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Quantification of liver iron with MRI: State of the art and remaining challenges

Authors

  • Diego Hernando PhD,

    Corresponding author
    1. Department of Radiology, University of Wisconsin – Madison, Madison, Wisconsin, USA
    • Address reprint requests to: D.H., Department of Radiology, University of Wisconsin, WIMR 1115, 1111 Highland Ave., Madison, WI, 53792. E-mail: dhernando@wisc.edu

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  • Yakir S. Levin MD, PhD,

    1. Liver Imaging Group, Department of Radiology, University of California – San Diego, San Diego, California, USA
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  • Claude B. Sirlin MD,

    1. Liver Imaging Group, Department of Radiology, University of California – San Diego, San Diego, California, USA
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  • Scott B. Reeder MD, PhD

    1. Department of Radiology, University of Wisconsin – Madison, Madison, Wisconsin, USA
    2. Department of Medical Physics, University of Wisconsin – Madison, Madison, Wisconsin, USA
    3. Department of Biomedical Engineering, University of Wisconsin – Madison, Madison, Wisconsin, USA
    4. Department of Medicine, University of Wisconsin – Madison, Madison, Wisconsin, USA
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Abstract

Liver iron overload is the histological hallmark of hereditary hemochromatosis and transfusional hemosiderosis, and can also occur in chronic hepatopathies. Iron overload can result in liver damage, with the eventual development of cirrhosis, liver failure, and hepatocellular carcinoma. Assessment of liver iron levels is necessary for detection and quantitative staging of iron overload and monitoring of iron-reducing treatments. This article discusses the need for noninvasive assessment of liver iron and reviews qualitative and quantitative methods with a particular emphasis on magnetic resonance imaging (MRI). Specific MRI methods for liver iron quantification include signal intensity ratio as well as R2 and R2* relaxometry techniques. Methods that are in clinical use, as well as their limitations, are described. Remaining challenges, unsolved problems, and emerging techniques to provide improved characterization of liver iron deposition are discussed. J. Magn. Reson. Imaging 2014;40:1003–1021. © 2014 Wiley Periodicals, Inc.

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