27/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Sirtuin 1 (Sirt1) is suppressed in non-alcoholic fatty liver disease (NAFLD), while its' stimulation or overexpression results in reduced disease severity in pre-clinical NAFLD models. Leucine allosterically activates Sirt1 and synergise with other Sirt/AMPK/NO pathway activators. We developed a triple combination of leucine, metformin and sildenafil (NS-0200), which was effective in a mouse model of non-alcoholic steatohepatitis (NASH). AIM To report the results from a Phase 2, randomised clinical trial of of NS-0200 in 91 subjects with NAFLD (liver fat ≥15% by magnetic resonance imaging-proton-density fat fraction (MRI-PDFF)). METHODS Subjects were randomised to placebo, low-dose (1.1 g leucine/0.5 g metformin/0.5 mg sildenafil) or high-dose NS-0200 (1.1 g leucine/0.5 g metformin/1.0 mg sildenafil) b.d. for 16 weeks; change in hepatic fat was assessed via MRI-PDFF, and lipid metabolism was assessed via changes in the lipidomic signature. Seventy subjects completed the trial and met a priori compliance criteria. Analyses were conducted on the full cohort and on those with alanine aminotransferase (ALT) values above median (50 U/L; n = 35). RESULTS In the full cohort, active treatments did not separate from placebo. High dose NS-0200 reduced hepatic fat by 15.7% (relative change from baseline) in the high ALT group (P < 0.005) while low dose NS-0200 and placebo did not significantly change hepatic fat. Lipidomic analysis showed dose-responsive treatment effects in both overall and high ALT cohorts, with significant decreases in metabolically active lipids and up-regulation of fatty acid oxidation. CONCLUSION These data support further evaluation of high-dose NS-0200 for treating NASH, especially in those with elevated ALT (NCT 02546609).
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Affiliation(s)
- N. Chalasani
- Indiana University School of MedicineIndianapolisINUSA
| | | | | | | | | | | | | | | | | | | | | | - C. B. Sirlin
- University of California at San DiegoSan DiegoCAUSA
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189
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Ma YJ, Zhu Y, Lu X, Carl M, Chang EY, Du J. Short T 2 imaging using a 3D double adiabatic inversion recovery prepared ultrashort echo time cones (3D DIR-UTE-Cones) sequence. Magn Reson Med 2018; 79:2555-2563. [PMID: 28913879 PMCID: PMC5821562 DOI: 10.1002/mrm.26908] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/22/2017] [Accepted: 08/16/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE To investigate high contrast imaging of short T2 tissues with a three-dimensional double adiabatic inversion recovery prepared ultrashort echo time Cones (3D DIR-UTE-Cones) sequence. METHODS The sequence used two sequential adiabatic inversion pulses to suppress signals from long T2 tissues, followed by multispoke UTE acquisition to detect signals from short T2 tissues. The two adiabatic inversion pulses are identical with a center frequency located at the water peak, but the spectral width is broad enough to cover both water and fat frequencies. The feasibility of this technique was demonstrated through numerical simulation and phantom studies. Finally, DIR-UTE-Cones was applied to three healthy volunteers to image cortical bone, patellar tendon, and Achilles tendon. T2* was also measured via single-component exponential fitting. RESULTS Numerical simulation suggests that the DIR technique provides perfect nulling of muscle and fat as well as efficient suppression of other long T2 tissues with T1 values between fat and water or those above water. Excellent image contrast can be achieved with DIR-UTE-Cones for the short T2 tissues, with fitted T2* values of 0.28-0.38 ms for cortical bone, 0.56 ± 0.07 ms for the patella tendon, and 0.45 ± 0.06 ms for the Achilles tendon, respectively. CONCLUSION The 3D DIR-UTE-Cones sequence provides robust suppression of long T2 tissues and allows selective imaging as well as T2* measurement of short T2 tissues such as cortical bone, patellar tendon, and the Achilles tendon. Magn Reson Med 79:2555-2563, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Ya-Jun Ma
- Department of Radiology, University of California, San Diego, CA
| | - Yanchun Zhu
- Department of Radiology, University of California, San Diego, CA
| | - Xing Lu
- Department of Radiology, University of California, San Diego, CA
| | | | - Eric Y Chang
- Department of Radiology, University of California, San Diego, CA
- Radiology Service, VA San Diego Healthcare System, San Diego, CA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA
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190
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Park CC, Hooker C, Hooker JC, Bass E, Haufe W, Schlein A, Covarrubias Y, Heba E, Bydder M, Wolfson T, Gamst A, Loomba R, Schwimmer J, Hernando D, Reeder SB, Middleton M, Sirlin CB, Hamilton G. Assessment of a high-SNR chemical-shift-encoded MRI with complex reconstruction for proton density fat fraction (PDFF) estimation overall and in the low-fat range. J Magn Reson Imaging 2018; 49:229-238. [PMID: 29707848 DOI: 10.1002/jmri.26168] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 04/04/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Improving the signal-to-noise ratio (SNR) of chemical-shift-encoded MRI acquisition with complex reconstruction (MRI-C) may improve the accuracy and precision of noninvasive proton density fat fraction (PDFF) quantification in patients with hepatic steatosis. PURPOSE To assess the accuracy of high SNR (Hi-SNR) MRI-C versus standard MRI-C acquisition to estimate hepatic PDFF in adult and pediatric nonalcoholic fatty liver disease (NAFLD) using an MR spectroscopy (MRS) sequence as the reference standard. STUDY TYPE Prospective. POPULATION/SUBJECTS In all, 231 adult and pediatric patients with known or suspected NAFLD. FIELD STRENGTH/SEQUENCE PDFF estimated at 3T by three MR techniques: standard MRI-C; a Hi-SNR MRI-C variant with increased slice thickness, decreased matrix size, and no parallel imaging; and MRS (reference standard). ASSESSMENT MRI-PDFF was measured by image analysts using a region of interest coregistered with the MRS-PDFF voxel. STATISTICAL TESTS Linear regression analyses were used to assess accuracy and precision of MRI-estimated PDFF for MRS-PDFF as a function of MRI-PDFF using the standard and Hi-SNR MRI-C for all patients and for patients with MRS-PDFF <10%. RESULTS In all, 271 exams from 231 patients were included (mean MRS-PDFF: 12.6% [SD: 10.4]; range: 0.9-41.9). High agreement between MRI-PDFF and MRS-PDFF was demonstrated across the overall range of PDFF, with a regression slope of 1.035 for the standard MRI-C and 1.008 for Hi-SNR MRI-C. Hi-SNR MRI-C, compared to standard MRI-C, provided small but statistically significant improvements in the slope (respectively, 1.008 vs. 1.035, P = 0.004) and mean bias (0.412 vs. 0.673, P < 0.0001) overall. In the low-fat patients only, Hi-SNR MRI-C provided improvements in the slope (1.058 vs. 1.190, P = 0.002), mean bias (0.168 vs. 0.368, P = 0.007), intercept (-0.153 vs. -0.796, P < 0.0001), and borderline improvement in the R2 (0.888 vs. 0.813, P = 0.01). DATA CONCLUSION Compared to standard MRI-C, Hi-SNR MRI-C provides slightly higher MRI-PDFF estimation accuracy across the overall range of PDFF and improves both accuracy and precision in the low PDFF range. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:229-238.
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Affiliation(s)
- Charlie C Park
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, California, USA
| | - Catherine Hooker
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, California, USA
| | - Jonathan C Hooker
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, California, USA
| | - Emily Bass
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, California, USA
| | - William Haufe
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, California, USA
| | - Alexandra Schlein
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, California, USA
| | - Yesenia Covarrubias
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, California, USA
| | - Elhamy Heba
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, California, USA
| | - Mark Bydder
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, California, USA
| | - Tanya Wolfson
- Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California - San Diego, San Diego, California, USA
| | - Anthony Gamst
- Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California - San Diego, San Diego, California, USA
| | - Rohit Loomba
- Division of Gastroenterology, Department of Medicine, University of California at San Diego, La Jolla, California, USA.,Division of Epidemiology, Department of Family Medicine and Preventive Medicine, University of California at San Diego, La Jolla, California, USA
| | - Jeffrey Schwimmer
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Diego School of Medicine, La Jolla, California, USA.,Department of Gastroenterology, Rady Children's Hospital San Diego, California, USA
| | - Diego Hernando
- Department of Radiology, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | - Scott B Reeder
- Department of Radiology, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Department of Medical Physics, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Department of Biomedical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Department of Medicine, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Department of Emergency Medicine, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | - Michael Middleton
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, California, USA
| | - Claude B Sirlin
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, California, USA
| | - Gavin Hamilton
- Liver Imaging Group, Department of Radiology, University of California at San Diego, La Jolla, California, USA
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191
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Pooler BD, Hernando D, Ruby JA, Ishii H, Shimakawa A, Reeder SB. Validation of a motion-robust 2D sequential technique for quantification of hepatic proton density fat fraction during free breathing. J Magn Reson Imaging 2018; 48:1578-1585. [PMID: 29665193 DOI: 10.1002/jmri.26056] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/27/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Current chemical-shift-encoded (CSE) MRI techniques for measuring hepatic proton density fat fraction (PDFF) are sensitive to motion artifacts. PURPOSE Initial validation of a motion-robust 2D-sequential CSE-MRI technique for quantification of hepatic PDFF. STUDY TYPE Phantom study and prospective in vivo cohort. POPULATION Fifty adult patients (27 women, 23 men, mean age 57.2 years). FIELD STRENGTH/SEQUENCE 3D, 2D-interleaved, and 2D-sequential CSE-MRI acquisitions at 1.5T. ASSESSMENT Three CSE-MRI techniques (3D, 2D-interleaved, 2D-sequential) were performed in a PDFF phantom and in vivo. Reference standards were 3D CSE-MRI PDFF measurements for the phantom study and single-voxel MR spectroscopy hepatic PDFF measurements (MRS-PDFF) in vivo. In vivo hepatic MRI-PDFF measurements were performed during a single breath-hold (BH) and free breathing (FB), and were repeated by a second reader for the FB 2D-sequential sequence to assess interreader variability. STATISTICAL TESTS Correlation plots to validate the 2D-sequential CSE-MRI against the phantom and in vivo reference standards. Bland-Altman analysis of FB versus BH CSE-MRI acquisitions to evaluate robustness to motion. Bland-Altman analysis to assess interreader variability. RESULTS Phantom 2D-sequential CSE-MRI PDFF measurements demonstrated excellent agreement and correlation (R2 > 0.99) with 3D CSE-MRI. In vivo, the mean (±SD) hepatic PDFF was 8.8 ± 8.7% (range 0.6-28.5%). Compared with BH acquisitions, FB hepatic PDFF measurements demonstrated bias of +0.15% for 2D-sequential compared with + 0.53% for 3D and +0.94% for 2D-interleaved. 95% limits of agreement (LOA) were narrower for 2D-sequential (±0.99%), compared with 3D (±3.72%) and 2D-interleaved (±3.10%). All CSE-MRI techniques had excellent correlation with MRS (R2 > 0.97). The FB 2D-sequential acquisition demonstrated little interreader variability, with mean bias of +0.07% and 95% LOA of ± 1.53%. DATA CONCLUSION This motion-robust 2D-sequential CSE-MRI can accurately measure hepatic PDFF during free breathing in a patient population with a range of PDFF values of 0.6-28.5%, permitting accurate quantification of liver fat content without the need for suspended respiration. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;48:1578-1585.
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Affiliation(s)
- B Dustin Pooler
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Diego Hernando
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Jeannine A Ruby
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Hiroshi Ishii
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Ann Shimakawa
- Global MR Applications and Workflow, GE Healthcare, Madison, Wisconsin, USA
| | - Scott B Reeder
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,Department of Biomedical Engineering, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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192
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Lin H, Fu C, Kannengiesser S, Cheng S, Shen J, Dong H, Yan F. Quantitative analysis of hepatic iron in patients suspected of coexisting iron overload and steatosis using multi-echo single-voxel magnetic resonance spectroscopy: Comparison with fat-saturated multi-echo gradient echo sequence. J Magn Reson Imaging 2018. [PMID: 29513377 DOI: 10.1002/jmri.25967] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The coexistence of hepatic iron and fat is common in patients with hyperferritinemia, which plays an interactive and aggressive role in the progression of diseases (fibrosis, cirrhosis, and hepatocellular carcinomas). PURPOSE To evaluate a modified high-speed T2 -corrected multi-echo, single voxel spectroscopy sequence (HISTOV) for liver iron concentration (LIC) quantification in patients with hyperferritinemia, with simultaneous fat fraction (FF) estimation. STUDY TYPE Retrospective cohort study. POPULATION Thirty-eight patients with hyperferritinemia were enrolled. FIELD STRENGTH/SEQUENCE HISTOV, a fat-saturated multi-echo gradient echo (GRE) sequence, and a spin echo sequence (FerriScan) were performed at 1.5T. ASSESSMENT R2 of the water signal and FF were calculated with HISTOV, and R2* values were derived from the GRE sequence, with R2 and LIC from FerriScan serving as the references. STATISTICAL TESTS Linear regression, correlation analyses, receiver operating characteristic analyses, and Bland-Altman analyses were conducted. RESULTS Abnormal hepatic iron load was detected in 32/38 patients, of whom 10/32 had coexisting steatosis. Strong correlation was found between R2* and FerriScan-LIC (R2 = 0.861), and between HISTOV-R2_ water and FerriScan-R2 (R2 = 0.889). Furthermore, HISTOV-R2_ water was not correlated with HISTOV-FF. The area under the curve (AUC) for HISTOV-R2_ water was 0.974, 0.971, and 1, corresponding to clinical FerriScan-LIC thresholds of 1.8, 3.2, and 7.0 mg/g dw, respectively. No significant difference in the AUC was found between HISTOV-R2_ water and R2* at any of the LIC thresholds, with P-values of 0.42, 0.37, and 1, respectively. HISTOV-LIC showed excellent agreement with FerriScan-LIC, with a mean bias of 0.00 ± 1.18 mg/g dw, whereas the mean bias between GRE-LIC and FerriScan-LIC was 0.53 ± 1.49 mg/g dw. DATA CONCLUSION HISTOV is useful for the quantification and grading of liver iron overload in patients with hyperferritinemia, particularly in cases with coexisting steatosis. HISTOV-LIC showed no systematic bias compared with FerriScan-LIC, making it a promising alternative for iron quantification. LEVEL OF EVIDENCE 3 Technical Efficacy Stage 2 J. Magn. Reson. Imaging 2018.
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Affiliation(s)
- Huimin Lin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Caixia Fu
- Application Development, Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, China
| | | | - Shu Cheng
- Department of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Shen
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haipeng Dong
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Ziegler D, Strom A, Kupriyanova Y, Bierwagen A, Bönhof GJ, Bódis K, Müssig K, Szendroedi J, Bobrov P, Markgraf DF, Hwang JH, Roden M. Association of Lower Cardiovagal Tone and Baroreflex Sensitivity With Higher Liver Fat Content Early in Type 2 Diabetes. J Clin Endocrinol Metab 2018; 103:1130-1138. [PMID: 29267946 DOI: 10.1210/jc.2017-02294] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 12/12/2017] [Indexed: 02/06/2023]
Abstract
CONTEXT Cardiovascular autonomic neuropathy (CAN) diagnosed by diminished heart rate variability (HRV) is prevalent and carries an increased risk of mortality in patients with diabetes and chronic liver diseases. OBJECTIVE To determine whether lower HRV is associated with increased liver fat content in recent-onset diabetes. DESIGN Cross-sectional study. SETTING German Diabetes Study (GDS), Düsseldorf, Germany. PARTICIPANTS Individuals with type 1 diabetes (n = 97) or type 2 diabetes (n = 109) with known diabetes duration ≤1 year and two age- and sex-matched glucose-tolerant control groups from the GDS baseline cohort. MAIN OUTCOME MEASURES Four time and frequency domain HRV indices each were measured over 3 hours during a hyperinsulinemic-euglycemic clamp, whereas spontaneous cross-correlation baroreflex sensitivity (xBRS) was computed over 5 minutes. Hepatic fat content was determined by 1H magnetic resonance spectroscopy, and values >5.56% were defined as hepatic steatosis. RESULTS Hepatic steatosis was observed in 52% and 5% of patients with type 2 and type 1 diabetes, respectively. After adjustment for sex, age, body mass index, smoking, diabetes duration, hemoglobin A1c, M-value, and triglycerides, all four vagus-mediated time domain HRV indices, three of four frequency domain indices, and xBRS were inversely associated with liver fat content in participants with type 2 diabetes (all P < 0.05) but not in the group with type 1 diabetes. CONCLUSIONS Both lower cardiovagal tone and baroreflex sensitivity are strongly associated with prevalent hepatic steatosis in patients with recent-onset type 2 as opposed to type 1 diabetes, suggesting a role for hepatic steatosis in the early development of parasympathetic CAN in type 2 diabetes.
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Affiliation(s)
- Dan Ziegler
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Alexander Strom
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Yuliya Kupriyanova
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Alessandra Bierwagen
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Gidon J Bönhof
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Kálmán Bódis
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Karsten Müssig
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Julia Szendroedi
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Pavel Bobrov
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
| | - Daniel F Markgraf
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Jong-Hee Hwang
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
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Xu K, Sigurdsson S, Gudnason V, Hue T, Schwartz A, Li X. Reliable quantification of marrow fat content and unsaturation level using in vivo MR spectroscopy. Magn Reson Med 2018; 79:1722-1729. [PMID: 28714169 PMCID: PMC5930928 DOI: 10.1002/mrm.26828] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/29/2017] [Accepted: 06/15/2017] [Indexed: 02/06/2023]
Abstract
PURPOSE To develop a novel technique for reliable quantification of bone marrow fat content and composition using in vivo MR spectroscopy (MRS). METHODS An MRS quantification method combining both advantages of Voigt line shape model and time-domain analysis was developed. The proposed method was tested using computer-simulated data and in vivo data acquired at lumbar vertebral bodies of 23 subjects (age, 83.8 ± 3.7 y; male, n = 13; female, n = 10) from L1 to L4. Reliability and reproducibility were calculated for the quantification results. Comparisons between the proposed method and some conventional methods were conducted. RESULTS Low mean absolute percentage errors and low mean coefficients of variation for computer simulations suggest that the proposed method is accurate and precise. By using this method, marrow fat content can be quantified reliably, even for data with low spectral resolution and low signal-to-noise ratio (SNR). Unsaturation level can be reliably quantified for data with moderate spectral resolution and moderate SNR. Results obtained from in vivo data using the proposed method demonstrated better model fit than conventional methods. CONCLUSION The method proposed in this study has better performance than conventional methods in the quantification of bone marrow MRS data and has great potential for wide applications of studying marrow fat content and composition. Magn Reson Med 79:1722-1729, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Kaipin Xu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco (UCSF), San Francisco, California, USA
| | | | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, IS 201 Iceland
- University of Iceland, Reykjavik, Iceland
| | - Trisha Hue
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, California, USA
| | - Ann Schwartz
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, California, USA
| | - Xiaojuan Li
- Department of Radiology and Biomedical Imaging, University of California, San Francisco (UCSF), San Francisco, California, USA
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195
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Middleton MS, Van Natta ML, Heba ER, Alazraki A, Trout AT, Masand P, Brunt EM, Kleiner DE, Doo E, Tonascia J, Lavine JE, Shen W, Hamilton G, Schwimmer JB, Sirlin CB. Diagnostic accuracy of magnetic resonance imaging hepatic proton density fat fraction in pediatric nonalcoholic fatty liver disease. Hepatology 2018; 67:858-872. [PMID: 29028128 PMCID: PMC6211296 DOI: 10.1002/hep.29596] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 09/11/2017] [Accepted: 10/12/2017] [Indexed: 12/11/2022]
Abstract
UNLABELLED We assessed the performance of magnetic resonance imaging (MRI) proton density fat fraction (PDFF) in children to stratify hepatic steatosis grade before and after treatment in the Cysteamine Bitartrate Delayed-Release for the Treatment of Nonalcoholic Fatty Liver Disease in Children (CyNCh) trial, using centrally scored histology as reference. Participants had multiecho 1.5 Tesla (T) or 3T MRI on scanners from three manufacturers. Of 169 enrolled children, 110 (65%) and 83 (49%) had MRI and liver biopsy at baseline and at end of treatment (EOT; 52 weeks), respectively. At baseline, 17% (19 of 110), 28% (31 of 110), and 55% (60 of 110) of liver biopsies showed grades 1, 2, and 3 histological steatosis; corresponding PDFF (mean ± SD) values were 10.9 ± 4.1%, 18.4 ± 6.2%, and 25.7 ± 9.7%, respectively. PDFF classified grade 1 versus 2-3 and 1-2 versus 3 steatosis with areas under receiving operator characteristic curves (AUROCs) of 0.87 (95% confidence interval [CI], 0.80, 0.94) and 0.79 (0.70, 0.87), respectively. PDFF cutoffs at 90% specificity were 17.5% for grades 2-3 steatosis and 23.3% for grade 3 steatosis. At EOT, 47% (39 of 83), 41% (34 of 83), and 12% (10 of 83) of biopsies showed improved, unchanged, and worsened steatosis grade, respectively, with corresponding PDFF (mean ± SD) changes of -7.8 ± 6.3%, -1.2 ± 7.8%, and 4.9 ± 5.0%, respectively. PDFF change classified steatosis grade improvement and worsening with AUROCs (95% CIs) of 0.76 (0.66, 0.87) and 0.83 (0.73, 0.92), respectively. PDFF change cut-off values at 90% specificity were -11.0% and +5.5% for improvement and worsening. CONCLUSION MRI-estimated PDFF has high diagnostic accuracy to both classify and predict histological steatosis grade and change in histological steatosis grade in children with NAFLD. (Hepatology 2018;67:858-872).
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Affiliation(s)
- Michael S. Middleton
- Liver Imaging Group, Department of Radiology, UCSD School of Medicine, San Diego, California
| | - Mark L. Van Natta
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Elhamy R. Heba
- Liver Imaging Group, Department of Radiology, UCSD School of Medicine, San Diego, California
| | - Adina Alazraki
- Emory University School of Medicine, Department of Radiology and Imaging Sciences, Atlanta, Georgia
| | - Andrew T. Trout
- Cincinnati Children’s Hospital, Department of Radiology, Cincinnati, Ohio
| | | | | | | | - Edward Doo
- Liver Diseases Section, Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases
| | - James Tonascia
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Joel E. Lavine
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Columbia University Medical Center, New York, New York
| | - Wei Shen
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Columbia University Medical Center, New York, New York
| | - Gavin Hamilton
- Liver Imaging Group, Department of Radiology, UCSD School of Medicine, San Diego, California
| | - Jeffrey B. Schwimmer
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Diego School of Medicine, La Jolla, California; and Department of Gastroenterology, Rady Children’s Hospital, San Diego, California
| | - Claude B. Sirlin
- Liver Imaging Group, Department of Radiology, UCSD School of Medicine, San Diego, California
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196
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Lin H, Wei H, He N, Fu C, Cheng S, Shen J, Wang B, Yan X, Liu C, Yan F. Quantitative susceptibility mapping in combination with water-fat separation for simultaneous liver iron and fat fraction quantification. Eur Radiol 2018; 28:3494-3504. [PMID: 29470640 DOI: 10.1007/s00330-017-5263-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/08/2017] [Accepted: 12/20/2017] [Indexed: 12/21/2022]
Abstract
PURPOSES To evaluate the feasibility of simultaneous quantification of liver iron concentration (LIC) and fat fraction (FF) using water-fat separation and quantitative susceptibility mapping (QSM). METHODS Forty-five patients suspected of liver iron overload (LIO) were included. A volumetric interpolated breath-hold examination sequence for QSM and FF, a fat-saturated gradient echo sequence for R2*, a spin echo sequence for LIC measurements and MRS analyses for FF (FF-MRS) were performed. Magnetic susceptibility and FF were calculated using a water-fat separation method (FF-MRI). Correlation and receiver operating characteristic analyses were performed. RESULTS Magnetic susceptibility showed strong correlation with LIC (rs=0.918). The optimal susceptibility cut-off values were 0.34, 0.63, 1.29 and 2.23 ppm corresponding to LIC thresholds of 1.8, 3.2, 7.0 and 15.0 mg/g dry weight. The area under the curve (AUC) were 0.948, 0.970, 1 and 1, respectively. No difference in AUC was found between susceptibility and R2* at all LIC thresholds. Correlation was found between FF-MRI and FF-MRS (R2=0.910). CONCLUSIONS QSM has a high diagnostic performance for LIC quantification, similar to that of R2*. FF-MRI provides simultaneous fat quantification. Findings suggest QSM in combination with water-fat separation has potential value for evaluating LIO, especially in cases with coexisting steatosis. KEY POINTS • Magnetic susceptibility showed strong correlation with LIC (r s =0.918). • QSM showed high diagnostic performance for LIC, similar to that of R 2* . • Simultaneously estimated FF-MRI showed strong correlation with MR-Spectroscopy-based FF (R 2 =0.910). • QSM combining water-fat separation has quantitative value for LIO with coexisted steatosis.
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Affiliation(s)
- Huimin Lin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, NO. 197 Ruijin Er Road, Shanghai, 200025, China
| | - Hongjiang Wei
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA
| | - Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, NO. 197 Ruijin Er Road, Shanghai, 200025, China
| | - Caixia Fu
- Application Development, Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China
| | - Shu Cheng
- Department of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Shen
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, NO. 197 Ruijin Er Road, Shanghai, 200025, China
| | - Baisong Wang
- Department of Biological Statistics, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xu Yan
- MR Collaboration NE Asia, Siemens Healthcare, Shanghai, China
| | - Chunlei Liu
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA.,Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, NO. 197 Ruijin Er Road, Shanghai, 200025, China.
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197
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West J, Romu T, Thorell S, Lindblom H, Berin E, Holm ACS, Åstrand LL, Karlsson A, Borga M, Hammar M, Leinhard OD. Precision of MRI-based body composition measurements of postmenopausal women. PLoS One 2018; 13:e0192495. [PMID: 29415060 PMCID: PMC5802932 DOI: 10.1371/journal.pone.0192495] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 01/24/2018] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To determine precision of magnetic resonance imaging (MRI) based fat and muscle quantification in a group of postmenopausal women. Furthermore, to extend the method to individual muscles relevant to upper-body exercise. MATERIALS AND METHODS This was a sub-study to a randomized control trial investigating effects of resistance training to decrease hot flushes in postmenopausal women. Thirty-six women were included, mean age 56 ± 6 years. Each subject was scanned twice with a 3.0T MR-scanner using a whole-body Dixon protocol. Water and fat images were calculated using a 6-peak lipid model including R2*-correction. Body composition analyses were performed to measure visceral and subcutaneous fat volumes, lean volumes and muscle fat infiltration (MFI) of the muscle groups' thigh muscles, lower leg muscles, and abdominal muscles, as well as the three individual muscles pectoralis, latissimus, and rhomboideus. Analysis was performed using a multi-atlas, calibrated water-fat separated quantification method. Liver-fat was measured as average proton density fat-fraction (PDFF) of three regions-of-interest. Precision was determined with Bland-Altman analysis, repeatability, and coefficient of variation. RESULTS All of the 36 included women were successfully scanned and analysed. The coefficient of variation was 1.1% to 1.5% for abdominal fat compartments (visceral and subcutaneous), 0.8% to 1.9% for volumes of muscle groups (thigh, lower leg, and abdomen), and 2.3% to 7.0% for individual muscle volumes (pectoralis, latissimus, and rhomboideus). Limits of agreement for MFI was within ± 2.06% for muscle groups and within ± 5.13% for individual muscles. The limits of agreement for liver PDFF was within ± 1.9%. CONCLUSION Whole-body Dixon MRI could characterize a range of different fat and muscle compartments with high precision, including individual muscles, in the study-group of postmenopausal women. The inclusion of individual muscles, calculated from the same scan, enables analysis for specific intervention programs and studies.
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Affiliation(s)
- Janne West
- Department of Medical and Health Sciences (IMH), Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Advanced MR Analytics AB, Linköping, Sweden
| | - Thobias Romu
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Advanced MR Analytics AB, Linköping, Sweden
- Department of Biomedical Engineering (IMT), Linköping University, Linköping, Sweden
| | - Sofia Thorell
- Department of Medical and Health Sciences (IMH), Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Department of Clinical and Experimental Medicine (IKE), Linköping University, Linköping, Sweden
| | - Hanna Lindblom
- Department of Medical and Health Sciences (IMH), Linköping University, Linköping, Sweden
| | - Emilia Berin
- Department of Clinical and Experimental Medicine (IKE), Linköping University, Linköping, Sweden
| | - Anna-Clara Spetz Holm
- Department of Clinical and Experimental Medicine (IKE), Linköping University, Linköping, Sweden
| | - Lotta Lindh Åstrand
- Department of Clinical and Experimental Medicine (IKE), Linköping University, Linköping, Sweden
| | - Anette Karlsson
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Department of Biomedical Engineering (IMT), Linköping University, Linköping, Sweden
| | - Magnus Borga
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Advanced MR Analytics AB, Linköping, Sweden
- Department of Biomedical Engineering (IMT), Linköping University, Linköping, Sweden
| | - Mats Hammar
- Department of Clinical and Experimental Medicine (IKE), Linköping University, Linköping, Sweden
| | - Olof Dahlqvist Leinhard
- Department of Medical and Health Sciences (IMH), Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Advanced MR Analytics AB, Linköping, Sweden
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Chikui T, Yamashita Y, Kise Y, Saito T, Okamura K, Yoshiura K. Estimation of proton density fat fraction of the salivary gland. Br J Radiol 2018; 91:20170671. [PMID: 29376736 DOI: 10.1259/bjr.20170671] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Our first objective was to prove the validity of the six-point Dixon method for estimating the proton density fat fraction (PDFF) of the salivary gland. The second objective was to estimate the salivary gland PDFF using Dixon method to evaluate the pathological conditions. METHODS At first, 12 volunteers underwent two types of sequences: single-voxel magnetic resonance spectroscopy and the Dixon method and the PDFFs obtained by the two methods were compared. Next, a total of 67 individuals [normal, n = 46; Sjögren's syndrome (SS), n = 11; and IgG4-related dacryoadenitis and sialadenitis (IgG4-DS), n = 4, parotitis, n = 6] were enrolled to estimate the parotid gland (PG) and submandibular gland (SMG) PDFF using the Dixon method. RESULTS This volunteer study demonstrated excellent correlation between two methods (R2 = 0.964, slope = 1.05). In the normal group, the PG-PDFF was correlated with the weight and body mass index (BMI) (ρ = 0.38, p = 0.0085; and ρ = 0.63, p < 0.0001). The SMG-PDFF was also correlated with the weight, BMI, and serum triglyceride (ρ = 0.37, p = 0.0067; ρ = 0.42, p = 0.0022; and ρ = 0.35, p = 0.024). The PG-PDFF of the SS group (48.2 ± 15.1%) was higher than that of any other groups; however, no significant difference was found due to the wide overlap. The SS group (39.0 ± 26.14%) also had significantly higher SMG-PDFF than the normal group (8.9 ± 5.4%), p < 0.0001) and IgG4-DS group (3.8 ± 2.3%), p = 0.020). CONCLUSION The Dixon method is a feasible method for estimating the PDFF and demonstrates fat accumulation in SMG in the SS group. Advances in knowledge: The PDFF obtained by the Dixon method is helpful for understanding the salivary gland pathological condition.
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Affiliation(s)
- Toru Chikui
- 1 Department of Oral and Maxillofacial Radiology, Faculty of Dental Science, Kyushu University , Fukuoka , Japan
| | - Yasuo Yamashita
- 2 Department of Medical Technology, Kyushu University Hospital , Fukuoka , Japan
| | - Yoshitaka Kise
- 3 Department of Oral and Maxillofacial Radiology, School of Dentistry, Aichi Gakuin University , Nagoya , Japan
| | - Tomonori Saito
- 2 Department of Medical Technology, Kyushu University Hospital , Fukuoka , Japan
| | - Kazutoshi Okamura
- 1 Department of Oral and Maxillofacial Radiology, Faculty of Dental Science, Kyushu University , Fukuoka , Japan
| | - Kazunori Yoshiura
- 1 Department of Oral and Maxillofacial Radiology, Faculty of Dental Science, Kyushu University , Fukuoka , Japan
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Mamidipalli A, Hamilton G, Manning P, Hong CW, Park CC, Wolfson T, Hooker J, Heba E, Schlein A, Gamst A, Durelle J, Paiz M, Middleton MS, Schwimmer JB, Sirlin CB. Cross-sectional correlation between hepatic R2* and proton density fat fraction (PDFF) in children with hepatic steatosis. J Magn Reson Imaging 2018; 47:418-424. [PMID: 28543915 PMCID: PMC5702271 DOI: 10.1002/jmri.25748] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 04/10/2017] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To determine the relationship between hepatic proton density fat fraction (PDFF) and R2* in vivo. MATERIALS AND METHODS In this Health Insurance Portability and Accountability Act (HIPAA)-compliant, Institutional Review Board (IRB)-approved, cross-sectional study, we conducted a secondary analysis of 3T magnetic resonance imaging (MRI) exams performed as part of prospective research studies in children in whom conditions associated with iron overload were excluded clinically. Each exam included low-flip-angle, multiecho magnitude (-M) and complex (-C) based chemical-shift-encoded MRI techniques with spectral modeling of fat to generate hepatic PDFF and R2* parametric maps. For each technique and each patient, regions of interest were placed on the maps in each of the nine Couinaud segments, and composite whole-liver PDFF and R2* values were calculated. Pearson's correlation coefficients between PDFF and R2* were computed for each MRI technique. Correlations were compared using Steiger's test. RESULTS In all, 184 children (123 boys, 61 girls) were included in this analysis. PDFF estimated by MRI-M and MRI-C ranged from 1.1-35.4% (9.44 ± 8.76) and 2.1-38.1% (10.1 ± 8.7), respectively. R2* estimated by MRI-M and MRI-C ranged from 32.6-78.7 s-1 (48.4 ± 9.8) and 27.2-71.5 s-1 (42.2 ± 8.6), respectively. There were strong and significant correlations between hepatic PDFF and R2* values estimated by MRI-M (r = 0.874; P < 0.0001) and MRI-C (r = 0.853; P < 0.0001). The correlation coefficients (0.874 vs. 0.853) were not significantly different (P = 0.15). CONCLUSION Hepatic PDFF and R2* are strongly correlated with each other in vivo. This relationship was observed using two different MRI techniques. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:418-424.
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Affiliation(s)
- Adrija Mamidipalli
- Liver Imaging Group, Department of Radiology, University of California, San Diego, California, USA
| | - Gavin Hamilton
- Liver Imaging Group, Department of Radiology, University of California, San Diego, California, USA
| | - Paul Manning
- Liver Imaging Group, Department of Radiology, University of California, San Diego, California, USA
| | - Cheng William Hong
- Liver Imaging Group, Department of Radiology, University of California, San Diego, California, USA
| | - Charlie C. Park
- Liver Imaging Group, Department of Radiology, University of California, San Diego, California, USA
| | - Tanya Wolfson
- Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California – San Diego, San Diego, California, USA
| | - Jonathan Hooker
- Liver Imaging Group, Department of Radiology, University of California, San Diego, California, USA
| | - Elhamy Heba
- Liver Imaging Group, Department of Radiology, University of California, San Diego, California, USA
| | - Alexandra Schlein
- Liver Imaging Group, Department of Radiology, University of California, San Diego, California, USA
| | - Anthony Gamst
- Computational and Applied Statistics Laboratory, San Diego Supercomputer Center, University of California – San Diego, San Diego, California, USA
| | - Janis Durelle
- Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California
| | - Melissa Paiz
- Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California
| | - Michael S. Middleton
- Liver Imaging Group, Department of Radiology, University of California, San Diego, California, USA
| | - Jeffrey B. Schwimmer
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California - San Diego, San Diego, California
- Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California
| | - Claude B. Sirlin
- Liver Imaging Group, Department of Radiology, University of California, San Diego, California, USA
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Yokoo T, Serai SD, Pirasteh A, Bashir MR, Hamilton G, Hernando D, Hu HH, Hetterich H, Kühn JP, Kukuk GM, Loomba R, Middleton MS, Obuchowski NA, Song JS, Tang A, Wu X, Reeder SB, Sirlin CB. Linearity, Bias, and Precision of Hepatic Proton Density Fat Fraction Measurements by Using MR Imaging: A Meta-Analysis. Radiology 2018; 286:486-498. [PMID: 28892458 PMCID: PMC5813433 DOI: 10.1148/radiol.2017170550] [Citation(s) in RCA: 210] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Purpose To determine the linearity, bias, and precision of hepatic proton density fat fraction (PDFF) measurements by using magnetic resonance (MR) imaging across different field strengths, imager manufacturers, and reconstruction methods. Materials and Methods This meta-analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic literature search identified studies that evaluated the linearity and/or bias of hepatic PDFF measurements by using MR imaging (hereafter, MR imaging-PDFF) against PDFF measurements by using colocalized MR spectroscopy (hereafter, MR spectroscopy-PDFF) or the precision of MR imaging-PDFF. The quality of each study was evaluated by using the Quality Assessment of Studies of Diagnostic Accuracy 2 tool. De-identified original data sets from the selected studies were pooled. Linearity was evaluated by using linear regression between MR imaging-PDFF and MR spectroscopy-PDFF measurements. Bias, defined as the mean difference between MR imaging-PDFF and MR spectroscopy-PDFF measurements, was evaluated by using Bland-Altman analysis. Precision, defined as the agreement between repeated MR imaging-PDFF measurements, was evaluated by using a linear mixed-effects model, with field strength, imager manufacturer, reconstruction method, and region of interest as random effects. Results Twenty-three studies (1679 participants) were selected for linearity and bias analyses and 11 studies (425 participants) were selected for precision analyses. MR imaging-PDFF was linear with MR spectroscopy-PDFF (R2 = 0.96). Regression slope (0.97; P < .001) and mean Bland-Altman bias (-0.13%; 95% limits of agreement: -3.95%, 3.40%) indicated minimal underestimation by using MR imaging-PDFF. MR imaging-PDFF was precise at the region-of-interest level, with repeatability and reproducibility coefficients of 2.99% and 4.12%, respectively. Field strength, imager manufacturer, and reconstruction method each had minimal effects on reproducibility. Conclusion MR imaging-PDFF has excellent linearity, bias, and precision across different field strengths, imager manufacturers, and reconstruction methods. © RSNA, 2017 Online supplemental material is available for this article. An earlier incorrect version of this article appeared online. This article was corrected on October 2, 2017.
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