title: Virtual iron concentration imaging based on dual-energy CT for noninvasive quantification and grading of liver iron content: An iron overload rabbit model study.
abstract: OBJECTIVE
  To assess the accuracy of liver iron content (LIC) quantification and grading ability associated with clinical LIC stratification using virtual iron concentration (VIC) imaging on dual-energy CT (DECT) in an iron overload rabbit model.
  
  
  METHODS
  Fifty-one rabbits were prepared as iron-loaded models by intravenous injection of iron dextran. DECT was performed at 80 and 140 kVp. VIC images were derived from an iron-specific algorithm. Postmortem LIC assessments were conducted on an inductively coupled plasma (ICP) spectrometer. Correlation between VIC and LIC was analyzed. VIC were stratified according to the corresponding clinical LIC thresholds of 1.8, 3.2, 7.0, and 15.0 mg Fe/g. Diagnostic performance of stratification was evaluated by receiver operating characteristic analysis.
  
  
  RESULTS
  VIC linearly correlated with LIC (r = 0.977, P < 0.01). No significant difference was observed between VIC-derived LICs and ICP (P > 0.05). For the four clinical LIC thresholds, the corresponding cutoff values of VIC were 19.6, 25.3, 36.9, and 61.5 HU, respectively. The highest sensitivity (100%) and specificity (100 %) were achieved at the threshold of 15.0 mg Fe/g.
  
  
  CONCLUSIONS
  Virtual iron concentration imaging on DECT showed potential ability to accurately quantify and stratify hepatic iron accumulation in the iron overload rabbit model.
  
  
  CONCLUSIONS
  • Virtual iron concentration (VIC) linearly correlates with liver iron content (LIC). • VIC accurately quantifies LIC. • VIC accurately grades LIC based on clinical LIC stratification.
authors.affiliation: Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No.197, Ruijin Er Road, Shanghai, 200025, China.
authors.forename: Xian Fu
authors.initials: XF
authors.lastname: Luo
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.forename: Jing
authors.initials: J
authors.lastname: Yan
authors.forename: Xue Qian
authors.initials: XQ
authors.lastname: Xie
authors.forename: Huan
authors.initials: H
authors.lastname: Zhang
authors.forename: Wei Min
authors.initials: WM
authors.lastname: Chai
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schmidt
authors.forename: Fu Hua
authors.initials: FH
authors.lastname: Yan
mesh_terms: D000465:Algorithms; D000818:Animals; D004195:Disease Models, Animal; D007501:Iron / Q000032:analysis; D019190:Iron Overload / Q000000981:diagnostic imaging*; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D012372:ROC Curve; D011817:Rabbits; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D007501:Iron