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Hao W, Xu Z, Lin H, Yan F. Using Dual-source Photon-counting Detector CT to Simultaneously Quantify Fat and Iron Content: A Phantom Study. Acad Radiol 2024:S1076-6332(24)00281-2. [PMID: 38772799 DOI: 10.1016/j.acra.2024.04.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/21/2024] [Accepted: 04/26/2024] [Indexed: 05/23/2024]
Abstract
RATIONALE AND OBJECTIVES To evaluate the feasibility of using photon-counting detector computed tomography (PCD CT) to simultaneously quantify fat and iron content MATERIALS AND METHODS: Phantoms with pure fat, pure iron and fat-iron deposition were scanned by two tube voltages (120 and 140 kV) and two image quality (IQ) settings (80 and 145). Using an iron-specific three-material decomposition algorithm, virtual noniron (VNI) and virtual iron content (VIC) images were generated at quantum iterative reconstruction (QIR) strength levels 1-4. RESULTS Significant linear correlations were observed between known fat content (FC) and VNI for pure fat phantoms (r = 0.981-0.999, p < 0.001) and between known iron content (IC) and VIC for pure iron phantoms (r = 0.897-0.975, p < 0.001). In fat-iron phantoms, the measurement for fat content of 5-30% demonstrated good linearity between FC and VNI (r = 0.919-0.990, p < 0.001), and VNI were not affected by 75, 150, and 225 µmol/g iron overload (p = 0.174-0.519). The measurement for iron demonstrated a linear range of 75-225 µmol/g between IC and VIC (r = 0.961-0.994, p < 0.001) and VIC was not confounded by the coexisting 5%, 20%, and 30% fat deposition (p = 0.943-0.999). The Bland-Altman of fat and iron measurements were not significantly different at varying tube voltages and IQ settings (all p > 0.05). No significant difference in VNI and VIC at QIR 1-4. CONCLUSION PCD CT can accurately and simultaneously quantify fat and iron, including scan parameters with lower radiation dose.
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Affiliation(s)
- Wanting Hao
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China.
| | - Zhihan Xu
- CT Collaboration, Siemens Healthcare Ltd., No. 278 Zhouzhu Road, Shanghai 200025, China.
| | - Huimin Lin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China.
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin Er Road, Shanghai 200025, China; Faculty of Medical Imaging Technology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine.
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Zhu L, Wang F, Wang H, Zhang J, Xie A, Pei J, Zhou J, Liu H. Liver fat volume fraction measurements based on multi-material decomposition algorithm in patients with nonalcoholic fatty liver disease: the influences of blood vessel, location, and iodine contrast. BMC Med Imaging 2024; 24:37. [PMID: 38326746 PMCID: PMC10848342 DOI: 10.1186/s12880-024-01215-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/29/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND In recent years, spectral CT-derived liver fat quantification method named multi-material decomposition (MMD) is playing an increasingly important role as an imaging biomarker of hepatic steatosis. However, there are various measurement ways with various results among different researches, and the impact of measurement methods on the research results is unknown. The aim of this study is to evaluate the reproducibility of liver fat volume fraction (FVF) using MMD algorithm in nonalcoholic fatty liver disease (NAFLD) patients when taking blood vessel, location, and iodine contrast into account during measurement. METHODS This retrospective study was approved by the institutional ethics committee, and the requirement for informed consent was waived because of the retrospective nature of the study. 101 patients with NAFLD were enrolled in this study. Participants underwent non-contrast phase (NCP) and two-phase enhanced CT scanning (late arterial phase (LAP) and portal vein phase (PVP)) with spectral mode. Regions of interest (ROIs) were placed at right posterior lobe (RPL), right anterior lobe (RAL) and left lateral lobe (LLL) to obtain FVF values on liver fat images without and with the reference of enhanced CT images. The differences of FVF values measured under different conditions (ROI locations, with/without enhancement reference, NCP and enhanced phases) were compared. Friedman test was used to compare FVF values among three phases for each lobe, while the consistency of FVF values was assessed between each two phases using Bland-Altman analysis. RESULTS Significant difference was found between FVF values obtained without and with the reference of enhanced CT images. There was no significant difference about FVF values obtained from NCP images under the reference of enhanced CT images between any two lobes or among three lobes. The FVF value increased after the contrast injection, and there were significant differences in the FVF values among three scanning phases. Poor consistencies of FVF values between each two phases were found in each lobe by Bland-Altman analysis. CONCLUSION MMD algorithm quantifying hepatic fat was reproducible among different lobes, while was influenced by blood vessel and iodine contrast.
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Affiliation(s)
- Liuhong Zhu
- Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, Jinhu Road No. 668, Huli District, Xiamen, Fujian, China
- Xiamen Municipal Clinical Research Center for Medical Imaging, Xiamen, Fujian, China
- Xiamen Radiological Control Center, Xiamen, Fujian, China
| | - Funan Wang
- Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, Jinhu Road No. 668, Huli District, Xiamen, Fujian, China
- Xiamen Municipal Clinical Research Center for Medical Imaging, Xiamen, Fujian, China
| | - Heqing Wang
- Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, Jinhu Road No. 668, Huli District, Xiamen, Fujian, China
- Xiamen Municipal Clinical Research Center for Medical Imaging, Xiamen, Fujian, China
| | - Jinhui Zhang
- Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, Jinhu Road No. 668, Huli District, Xiamen, Fujian, China
| | - Anjie Xie
- Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, Jinhu Road No. 668, Huli District, Xiamen, Fujian, China
| | - Jinkui Pei
- Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, Jinhu Road No. 668, Huli District, Xiamen, Fujian, China
| | - Jianjun Zhou
- Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, Jinhu Road No. 668, Huli District, Xiamen, Fujian, China.
- Department of Radiology, Zhongshan Hospital Fudan University, Fenglin Road No.180, Xuhui District, Shanghai, 200032, China.
| | - Hao Liu
- Department of Radiology, Zhongshan Hospital Fudan University, Fenglin Road No.180, Xuhui District, Shanghai, 200032, China.
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Hollý S, Chmelík M, Suchá S, Suchý T, Beneš J, Pátrovič L, Juskanič D. Photon-counting CT using multi-material decomposition algorithm enables fat quantification in the presence of iron deposits. Phys Med 2024; 118:103210. [PMID: 38219560 DOI: 10.1016/j.ejmp.2024.103210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 11/29/2023] [Accepted: 01/04/2024] [Indexed: 01/16/2024] Open
Abstract
PURPOSE A new generation of CT detectors were recently developed with the ability to measure individual photon's energy and thus provide spectral information. The aim of this work was to assess the performance of simultaneous fat and iron quantification using a clinical photon-counting CT (PCCT) and its comparison to dual-energy CT (DECT), MRS and MRI at 3 T. METHODS Two 3D printed cylindrical phantoms with 32 samples (n = 12 fat fractions between 0 % and 100 %, n = 20 with mixtures of fat and iron) were scanned with PCCT and DECT scanners for comparison. A three-material decomposition approach was used to estimate the volume fractions of fat (FF), iron and soft tissue. The same phantoms were examined by MRI (6-echo DIXON, a.k.a. Q-DIXON) and MRS (multi-echo STEAM, a.k.a. HISTO) at 3 T for comparison. RESULTS PCCT, DECT, MRI and MRS computed FFs showed correlation with reference fat fraction values in samples with no iron (r > 0.98). PCCT decomposition showed slightly weaker correlation with FFref in samples with added iron (r = 0.586) compared to MRI (r = 0.673) and MRS (r = 0.716) methods. On the other hand, it showed no systematic over- or underestimation. Surprisingly, DECT decomposition-derived FF showed strongest correlation (r = 0.758) in these samples, however systematic overestimation was observed. FF values computed by three-material PCCT decomposition, DECT decomposition, MRI and MRS were unaffected by iron concentration. CONCLUSIONS This in-vitro study shows for the first time that photon-counting computed tomography may be used for quantification of fat content in the presence of iron deposits.
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Affiliation(s)
- Samuel Hollý
- JESSENIUS - diagnostic center, Nitra, Slovakia; Institute of Biophysics and Informatics, First Faculty of Medicine Charles University, Prague, Czech Republic
| | - Marek Chmelík
- JESSENIUS - diagnostic center, Nitra, Slovakia; Department of Technical Disciplines in Health Care, Faculty of Health Care, University of Prešov, Slovakia.
| | - Slavomíra Suchá
- Department of Technical Disciplines in Health Care, Faculty of Health Care, University of Prešov, Slovakia
| | - Tomáš Suchý
- Department of Technical Disciplines in Health Care, Faculty of Health Care, University of Prešov, Slovakia
| | - Jiři Beneš
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | | | - Dominik Juskanič
- JESSENIUS - diagnostic center, Nitra, Slovakia; Medical Faculty, Commenius University in Bratislava, Slovakia
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Feng Q, Yi J, Li T, Liang B, Xu F, Peng P. Narrative review of magnetic resonance imaging in quantifying liver iron load. Front Med (Lausanne) 2024; 11:1321513. [PMID: 38362538 PMCID: PMC10867177 DOI: 10.3389/fmed.2024.1321513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/18/2024] [Indexed: 02/17/2024] Open
Abstract
Objective To summarize the research progress of magnetic resonance imaging (MRI) in quantifying liver iron load. Methods To summarize the current status and progress of MRI technology in the quantitative study of liver iron load through reviewing the relevant literature at home and abroad. Results Different MRI sequence examination techniques have formed a series of non-invasive methods for the examination of liver iron load. These techniques have important clinical significance in the imaging diagnosis of liver iron load. So far, the main MRI methods used to assess liver iron load are: signal intensity measurement method (signal intensity, SI) [signal intensity ratio (SIR) and difference in in-phase and out-of-phase signal intensity], T2/R2 measurement (such as FerriScan technique), ultra-short echo time (UTE) imaging technique, and susceptibility weighted imaging (including conventional susceptibility weighted imaging) (SWI), quantitative susceptibility mapping (QSM), T2*/R2* measurement, Dixon and its derivative techniques. Conclusion MRI has become the first choice for the non-invasive examination of liver iron overload, and it is helpful to improve the early detection of liver injury, liver fibrosis, liver cirrhosis and liver cancer caused by liver iron overload.
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Affiliation(s)
- Qing Feng
- Department of Radiology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou Workers' Hospital, Liuzhou, China
| | - Jixing Yi
- Department of Radiology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou Workers' Hospital, Liuzhou, China
| | - Tao Li
- Department of Radiology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou Workers' Hospital, Liuzhou, China
| | - Bumin Liang
- School of International Education, Guangxi Medical University, Nanning, China
| | - Fengming Xu
- Department of Radiology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou Workers' Hospital, Liuzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Peng Peng
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Du D, Wu X, Wang J, Chen H, Song J, Liu B. Impact of iron deposit on the accuracy of quantifying liver fat fraction using multi-material decomposition algorithm in dual-energy spectral computed tomography. J Appl Clin Med Phys 2021; 22:236-242. [PMID: 34288379 PMCID: PMC8364258 DOI: 10.1002/acm2.13368] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/04/2021] [Accepted: 07/11/2021] [Indexed: 12/31/2022] Open
Abstract
Objectives To investigate the accuracy of using multi‐material decomposition (MMD) algorithm in dual‐energy spectral computed tomography (CT) for quantifying fat fraction (FF) in the presence of iron. Materials Nine tubes with various proportions of fat and iron were prepared. FF were divided into three levels (10%, 20%, and 30%), recorded as references (FFref). Iron concentrations (in mg/100 g) were divided into three ranges (25.25–25.97, 50.38–51.55 and 75.57–77.72). The nine‐tube phantom underwent dual‐energy CT and MR. CT attenuation was measured and FF were determined using MMD in CT (FFCT) and Iterative Decomposition of water and fat with Echo Asymmetry and Least squares estimation (IDEAL‐IQ) in MR (FFMR) for each tube. Statistical analyses used were: Spearman rank correlation for correlations between FFref and CT attenuation, FFCT, and FFMR; one‐way ANOVA, and one‐sample t‐test for the differences between FFCT and FFref and between FFMR and FFref. A multivariate linear regression model was established to analyze the differences between the corresponding values with different iron concentrations under the same FFref. Results Fat fraction on CT (FFCT) and FFMR were positively correlated with FFref (all p < 0.001), while the CT attenuation was negatively correlated with FFref in the three iron concentration ranges. For a given FFref, FFCT decreased and FFMR increased as the iron concentration increased. The mean difference between FFCT and FFref over the nine tube measurements was 0.25 ± 2.45%, 5.7% lower the 5.98 ± 3.33% value between FFMR and FFref (F = 310.017, p < 0.01). Conclusion The phantom results indicate that MMD in dual‐energy CT can directly quantify volumetric FF and is less affected by iron concentration than MR IDEAL‐IQ method.
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Affiliation(s)
- Dandan Du
- Department of Radiology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xingwang Wu
- Department of Radiology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jinchuan Wang
- Department of Radiology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Hua Chen
- Department of Radiology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jian Song
- Department of Radiology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Bin Liu
- Department of Radiology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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