Measurement of Hepatic Lipid: High-Speed T2-Corrected Multiecho Acquisition at 1H MR Spectroscopy—A Rapid and Accurate Technique

We have developed a rapid breath-hold MR spectroscopic technique, high-speed T2-corrected multiecho, which acquires multiple echo times and allows more accurate quantification of hepatic lipid levels.

Purpose

To evaluate the feasibility, accuracy, and reproducibility of a fast breath-hold magnetic resonance (MR) spectroscopic method for T2-corrected hepatic lipid measurement in phantoms and in humans.

Materials and Methods

All experiments were institutional review board approved and HIPAA compliant; informed consent was obtained from all subjects. The 15-second breath-hold high-speed T2-corrected multiecho (HISTO) MR spectroscopic technique was developed to acquire multiple echoes in a single acquisition, which enables the quantification of water and lipid T2, and subsequently to provide a corrected measure of hepatic lipid fraction. The accuracy of T2-corrected MR spectroscopy was evaluated in eight lipid phantoms doped with iron to simulate variable T2 effects. The mean absolute error of the HISTO technique with the known lipid amounts, as well as with uncorrected MR spectroscopic measures, was evaluated. The HISTO sequence was performed in 25 male subjects (mean age, 23.0 years ± 19.2 [standard deviation]) to evaluate measurement bias with conventional, uncorrected MR spectroscopy. Three additional male subjects (mean age, 30.0 years ± 1.0) were examined to assess reproducibility by using analysis of variance testing within subject and between separate imaging sessions.

Results

The absolute error in quantifying lipid fraction by using iron-doped lipid phantoms was less than 11% for the HISTO technique, compared with more than 50% for uncorrected MR spectroscopy. In the 25 human subjects, hepatic lipid measured by using HISTO differed significantly from that by using uncorrected MR spectroscopic methods by 5.1% ± 2.6. Analysis of variance of three separate imaging sessions with the HISTO technique indicated no significant variance (P = .13) in three subjects.

Conclusion

HISTO is an accurate, reproducible MR spectroscopic sequence for quantifying hepatic lipid noninvasively. Evidence has shown this method to be feasible in vivo for clinical use.

© RSNA, 2009

References

  • 1 Patton HM , Sirlin C , Behling C , Middleton M , Schwimmer JB , Lavine JE. Pediatric nonalcoholic fatty liver disease: a critical appraisal of current data and implications for future research. J Pediatr Gastroenterol Nutr 2006; 43( 4): 413– 427. Crossref, MedlineGoogle Scholar
  • 2 Schwimmer JB , Deutsch R , Kahen T , Lavine JE , Stanley C , Behling C. Prevalence of fatty liver in children and adolescents. Pediatrics 2006; 118( 4): 1388– 1393. Crossref, MedlineGoogle Scholar
  • 3 Fishbein MH , Miner M , Mogren C , Chalekson J. The spectrum of fatty liver in obese children and the relationship of serum aminotransferases to severity of steatosis. J Pediatr Gastroenterol Nutr 2003; 36( 1): 54– 61. Crossref, MedlineGoogle Scholar
  • 4 Radetti G , Kleon W , Stuefer J , Pittschieler K. Non-alcoholic fatty liver disease in obese children evaluated by magnetic resonance imaging. Acta Paediatr 2006; 95( 7): 833– 837. Crossref, MedlineGoogle Scholar
  • 5 Reddy JK , Rao MS. Lipid metabolism and liver inflammation. II. Fatty liver disease and fatty acid oxidation. Am J Physiol Gastrointest Liver Physiol 2006; 290( 5): G852– G858. Crossref, MedlineGoogle Scholar
  • 6 Wang ZJ , Haselgrove JC , Martin MB. Evaluation of iron overload by single voxel MRS measurement of liver T2. J Magn Reson Imaging 2002; 15( 5): 395– 400. Crossref, MedlineGoogle Scholar
  • 7 Thampanitchawong P , Piratvisuth T. Liver biopsy: complications and risk factors. World J Gastroenterol 1999; 5( 4): 301– 304. Crossref, MedlineGoogle Scholar
  • 8 Fishbein MH , Gardner KG , Potter CJ , Schmalbrock P , Smith MA. Introduction of fast MR imaging in the assessment of hepatic steatosis. Magn Reson Imaging 1997; 15( 3): 287– 293. Crossref, MedlineGoogle Scholar
  • 9 Hollingsworth KG , Abubacker MZ , Joubert I , Allison ME , Lomas DJ. Low-carbohydrate diet induced reduction of hepatic lipid content observed with a rapid non-invasive MRI technique. Br J Radiol 2006; 79( 945): 712– 715. Crossref, MedlineGoogle Scholar
  • 10 Schuchmann S , Weigel C , Albrecht L , et al.. Non-invasive quantification of hepatic fat fraction by fast 1.0, 1.5 and 3.0 T MR imaging. Eur J Radiol 2007; 62( 3): 416– 422. Crossref, MedlineGoogle Scholar
  • 11 Chan DC , Watts GF , Ng TW , Hua J , Song S , Barrett PH. Measurement of liver fat by magnetic resonance imaging: relationship with body fat distribution, insulin sensitivity and plasma lipids in healthy men. Diabetes Obes Metab 2006; 8( 6): 698– 702. Crossref, MedlineGoogle Scholar
  • 12 Szczepaniak LS , Babcock EE , Schick F , et al.. Measurement of intracellular triglyceride stores by 1H spectroscopy: validation in vivo. Am J Physiol Endocrinol Metab 1999; 276: E977– E989. Crossref, MedlineGoogle Scholar
  • 13 Kim H , Taksali SE , Dufour S , et al.. Comparative MR study of hepatic fat quantification using single-voxel proton spectroscopy, two-point Dixon and three-point IDEAL. Magn Reson Med 2008; 59( 3): 521– 527. Crossref, MedlineGoogle Scholar
  • 14 Dixon WT. Simple proton spectroscopic imaging. Radiology 1984; 153( 1): 189– 194. LinkGoogle Scholar
  • 15 Fishbein MH , Stevens WR. Rapid MRI using a modified Dixon technique: a non-invasive and effective method for the detection and monitoring of fatty metamorphosis of the liver. Pediatr Radiol 2001; 31( 11): 806– 809. Crossref, MedlineGoogle Scholar
  • 16 Glover GH , Schneider E. Three-point Dixon technique for true water/fat decomposition with B0 inhomogeneity correction. Magn Reson Med 1991; 18( 2): 371– 383. Crossref, MedlineGoogle Scholar
  • 17 Glover GH. Multipoint Dixon technique for water and fat proton and susceptibility imaging. J Magn Reson Imaging 1991; 1( 5): 521– 530. Crossref, MedlineGoogle Scholar
  • 18 Reeder SB , Wen Z , Yu H , et al.. Multicoil Dixon chemical species separation with an iterative least-squares estimation method. Magn Reson Med 2004; 51( 1): 35– 45. Crossref, MedlineGoogle Scholar
  • 19 Thomas EL , Hamilton G , Patel N , et al.. Hepatic triglyceride content and its relation to body adiposity: a magnetic resonance imaging and proton magnetic resonance spectroscopy study. Gut 2005; 54( 1): 122– 127. Crossref, MedlineGoogle Scholar
  • 20 Szczepaniak LS , Nurenberg P , Leonard D , et al.. Magnetic resonance spectroscopy to measure hepatic triglyceride content: prevalence of hepatic steatosis in the general population. Am J Physiol Endocrinol Metab 2005; 288( 2): E462– E468. Crossref, MedlineGoogle Scholar
  • 21 Machann J , Thamer C , Schnoedt B , et al.. Hepatic lipid accumulation in healthy subjects: a comparative study using spectral fat-selective MRI and volume-localized 1H-MR spectroscopy. Magn Reson Med 2006; 55( 4): 913– 917. Crossref, MedlineGoogle Scholar
  • 22 O'Regan DP , Callaghan MF , Wylezinska-Arridge M , et al.. Liver fat content and T2*: simultaneous measurement by using breath-hold multiecho MR imaging at 3.0 T—feasibility. Radiology 2008; 247( 2): 550– 557. LinkGoogle Scholar
  • 23 Kreis R. Quantitative localized (1)H MR spectroscopy for clinical use. J Prog NMR 1997; 31: 155– 195. CrossrefGoogle Scholar
  • 24 Provencher SW. Automatic quantitation of localized in vivo 1H spectra with LCModel. NMR Biomed 2001; 14( 4): 260– 264. Crossref, MedlineGoogle Scholar
  • 25 Chang JS , Taouli B , Salibi N , Hecht EM , Chin DG , Lee VS. Opposed-phase MRI for fat quantification in fat-water phantoms with 1H MR spectroscopy to resolve ambiguity of fat or water dominance. AJR Am J Roentgenol 2006; 187( 1): W103– W106. Crossref, MedlineGoogle Scholar
  • 26 Westphalen AC , Qayyum A , Yeh BM , et al.. Liver fat: effect of hepatic iron deposition on evaluation with opposed-phase MR imaging. Radiology 2007; 242( 2): 450– 455. LinkGoogle Scholar
  • 27 St Pierre TG , Clark PR , Chua-anusorn W. Noninvasive measurement and imaging of liver iron concentrations using proton magnetic resonance. Blood 2005; 105( 2): 855– 861. Crossref, MedlineGoogle Scholar

Article History

Received November 24, 2008; revision requested January 21, 2009; revision received February 24; accepted March 17; final version accepted March 31.
Published in print: Aug 2009