Abstract
ObjectiveTo explore the feasibility of dual-source dual-energy computed tomography (DSDECT) for hepatic iron and fat separation in vivo.Materials and MethodsAll of the procedures in this study were approved by the Research Animal Resource Center of Shanghai Ruijin Hospital. Sixty rats that underwent DECT scanning were divided into the normal group, fatty liver group, liver iron group, and coexisting liver iron and fat group, according to Prussian blue and HE staining. The data for each group were reconstructed and post-processed by an iron-specific, three-material decomposition algorithm. The iron enhancement value and the virtual non-iron contrast value, which indicated overloaded liver iron and residual liver tissue, respectively, were measured. Spearman's correlation and one-way analysis of variance (ANOVA) were performed, respectively, to analyze statistically the correlations with the histopathological results and differences among groups.ResultsThe iron enhancement values were positively correlated with the iron pathology grading (r = 0.729, p<0.001). Virtual non-iron contrast (VNC) values were negatively correlated with the fat pathology grading (r = −0.642,p<0.0001). Different groups showed significantly different iron enhancement values and VNC values (F = 25.308,p<0.001; F = 10.911, p<0.001, respectively). Among the groups, significant differences in iron enhancement values were only observed between the iron-present and iron-absent groups, and differences in VNC values were only observed between the fat-present and fat-absent groups.ConclusionSeparation of hepatic iron and fat by dual energy material decomposition in vivo was feasible, even when they coexisted.
Highlights
The iron enhancement values were positively correlated with the iron pathology grading (r = 0.729, p,0.001)
Virtual non-iron contrast (VNC) values were negatively correlated with the fat pathology grading (r = 20.642,p,0.0001)
Coexisting hepatic iron deposition and steatosis can be associated with numerous liver diseases, such as fatty liver diseases, chronic hepatitis C and B, hepatocellular carcinoma, hemochromatosis and hemosiderosis [1,2]
Summary
Coexisting hepatic iron deposition and steatosis can be associated with numerous liver diseases, such as fatty liver diseases, chronic hepatitis C and B, hepatocellular carcinoma, hemochromatosis and hemosiderosis [1,2]. Iron deposits increase the CT value of the liver parenchyma, while the opposite relationship is true for liver fat. If liver iron and fat coexist, quantification of the fat or iron by conventional, single energy CT is no longer reliable due to the inverse effects of the iron and fat [13]. Previous studies have shown that the false negative rate of single energy CT on iron deposition was as high as 40% [14]. The accuracy of conventional CT in the diagnosis of fatty liver was approximately 67% in the absence of iron deposition and only 20% when there was iron deposition [15]
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