Quantitative magnetic resonance imaging evaluation of hepatic fat content with iron deposition: will it be disturbed?

Objective To explore noninvasive assessment of liver fat content with iron deposition using magnetic resonance (MR) quantitative technology. Methods A water–fat phantom with iron deposition containing 63 vials with predetermined fat percentages and iron concentrations was constructed. Thirty-three patients underwent fat quantitative MR examinations. The fat fraction (FF) was determined by three Dixon techniques. Pathological evaluation findings and the steatosis area rate (SAR) were used as the gold standards. Results FFIOP and FFLAVA-Flex significantly differed from FFTEST for iron concentrations of 1 to 30 µg/mL and fat components of 10% to 80%. Using the three Dixon techniques, FFIOP was 15.76% ± 6.98%, FFLAVA-Flex was 16.71% ± 6.77%, and FFIDEAL IQ was 13.18% ± 6.42% in patients without liver cirrhosis; these values in patients with liver cirrhosis were 20.35% ± 6.11%, 20.89% ± 8.49%, and 12.86% ± 4.00%, respectively. The SAR in patients without and with liver cirrhosis was 11.31% ± 5.89% and 9.84% ± 4.17%, respectively. There were significant positive correlations between FFIDEAL IQ and SAR with or without liver cirrhosis. Conclusion Iron deposition must be considered when using quantitative MR techniques to evaluate the hepatic fat content. Compared with the IOP and LAVA-Flex techniques, the IDEAL IQ technique has more stability and accuracy in measurement of the hepatic fat content, free from iron deposition.