A model for hepatic fibrosis: The competing effects of cell loss and iron on shortened Modified Look-Locker inversion recovery T1 (shMOLLI-T1) in the liver

Tunnicliffe, E; Banerjee, R; Pavlides, M; Neubauer, S; Robson, M

Journal article

A model for hepatic fibrosis: The competing effects of cell loss and iron on shortened Modified Look-Locker inversion recovery T1 (shMOLLI-T1) in the liver

Abstract:: Purpose: Liver T1 values have shown sensitivity to inflammation and fibrosis, but are also affected by hepatic iron content. Modified Look-Locker inversion recovery (MOLLI) T1 measurements are biased by the lower T2 associated with high iron. The purpose of this work is to propose a simple multi-compartment model of the liver and use Bloch-McConnell simulations to demonstrate the effects of iron and fibrosis on shortened-MOLLI (shMOLLI) T1 measurements.
Methods: A tissue model was generated consisting of liver cells and extracellular fluid (ECF), with iron-dependent relaxation rates. Fibrosis was imitated by increasing the ECF proportion. Simulations of the shMOLLI sequence produced a look-up table (LUT) of shMOLLI-T1 for a given ECF fraction and iron content. The LUT was used to calculate ECF(shMOLLI-T1), assuming normal hepatic iron content (HIC), and ECF(shMOLLI-T1,T2*), accounting for HIC determined by T2*, for 77 patients and compared to fibrosis assessed by liver biopsy.
Results: Simulations showed that increasing HIC decreases shMOLLI-T1, with an increase in HIC from 1.0 to 2.5mg/g at normal ECF fraction decreasing shMOLLI-T1 by 160ms, while increasing ECF increased ShMOLLI-T1, with an increase of 20% ECF at normal iron increasing shMOLLI-T1 by 200ms. Calculated patient ECF(shMOLLI-T1) showed a strong dependence on Ishak score (3.3±0.8 %ECF/Ishak stage) and 1/T2* (-0.23±0.04 %ECF/Hz). However, when iron was accounted for to produce ECF(shMOLLI-T1,T2*), it was independent of HIC but retained sensitivity to Ishak score.
Conclusion: Use of this multi-compartment model of the liver with Bloch-McConnell simulation should enable compensation of iron effects when using shMOLLI-T1 to assess fibrosis.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Tunnicliffe, E., Banerjee, R., Pavlides, M., Neubauer, S., & Robson, M. (2016). A model for hepatic fibrosis: The competing effects of cell loss and iron on shortened Modified Look-Locker inversion recovery T1 (shMOLLI-T1) in the liver. Journal of Magnetic Resonance Imaging, 45(2), 450–462.

MLA Style

Tunnicliffe, E., et al. “A Model for Hepatic Fibrosis: The Competing Effects of Cell Loss and Iron on Shortened Modified Look-Locker Inversion Recovery T1 (shMOLLI-T1) in the Liver.” Journal of Magnetic Resonance Imaging, vol. 45, no. 2, 2016, pp. 450–62.

Chicago Style

Tunnicliffe, E., R. Banerjee, M. Pavlides, S. Neubauer, and M. Robson. 2016. “A Model for Hepatic Fibrosis: The Competing Effects of Cell Loss and Iron on Shortened Modified Look-Locker Inversion Recovery T1 (shMOLLI-T1) in the Liver.” Journal of Magnetic Resonance Imaging 45 (2): 450–62.
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