Improved liver T1rho measurement precision with a breathhold black blood single shot fast spin echo acquisition: a validation study in healthy vol

📝 Abstract

Purpose: To explore the usability and normal T1rho value of liver parenchyma with a novel single breathhold black blood single shot fast spin echo acquisition based liver imaging sequence. Materials and Methods: In total 19 health subjects (10 males, 9 females; mean age: 37.4 yrs; range: 23-54 yrs) participated in the study. 11 subjects had liver scanned twice in the same session to access scan-rescan repeatability. 12 subjects had liver scanned twice in two sessions with 7-10 days’ interval to access scan-rescan reproducibility. MR was performed with a 3.0 T scanner with dual transmitter. The MR sequence allows simultaneous acquisition of 4 spin lock times (TSLs: 0ms, 10 ms, 30 ms, 50ms) in 10 second. Inherent black blood effect of fast spin echo and double inversion recovery were utilized to achieve blood signal suppression. Results: The technique demonstrated good image quality and minimal artifacts. For liver parenchyma, Bland-Altman plot showed the scan-rescan repeatability mean difference was 0.025 ms (95% limits of agreement: -1.163 to 1.213 ms), and intraclass correlation coefficient (ICC) was 0.977. The scan-rescan reproducibility mean difference was -0.075 ms (95% limits of agreement: -3.280 to 3.310 ms), and ICC was 0.820 which is better than the ICC of 0.764 of a previous bright blood multi-breath hold gradient echo acquisition technique. The liver T1rho value was 39.9 +/- 2.4 ms (range: 36.1 - 44.2 ms), which is lower than the value of 42.8=/-2.1 ms acquired with the previous bright blood technique. Conclusion: This study validated the application of a single breathhold black blood single shot fast spin echo acquisition based for human liver T1rho imaging. The lower liver parenchyma T1rho value and higher scan rescan reproducibility may improve of the sensitivity of this technique.

💡 Analysis

Purpose: To explore the usability and normal T1rho value of liver parenchyma with a novel single breathhold black blood single shot fast spin echo acquisition based liver imaging sequence. Materials and Methods: In total 19 health subjects (10 males, 9 females; mean age: 37.4 yrs; range: 23-54 yrs) participated in the study. 11 subjects had liver scanned twice in the same session to access scan-rescan repeatability. 12 subjects had liver scanned twice in two sessions with 7-10 days’ interval to access scan-rescan reproducibility. MR was performed with a 3.0 T scanner with dual transmitter. The MR sequence allows simultaneous acquisition of 4 spin lock times (TSLs: 0ms, 10 ms, 30 ms, 50ms) in 10 second. Inherent black blood effect of fast spin echo and double inversion recovery were utilized to achieve blood signal suppression. Results: The technique demonstrated good image quality and minimal artifacts. For liver parenchyma, Bland-Altman plot showed the scan-rescan repeatability mean difference was 0.025 ms (95% limits of agreement: -1.163 to 1.213 ms), and intraclass correlation coefficient (ICC) was 0.977. The scan-rescan reproducibility mean difference was -0.075 ms (95% limits of agreement: -3.280 to 3.310 ms), and ICC was 0.820 which is better than the ICC of 0.764 of a previous bright blood multi-breath hold gradient echo acquisition technique. The liver T1rho value was 39.9 +/- 2.4 ms (range: 36.1 - 44.2 ms), which is lower than the value of 42.8=/-2.1 ms acquired with the previous bright blood technique. Conclusion: This study validated the application of a single breathhold black blood single shot fast spin echo acquisition based for human liver T1rho imaging. The lower liver parenchyma T1rho value and higher scan rescan reproducibility may improve of the sensitivity of this technique.

📄 Content

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Improved liver T1rho measurement precision with a breathhold black blood single shot fast spin echo acquisition: a validation study in healthy volunteers.

Yì Xiáng J Wáng MMed PhD 1, Min Deng MMed1, Gladys G Lo MD2, Queenie Chan PhD3, Yuan Jing PhD4, Weitian Chen PhD1,

1Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR 2Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR 3 MR Clinical Science, Philips Healthcare Greater China, Hong Kong SAR 4 Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong SAR

Running title: a breathhold black blood single shot T1rho acquisition

Funding: This study was partially supported by grants from the Research Grants Council of the Hong Kong SAR (Project No. 476313 and Project No. SEG CUHK02). Conflict-of-interest: Queenie Chan is an employee of Philips Healthcare. The other authors declare t no conflict of interest.

Correspondence to: Yì-Xiáng Wáng; e-mail: yixiang_wang@cuhk.edu.hk

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Abstract

Purpose: To explore the usability and normal T1rho value of liver parenchyma with a novel single breathhold black blood single shot fast spin echo acquisition based liver imaging sequence. Materials and Methods: The institutional Ethics Committee approved this study. In total

19 health subjects (10 males, 9 females; mean age: 37.4 yrs; range: 23-54 yrs) participated in the study. 11 subjects had liver scanned twice in the same session to access scan-rescan repeatability. 12 subjects had liver scanned twice in two sessions with 7-10 days’ interval to access scan-rescan reproducibility. MR was performed with a 3.0 T scanner with dual transmitter. The MR sequence allows simultaneous acquisition of 4 spin lock times (TSLs: 0msec, 10 msec, 30 msec, 50msec) in 10 second, and the spin- lock frequency was 500Hz. Inherent black blood effect of fast spin echo and double inversion recovery were utilized to achieve blood signal suppression. Three axial slices were obtained with a resolution of 1.5 × 1.5 × 6.00 mm3. Region-of-interest method was used to measure liver T1 rho value. Results: The technique demonstrated good image quality and minimal artifacts. For liver parenchyma, Bland-Altman plot showed the scan-rescan repeatability mean difference was 0.025 msec (95% limits of agreement: -1.163 to 1.213 msec), and intraclass correlation coefficient (ICC) was 0.977. The scan-rescan reproducibility mean difference was -0.075 msec (95% limits of agreement: -3.280 to 3.310 msec), and ICC was 0.820 which is better than the ICC of 0.764 of a previous bright blood multi-breath hold gradient echo acquisition technique. The liver T1rho value was 39.9 ± 2.4 msec (range: 36.1 - 44.2 msec), which is lower than the value of 42.8±2.1 msec acquired with the

previous bright blood technique.

Conclusion: This study validated the application of a single breathhold black blood single shot fast spin echo acquisition based for human liver T1rho imaging. The lower liver 3

parenchyma T1rho value and higher scan rescan reproducibility may improve of the sensitivity of this technique.

Keywords: T1rho; liver; breathhold, fibrosis; cirrhosis; black blood; fast spin echo (FSE) 4

Introduction

Chronic liver disease is a major public health problem worldwide. Hepatitis virus is the most common blood-borne infection in USA and worldwide [1,2]. Chronic viral hepatitis can lead to hepatic fibrosis, cirrhosis and hepatocellular carcinoma and is the leading cause of liver transplantation nationwide [3]. The epidemic trend of chronic liver disease is expected to increase owing to an aging population, the growing epidemic of obesity and non-alcoholic steatohepatitis. To date, noninvasive diagnostic tests available from clinical practice are not sensitive or specific enough to detect liver injury at early stages [4]. Liver biopsy remains the standard of reference for the diagnosis and staging of liver fibrosis. However, it is an invasive procedure with potential complications [5]. Histologic assessment of fibrosis is also an inherently subjective process and subject to sampling variability [6]. A noninvasive and quantitative technique for assessing liver fibrosis and monitoring disease progression or therapeutic intervention is highly desirable.

Compared with molecular imaging based on injectable agents, MR based molecular imaging techniques have the major advantage that the regulatory hurdle is much less [6- 18]. T1rho (T1ρ) is the relaxation rate constant of transverse magnetization for the duration of the spin-lock radiofrequency (RF) pulse. In magnetic resonance T1rho imaging, the equilibrium magnetization (M0) is rotated into the transverse plane first. This magnetiza

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