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Quantification of liver iron content with CT—added value of dual-energy

  • Hepatobiliary-Pancreas
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Abstract

Objective

To evaluate the value of dual-energy CT (DECT) with use of an iron-specific, three-material decomposition algorithm for the quantification of liver iron content (LIC).

Methods

Thirty-one phantoms containing liver tissue, fat and iron were scanned with dual-source CT using single-energy at 120 kV (SECT) and DECT at 80 kV and 140 kV. Virtual iron concentration (VIC) images derived from an iron-specific, three-material decomposition algorithm and measurements of fat-free and fat-containing phantoms were compared with the LIC and healthy liver tissue.

Results

In the absence of fat significant linear correlations were found between LIC and HU from SECT and VIC (r = 0.984–0.997, p < 0.001) with a detection limit of 145.4 μmol/g LIC for SECT, whereas VIC accurately quantified the lowest LIC of 20 μmol/g dry liver. In the presence of fat, no significant correlation was observed between LIC and SECT, whereas significant correlations were found for VIC. Compared with fat-free phantoms, significant underestimation of LIC was seen for SECT with increasing amounts of fat (all, p ≤ 0.01). On the other hand, similar HU were seen for VIC of fat-containing compared with fat-free phantoms (p > 0.632).

Conclusions

Virtual iron concentration images generated from DECT provide added value for the quantification of LIC by disregarding the confounding effect of the natural variation of healthy liver attenuation and of co-existing liver fat.

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References

  1. Pietrangelo A (2010) Hereditary hemochromatosis: pathogenesis, diagnosis, and treatment. Gastroenterology 139:393–408. doi:S0016-5085(10)00872-3, 408 e391-392

    Article  PubMed  Google Scholar 

  2. Bonkovsky HL, Lambrecht RW, Shan Y (2003) Iron as a co-morbid factor in nonhemochromatotic liver disease. Alcohol 30:137–144. doi:S0741832903001277

    Article  PubMed  CAS  Google Scholar 

  3. Gandon Y, Olivie D, Guyader D et al (2004) Non-invasive assessment of hepatic iron stores by MRI. Lancet 363:357–362. doi:10.1016/S0140-6736(04)15436-6

    Article  PubMed  CAS  Google Scholar 

  4. Bydder M, Shiehmorteza M, Yokoo T et al (2010) Assessment of liver fat quantification in the presence of iron. Magn Reson Imaging 28:767–776. doi:S0730-725X(10)00080-9

    Article  PubMed  CAS  Google Scholar 

  5. Castiella A, Alustiza JM, Emparanza JI, Zapata EM, Costero B, Diez MI (2011) Liver iron concentration quantification by MRI: are recommended protocols accurate enough for clinical practice? Eur Radiol 21:137–141. doi:10.1007/s00330-010-1899-z

    Article  PubMed  Google Scholar 

  6. Gandon Y, Guyader D, Heautot JF et al (1994) Hemochromatosis - diagnosis and quantification of liver iron with gradient-echo Mr-Imaging. Radiology 193:533–538

    PubMed  CAS  Google Scholar 

  7. Boll DT, Merkle EM (2009) Diffuse liver disease: strategies for hepatic CT and MR imaging. Radiographics 29:1591–U1584. doi:10.1148/Rg.296095513

    Article  PubMed  Google Scholar 

  8. Goldberg HI, Cann CE, Moss AA, Ohto M, Brito A, Federle M (1982) Noninvasive quantitation of liver iron in dogs with hemochromatosis using dual-energy CT scanning. Invest Radiol 17:375–380

    Article  PubMed  CAS  Google Scholar 

  9. Raptopoulos V, Karellas A, Bernstein J, Reale FR, Constantinou C, Zawacki JK (1991) Value of dual-energy CT in differentiating focal fatty infiltration of the liver from low-density masses. Am J Roentgenol 157:721–725

    CAS  Google Scholar 

  10. Olivieri NF, Saxon BR, NisbetBrown E, Klein NC, Adamkiewicz T, Brittenham GM (1997) Quantitative assessment of tissue iron in patients (pts) with sickle cell disease. Blood 90:1976–1976

    Google Scholar 

  11. Karlo C, Lauber A, Gotti RP et al (2011) Dual-energy CT with tin filter technology for the discrimination of renal lesion proxies containing blood, protein, and contrast-agent. An experimental phantom study. Eur Radiol 21:385–392. doi:10.1007/s00330-010-1926-0

    Article  PubMed  Google Scholar 

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Correspondence to Hatem Alkadhi.

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Fischer, M.A., Reiner, C.S., Raptis, D. et al. Quantification of liver iron content with CT—added value of dual-energy. Eur Radiol 21, 1727–1732 (2011). https://doi.org/10.1007/s00330-011-2119-1

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  • DOI: https://doi.org/10.1007/s00330-011-2119-1

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