title: Multiparametric or practical quantitative liver MRI: towards millisecond, fat fraction, kilopascal and function era.
abstract: New advances in liver magnetic resonance imaging (MRI) may enable diagnosis of unseen pathologies by conventional techniques. Normal T1 (550-620 ms for 1.5 T and 700-850 ms for 3 T), T2, T2* (>20 ms), T1rho (40-50 ms) mapping, proton density fat fraction (PDFF) (≤5%) and stiffness (2-3kPa) values can enable differentiation of a normal liver from chronic liver and diffuse diseases. Gd-EOB-DTPA can enable assessment of liver function by using postcontrast hepatobiliary phase or T1 reduction rate (normally above 60%). T1 mapping can be important for the assessment of fibrosis, amyloidosis and copper overload. T1rho mapping is promising for the assessment of liver collagen deposition. PDFF can allow objective treatment assessment in NAFLD and NASH patients. T2 and T2* are used for iron overload determination. MR fingerprinting may enable single slice acquisition and easy implementation of multiparametric MRI and follow-up of patients. Areas covered: T1, T2, T2*, PDFF and stiffness, diffusion weighted imaging, intravoxel incoherent motion imaging (ADC, D, D* and f values) and function analysis are reviewed. Expert commentary: Multiparametric MRI can enable biopsyless diagnosis and more objective staging of diffuse liver disease, cirrhosis and predisposing diseases. A comprehensive approach is needed to understand and overcome the effects of iron, fat, fibrosis, edema, inflammation and copper on MR relaxometry values in diffuse liver disease.
authors.affiliation: a Liver Imaging Team, Department of Radiology , Hacettepe University School of Medicine , Ankara , Turkey.|b Department of Radiology , Zonguldak Ataturk State Hospital , Zonguldak , Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Unal
authors.affiliation: a Liver Imaging Team, Department of Radiology , Hacettepe University School of Medicine , Ankara , Turkey.|c Department of Radiology , Ankara Ataturk Education and Research Hospital , Ankara , Turkey.
authors.forename: Ilkay Sedakat
authors.initials: IS
authors.lastname: Idilman
authors.affiliation: a Liver Imaging Team, Department of Radiology , Hacettepe University School of Medicine , Ankara , Turkey.
authors.forename: Muşturay
authors.initials: M
authors.lastname: Karçaaltıncaba
mesh_terms: D003287:Contrast Media / Q000008:administration & dosage; D038524:Diffusion Magnetic Resonance Imaging; D054459:Elasticity Imaging Techniques; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012720:Severity of Illness Index
chemical_list: D003287:Contrast Media
keywords: Cirrhosis; diffuse liver disease; hemosiderosis; liver imaging; magnetic resonance imaging; steatosis