Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2023; 11(25): 5887-5896
Published online Sep 6, 2023. doi: 10.12998/wjcc.v11.i25.5887
Hepatic MR imaging using IDEAL-IQ sequence: Will Gd-EOB-DTPA interfere with reproductivity of fat fraction quantification?
Yuan Tian, Peng-Fei Liu, Jia-Yu Li, Ya-Nan Li, Peng Sun
Yuan Tian, Peng-Fei Liu, Jia-Yu Li, Ya-Nan Li, Peng Sun, Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Author contributions: Tian Y and Sun P contributed equally to this work; Tian Y, Liu PF, and Sun P designed the research study; Tian Y, Li JY performed the research; Li YN and Li JY scanned patients and collected data; Tian Y, Sun P and Li JY analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Supported by National Natural Science Foundation of China, No. 82272053.
Institutional review board statement: The study was reviewed and approved by The First Affiliated Hospital of Harbin Medical University Institutional Review Board [(Approval No. 2020JS09)].
Conflict-of-interest statement: All authors disclosed no relevant relationships.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peng Sun, MM, Attending Doctor, Department of Magnetic Resonance, The First Affiliated Hospital of Harbin Medical University, No. 23 Youzheng Street, Nangang District, Harbin 150001, Heilongjiang Province, China. 19526333113@163.com
Received: April 11, 2023
Peer-review started: April 11, 2023
First decision: April 26, 2023
Revised: May 31, 2023
Accepted: July 14, 2023
Article in press: July 14, 2023
Published online: September 6, 2023
Processing time: 143 Days and 7.7 Hours
Abstract
BACKGROUND

Iterative decomposition of water and fat with echo asymmetry and least squares estimation quantification sequence (IDEAL-IQ) is based on chemical shift-based water and fat separation technique to get proton density fat fraction. Multiple studies have shown that using IDEAL-IQ to test the stability and repeatability of liver fat is acceptable and has high accuracy.

AIM

To explore whether Gadoxetate Disodium (Gd-EOB-DTPA) interferes with the measurement of the hepatic fat content quantified with the IDEAL-IQ and to evaluate the robustness of this technique.

METHODS

IDEAL-IQ was used to quantify the liver fat content at 3.0T in 65 patients injected with Gd-EOB-DTPA contrast. After injection, IDEAL-IQ was estimated four times, and the fat fraction (FF) and R2* were measured at the following time points: Pre-contrast, between the portal phase (70 s) and the late phase (180 s), the delayed phase (5 min) and the hepatobiliary phase (20 min). One-way repeated-measures analysis was conducted to evaluate the difference in the FFs between the four time points. Bland-Altman plots were adopted to assess the FF changes before and after injection of the contrast agent. P < 0.05 was considered statistically significant.

RESULTS

The assessment of the FF at the four time points in the liver, spleen and spine showed no significant differences, and the measurements of hepatic FF yielded good consistency between T1 and T2 [95% confidence interval: -0.6768%, 0.6658%], T1 and T3 (-0.3900%, 0.3178%), and T1 and T4 (-0.3750%, 0.2825%). R2* of the liver, spleen and spine increased significantly after injection (P < 0.0001).

CONCLUSION

Using the IDEAL-IQ sequence to measure the FF, we can obtain results that will not be affected by Gd-EOB-DTPA. The high reproducibility of the IDEAL-IQ sequence makes it available in the scanning interval to save time during multiphase examinations.

Keywords: Gadoxetate Disodium; Iterative decomposition of water and fat with echo asymmetry and least squares estimation quantification sequence; Fat fraction; Enhanced-Magnetic resonance imaging; R2*

Core Tip: The measurement of fat fraction was stable when using Iterative decomposition of water and fat with echo asymmetry and least squares estimation quantification sequence (IDEAL-IQ) before and after injection of hepatocyte-specific contrast agent. Such strong reproducibility makes IDEAL-IQ available in the interval for saving time during examination and optimizes the scanning protocol.