Liver iron quantification with MR imaging: A primer for radiologists

Roxanne Labranche, Guillaume Gilbert, Milena Cerny, Kim Nhien Vu, Denis Soulières, Damien Olivié, Jean Sébastien Billiard, Takeshi Yokoo, An Tang

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Iron overload is a systemic disorder and is either primary (genetic) or secondary (exogenous iron administration). Primary iron overload is most commonly associated with hereditary hemochromatosis and secondary iron overload with ineffective erythropoiesis (pre-dominantly caused by b-thalassemia major and sickle cell disease) that requires long-term transfusion therapy, leading to transfusional hemosiderosis. Iron overload may lead to liver cirrhosis and hepatocellular carcinoma, in addition to cardiac and endocrine complications. The liver is one of the main iron storage organs and the first to show iron overload. Therefore, detection and quantification of liver iron overload are critical to initiate treatment and prevent complications. Liver biopsy was the historical reference standard for detection and quantification of liver iron content. Magnetic resonance (MR) imaging is now commonly used for liver iron quantification, including assessment of distribution, detection, grading, and monitoring of treatment response in iron overload. Several MR imaging techniques have been developed for iron quantification, each with advantages and limitations. The liver-to-muscle signal intensity ratio technique is simple and widely available; however, it assumes that the reference tissue is normal. Transverse magnetization (also known as R2) relaxometry is validated but is prone to respiratory motion artifacts due to a long acquisition time, is presently available only for 1.5-T imaging, and requires additional cost and delay for off-line analysis. The R2* technique has fast acquisition time, demonstrates a wide range of liver iron content, and is available for 1.5-T and 3.0-T imaging but requires additional postprocessing software. Quantitative susceptibility mapping has the highest sensitivity for detecting iron deposition; however, it is still investigational, and the correlation with liver iron content is not yet established.

Original languageEnglish (US)
Pages (from-to)392-412
Number of pages21
JournalRadiographics
Volume38
Issue number2
DOIs
StatePublished - Mar 1 2018

Fingerprint

Iron Overload
Iron
Magnetic Resonance Imaging
Liver
Hemosiderosis
Hemochromatosis
Radiologists
Erythropoiesis
beta-Thalassemia
Sickle Cell Anemia
Liver Cirrhosis
Artifacts
Hepatocellular Carcinoma
Therapeutics
Software
Biopsy
Costs and Cost Analysis
Muscles

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Labranche, R., Gilbert, G., Cerny, M., Vu, K. N., Soulières, D., Olivié, D., ... Tang, A. (2018). Liver iron quantification with MR imaging: A primer for radiologists. Radiographics, 38(2), 392-412. https://doi.org/10.1148/rg.2018170079

Liver iron quantification with MR imaging : A primer for radiologists. / Labranche, Roxanne; Gilbert, Guillaume; Cerny, Milena; Vu, Kim Nhien; Soulières, Denis; Olivié, Damien; Billiard, Jean Sébastien; Yokoo, Takeshi; Tang, An.

In: Radiographics, Vol. 38, No. 2, 01.03.2018, p. 392-412.

Research output: Contribution to journalArticle

Labranche, R, Gilbert, G, Cerny, M, Vu, KN, Soulières, D, Olivié, D, Billiard, JS, Yokoo, T & Tang, A 2018, 'Liver iron quantification with MR imaging: A primer for radiologists', Radiographics, vol. 38, no. 2, pp. 392-412. https://doi.org/10.1148/rg.2018170079
Labranche R, Gilbert G, Cerny M, Vu KN, Soulières D, Olivié D et al. Liver iron quantification with MR imaging: A primer for radiologists. Radiographics. 2018 Mar 1;38(2):392-412. https://doi.org/10.1148/rg.2018170079
Labranche, Roxanne ; Gilbert, Guillaume ; Cerny, Milena ; Vu, Kim Nhien ; Soulières, Denis ; Olivié, Damien ; Billiard, Jean Sébastien ; Yokoo, Takeshi ; Tang, An. / Liver iron quantification with MR imaging : A primer for radiologists. In: Radiographics. 2018 ; Vol. 38, No. 2. pp. 392-412.
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