Validation of T2* in-line analysis for tissue iron quantification at 1.5 T.
There is a need for improved worldwide access to tissue iron quantification using T2* cardiovascular magnetic resonance (CMR). One route to facilitate this would be simple in-line T2* analysis widely available on MR scanners. We therefore compared our clinically validated and established T2* method at Royal Brompton Hospital (RBH T2*) against a novel work-in-progress (WIP) sequence with in-line T2* measurement from Siemens (WIP T2*).



Healthy volunteers (n = 22) and patients with iron overload (n = 78) were recruited (53 males, median age 34 years). A 1.5 T study (Magnetom Avanto, Siemens) was performed on all subjects. The same mid-ventricular short axis cardiac slice and transaxial slice through the liver were used to acquire both RBH T2* images and WIP T2* maps for each participant. Cardiac white blood (WB) and black blood (BB) sequences were acquired. Intraobserver, interobserver and interstudy reproducibility were measured on the same data from a subset of 20 participants.



Liver T2* values ranged from 0.8 to 35.7 ms (median 5.1 ms) and cardiac T2* values from 6.0 to 52.3 ms (median 31 ms). The coefficient of variance (CoV) values for direct comparison of T2* values by RBH and WIP were 6.1-7.8 % across techniques. Accurate delineation of the septum was difficult on some WIP T2* maps due to artefacts. The inability to manually correct for noise by truncation of erroneous later echo times led to some overestimation of T2* using WIP T2* compared with the RBH T2*. Reproducibility CoV results for RBH T2* ranged from 1.5 to 5.7 % which were better than the reproducibility of WIP T2* values of 4.1-16.6 %.



Iron estimation using the T2* CMR sequence in combination with Siemens' in-line data processing is generally satisfactory and may help facilitate global access to tissue iron assessment. The current automated T2* map technique is less good for tissue iron assessment with noisy data at low T2* values.
Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.|National Heart and Lung Institute, Imperial College, London, UK.
Mohammed H
MH
Alam
Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.|National Heart and Lung Institute, Imperial College, London, UK.|Cardiovascular Science Research Center, St George's, University of London, London, UK.
Taigang
T
He
Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.|National Heart and Lung Institute, Imperial College, London, UK.
Dominique
D
Auger
Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.|National Heart and Lung Institute, Imperial College, London, UK.
Gillian C
GC
Smith
Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
Peter
P
Drivas
Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
Rick
R
Wage
Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
Cemil
C
Izgi
Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.
Karen
K
Symmonds
Siemens AG Healthcare, Erlangen, Germany.
Andreas
A
Greiser
Siemens Medical Solutions USA Inc, Malvern, PA, USA.
Bruce S
BS
Spottiswoode
Cardiovascular Science Research Center, St George's, University of London, London, UK.
Lisa
L
Anderson
Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK.|National Heart and Lung Institute, Imperial College, London, UK.
David
D
Firmin
Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK. Dj.pennell@rbht.nhs.uk.|National Heart and Lung Institute, Imperial College, London, UK. Dj.pennell@rbht.nhs.uk.
Dudley J
DJ
Pennell
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D016477:Artifacts; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007501:Iron / Q000032:analysis*; D019190:Iron Overload / Q000175:diagnosis* / Q000378:metabolism; D008099:Liver / Q000737:chemistry / Q000000981:diagnostic imaging*; D008107:Liver Diseases / Q000175:diagnosis* / Q000378:metabolism; D008131:London; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000737:chemistry*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D055815:Young Adult
D007501:Iron
CMR; Heart; In-line processing; Iron overload; Liver; T2*