MR liver iron quantification

Last revised by Pablo Lorenzzoni on 31 Mar 2021

Citation, DOI, disclosures and article data

Citation:

Gerstenmaier J, Lorenzzoni P, Bell D, et al. MR liver iron quantification. Reference article, Radiopaedia.org (Accessed on 16 Apr 2024) https://doi.org/10.53347/rID-31338

DOI:

https://doi.org/10.53347/rID-31338

Permalink:

https://radiopaedia.org/articles/31338

rID:

31338

Article created:

2 Oct 2014, Jan Frank Gerstenmaier

Disclosures:

At the time the article was created Jan Frank Gerstenmaier had no recorded disclosures.

View Jan Frank Gerstenmaier's current disclosures

Last revised:

31 Mar 2021, Pablo Lorenzzoni ◉

Disclosures:

At the time the article was last revised Pablo Lorenzzoni had no recorded disclosures.

View Pablo Lorenzzoni's current disclosures

Revisions:

8 times, by 8 contributors - see full revision history and disclosures

Systems:

Hepatobiliary, Haematology

Sections:

Imaging Technology

Tags:

Synonyms:

Liver iron quantification on MRI
MRI hepatic iron quantification

MR liver iron quantification is a non-invasive means of measuring liver iron concentration, a key indicator in the management of patients with hemochromatosis (primary or secondary).

Advantages

Apart from being non-invasive, sampling occurs in a large cross-section of the liver, as opposed to a biopsy, which typically represents 1/50,000 of the whole liver.

The acquisition for both methods described below is usually short and usually takes up 10 minutes of magnet time only.

Physics

There are two principle methods of liver iron quantification by MRI: T2 relaxometry and signal intensity ratio.

T2 relaxometry

Iron within liver has paramagnetic properties and results in a decrease in T2 relaxation times. The accelerated relaxation is proportional to iron content. Decay models are attributed to the average signal intensity at different echo times. To obtain reliable measurements of T2 times at different levels of iron overload, acquisition sequences with several different echo times are needed. Signal intensity as a function of echo time can be used to obtain a T2 parametric map ¹.

An online tool is available to perform the relevant calculations ⁴.

Signal intensity ratio (SIR)

The ratio between the signal intensity of the liver and the signal intensity of paraspinal muscle that does not accumulate iron can be used to determine liver iron concentration. Using the same slice, signal intensity measurements are performed using ROIs, avoiding large vessels in the liver. The sequences used are gradient recalled echoes, as these are more sensitive to the paramagnetic effect of iron.

One of the most recognized SIR methods was developed at the University of Rennes, France ².

T2 relaxometry vs. SIR methods

Estimating liver iron content is easier to perform with SIR compared with T2 relaxometry. SIR methods are less accurate at an iron concentration of >350 micromol Fe/g. However, SIR methods are highly specific at all levels of iron concentration and are reproducible. Overall, T2 relaxation methods are more accurate, but not yet standardized, and normally require off-site processing, which attracts additional cost. An advantage of T2 relaxation methods is the utility of myocardial iron concentration measurement ³.