title: Evaluation of iron content in human cerebral cavernous malformation using quantitative susceptibility mapping.
abstract: OBJECTIVE
  The aims of this study were to investigate and validate quantitative susceptibility mapping (QSM) for lesional iron quantification in cerebral cavernous malformations (CCMs).
  
  
  METHODS
  Magnetic resonance imaging studies were performed in phantoms and 16 patients on a 3-T scanner. Susceptibility weighted imaging, QSM, and R2* maps were reconstructed from in vivo data acquired with a 3-dimensional, multi-echo, and T2*-weighted gradient echo sequence. Magnetic susceptibility measurements were correlated to susceptibility weighted imaging and R2* results. In addition, iron concentrations from surgically excised CCM lesion specimens were determined using inductively coupled plasma mass spectrometry and correlated with QSM measurements.
  
  
  RESULTS
  The QSM images demonstrated excellent image quality for depicting CCM lesions in both sporadic and familial cases. Susceptibility measurements revealed a positive linear correlation with R2* values (R(2) = 0.99 for total, R(2) = 0.69 for mean; P < 0.01). Quantitative susceptibility mapping values of known iron-rich brain regions matched closely with those of previous studies and in interobserver consistency. A strong correlation was found between QSM and the concentration of iron phantoms (0.925; P < 0.01), as well as between QSM and mass spectroscopy estimation of iron deposition (0.999 for total iron, 0.86 for iron concentration; P < 0.01) in 18 fragments of 4 excised human CCM lesion specimens.
  
  
  CONCLUSIONS
  The ability of QSM to evaluate iron deposition in CCM lesions was illustrated via phantom, in vivo, and ex vivo validation studies. Quantitative susceptibility mapping may be a potential biomarker for monitoring CCM disease activity and response to treatments.
authors.affiliation: From the *Department of Surgery (Neurosurgery), University of Chicago Medicine and Biological Sciences, Chicago, IL; †MedImageMetric LLC, New York, NY; ‡Department of Radiology, NorthShore University HealthSystem, Evanston; §Department of Radiology, Pritzker School of Medicine, University of Chicago, Chicago; ∥Department of Biomedical Engineering, Northwestern University; ¶Department of Chemistry, Northwestern University, Evanston, IL; #Department of Radiology, Weill Cornell Medical College, New York; **Department of Biomedical Engineering, Cornell University, Ithaca, NY; and ††Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
authors.forename: Huan
authors.initials: H
authors.lastname: Tan
authors.forename: Tian
authors.initials: T
authors.lastname: Liu
authors.forename: Ying
authors.initials: Y
authors.lastname: Wu
authors.forename: Jon
authors.initials: J
authors.lastname: Thacker
authors.forename: Robert
authors.initials: R
authors.lastname: Shenkar
authors.forename: Abdul Ghani
authors.initials: AG
authors.lastname: Mikati
authors.forename: Changbin
authors.initials: C
authors.lastname: Shi
authors.forename: Conner
authors.initials: C
authors.lastname: Dykstra
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.forename: Pottumarthi V
authors.initials: PV
authors.lastname: Prasad
authors.forename: Robert R
authors.initials: RR
authors.lastname: Edelman
authors.forename: Issam A
authors.initials: IA
authors.lastname: Awad
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001932:Brain Neoplasms / Q000737:chemistry* / Q000473:pathology*; D005260:Female; D020786:Hemangioma, Cavernous, Central Nervous System / Q000737:chemistry* / Q000473:pathology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007501:Iron / Q000032:analysis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D007501:Iron