MO‐F‐211‐03: A Practical Approach for Liver Iron Measurement in Clinical Setting

Abstract

Purpose: To quantitatively and noninvasively determine a wide range of hepatic iron concentration (HIC) for hematologic oncology patients in a routine clinical setting. Methods: A total of 28 consecutive patients who underwent a bone marrow stem cell transplant at our institution within last five years were included in this study. A breath‐hold multiecho gradient‐echo sequence was used to acquire T2*‐weighted images using a 1.5‐T MRI scanner. To cover a wide range of clinically relevant T2* values, we used three HIC measurement protocols with different temporal resolutions to acquire data for each patient in three breath‐holds. Of the three measurement protocols, the one that provided the most reliable T2* values was selected for clinical use. An in‐house image post‐processing software tool was developed to generate T2*, R2*, and HIC maps for each patient. To validate the repeatability and reproducibility, a Ferri phantom consisting with different T2* tubes was used to measure T2* values with the same protocol for patients in every three to four months over a period of one year. Results: This technique is successfully used to measure a wide range of liver T2* values from 1.0 msec to 25.0 msec. Those T2* values correspond to HIC values ranging from 1.3 mg/g to 26.0 mg/g (dry weight). Phantom test for T2* tubes (range from 4.0 msec to 32.0 msec) demonstrated very good repeatability and reproducibility, with standard deviation error less than 2.0%. Conclusions: Although it is well known that T2* is proportional iron deposition in liver, clinical iron measurements using MRI are still far from routine. With the technique developed in this work, a wide range of clinically relevant HIC values can be accurately and noninvasively quantified in routine clinical settings by carefully combining breath‐holding protocols and using in‐house image post‐processing software.