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Published online before print December 10, 2003, 10.1148/radiol.2302020820
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(Radiology 2004;230:479-484.)
© RSNA, 2003

Gastrointestinal Imaging

MR Quantification of Hepatic Iron Concentration1

José M. Alústiza, MD, José Artetxe, MD, Agustín Castiella, MD, Cristina Agirre, MD, José I. Emparanza, PhD, Pedro Otazua, MD, Manuel García-Bengoechea, MD, Jesús Barrio, MD, Fernando Mújica, MD and José A. Recondo, MD, , For the Gipuzkoa Hepatic Iron Concentration By MRI Study Group

1 From OSATEK, Alta Tecnología Sanitaria S.A., Paseo Dr Beguiristain 109, 20014 San Sebastián, Basque Country, Spain (J.M.A., J.A.R.); Donostia Hospital, San Sebastián, Spain (J.A., C.A., J.I.E., M.G.B., F.M.); Mendaro Hospital, Spain (A.C.); Alto Deba Hospital, Arrasate-Mondragón, Spain (P.O.); and Bidasoa Hospital, Hondarribia, Spain (J.B.). The members of the Group and their affiliations are listed at the end of this article. Received July 1, 2002; revision requested September 4; final revision received May 19, 2003; accepted June 13. Address correspondence to J.M.A. (e-mail: rm.donostia@osatek.es).

PURPOSE: To evaluate the accuracy of magnetic resonance (MR) imaging in the quantification of hepatic iron concentration.

MATERIALS AND METHODS: Between April 1999 and June 2001, 112 patients were recruited prospectively. All had undergone liver biopsy and hepatic iron concentration quantification with spectrophotometry, followed by MR imaging. MR imaging involved use of four gradient-echo sequences and one spin-echo sequence. Signal intensity (SI) was measured on images obtained with each sequence by means of regions of interest placed in the liver and paraspinal muscle to obtain the liver-to-muscle SI ratio. The relationship between hepatic iron concentration and SI ratio for each sequence was analyzed with multiple linear regression. Receiver operating characteristic analysis was performed to find the diagnostic thresholds.

RESULTS: Sixty-eight patients had normal hepatic iron levels (<36 µmol/g), 23 had hemosiderosis (36–80 µmol/g), and 21 had hemochromatosis (>80 µmol/g). With all sequences, an inverse linear relationship between iron concentration and SI ratio was apparent. The authors generated a mathematic model to estimate the iron concentrations from MR imaging data (r = 0.937). For estimated concentrations of more than 85 µmol/g, the positive predictive value for hemochromatosis was 100%; for those less than 40 µmol/g, the negative predictive value for hemochromatosis was 100%. For estimated concentrations of more than 58 µmol/g, the positive predictive value for iron overload was 100%; for those less than 20 µmol/g, the negative predictive value for iron overload was 100%.

CONCLUSION: MR imaging is a useful and noninvasive diagnostic tool for quantification of hepatic iron concentration.

© RSNA, 2003

Index terms: Hemochromatosis, 761.659 • Liver, biopsy, 761.1261 • Liver, diseases, 761.659 • Magnetic resonance (MR), comparative studies, 761.121411, 761.121412




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