Differences in multi-echo chemical shift encoded MRI proton density fat fraction estimation based on multifrequency fat peaks selection in non-alcoholic fatty liver disease patients

Autores de IIS La Fe

• David Martí Aguado

  Autor

• 

  Luis Martí Bonmatí

  Autor

Participantes ajenos a IIS La Fe

• Alberich-Bayarri Á.
• Martín-Rodríguez J.L.
• França M.
• García-Castro F.
• González-Cantero J.
• González-Cantero Á.

Grupos

• Investigacion Biomédica en Imagen (GIBI 2-30)

Abstract

AIM: To compare the performance of multi-echo chemical-shift-encoded (MECSE) magnetic resonance imaging (MRI) proton density fat fraction (PDFF) estimation, considering three different fat frequency peak combinations, for the quantification of steatosis in patients with non-alcoholic fatty liver disease (NAFLD). MATERIALS AND METHODS: The present study was a prospective cross-sectional research of 121 patients with metabolic syndrome and evidence of hepatic steatosis on ultrasound, who underwent a 3 T MRI examination. All patients were studied with a multifrequency MECSE sequence. The PDFF was calculated using six peaks (MECSEp123456), three peaks (MECSEp456), and a single peak (MECSEp5) model. The two simpler fat peak models were compared to the six peaks model, which was considered the reference standard. Linearity was evaluated using linear regression while agreement was described using Bland–Altman analysis. RESULTS: The mean age was 47 (±9) years and BMI was 29.9 (±2.9) kg/m2. Steatosis distribution was 15%/31%/54% (S1/S2/S3, respectively). Compared to MECSEp123456, both models provided linear PDFF measurements (R2= 0.99 and 0.97, MECSEp456 and MECSEp5 respectively). Regression slope (0.92; p<0.001) and mean Bland–Altman bias (–1.5%; 95% limits of agreement: –3.19%, 0.22%) indicated minimal underestimation by using PDFF-MECSEp456. Nonetheless, mean differences in PDFF estimations varied from –1.5% (MECSEp456, p=0.006) to –2.2% (MECSEp5, p<0.001) when compared to full six fat frequencies model. CONCLUSION: Although simpler spectral fat MECSE analysis shows a linear relationship with the standard six peaks model, their variation in estimated PDFF values introduces a low but clinically significant bias in fat quantification and steatosis grading in NAFLD patients. © 2020 The Royal College of Radiologists

Keywords

• Adipose Tissue; Cross-Sectional Studies; Fatty Liver; Female; Humans; Liver; Magnetic Resonance Imaging; Male; Middle Aged; Non-alcoholic Fatty Liver Disease; Prospective Studies; iron; adult; Article; controlled study; cross-sectional study; diagnostic accuracy; diagnostic test accuracy study; echography; fatty liver; human; intermethod comparison; major clinical study; metabolic syndrome X; middle aged; multi echo chemical shift encoded magnetic resonance imaging; non invasive measurement; nonalcoholic fatty liver; nuclear magnetic resonance imaging; priority journal; prospective study; standard; adipose tissue; diagnostic imaging; female; liver; male; nonalcoholic fatty liver; pathology