Abstract #0412

Flip-angle modulated 2D-CSE-MRI for motion-robust free-breathing liver PDFF and R2* mapping in a clinical setting

Julius Frederik Heidenreich^1,2, Raphael do Vale Souza¹, Alexandra Anagnostopoulos¹, Jan-Peter Grunz^1,2, Lukas Müller^1,3, Jiayi Tang^1,4, Daiki Tamada¹, Ali Pirasteh¹, Scott B Reeder^1,4,5,6,7, and Diego Hernando^1,5,7

¹Department of Radiology, University Madison Wisconsin, Madison, WI, United States, ²Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany, ³Department of Radiology, University Hospital Mainz, Mainz, Germany, ⁴Department of Medical Physics, University Madison Wisconsin, Madison, WI, United States, ⁵Department of Medicine, University Madison Wisconsin, Madison, WI, United States, ⁶Department of Emergency Medicine, University Madison Wisconsin, Madison, WI, United States, ⁷Department of Electrical and Computer Engineering, University Madison Wisconsin, Madison, WI, United States

Synopsis

Keywords: Hepatobiliary, Quantitative Imaging

Motivation: Breath-held 3D-CSE-MRI is widely for non-invasive liver fat and iron quantification but is often compromised by respiratory motion. Free-breathing 2D acquisitions using flip-angle modulation (FAM) address this with a short temporal aperture.

Goal(s): To assess feasibility, image quality, and performance of 2D-FAM-based free-breathing liver fat and iron quantification in a clinical setting.

Approach: 2D-FAM-based proton density fat-fraction and R2* maps were acquired in consecutive patients over an eight month period during routine clinical care, and compared to breath-held 3D-CSE-MRI.

Results: In 210 patients, 2D-FAM showed high concordance with commercial 3D-CSE-MRI, yielding superior image quality with limitations in the presence of high iron overload.

Impact: The motion robustness and short acquisition time of free-breathing 2D-FAM-CSE-MRI offers significant advantages, enabling reliable quantification of liver fat and iron. This is essential for diagnosis and treatment monitoring of diffuse liver disease, and with potential to improve clinical outcomes.

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