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Multiparametric MR assessment of liver fat, iron, and fibrosis: a concise overview of the liver “Triple Screen”

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Abstract

Chronic liver disease (CLD) is a common source of morbidity and mortality worldwide. Non-alcoholic fatty liver disease (NAFLD) serves as a major cause of CLD with a rising annual prevalence. Additionally, iron overload can be both a cause and effect of CLD with a negative synergistic effect when combined with NAFLD. The development of state-of-the-art multiparametric MR solutions has led to a change in the diagnostic paradigm in CLD, shifting from traditional liver biopsy to innovative non-invasive methods for providing accurate and reliable detection and quantification of the disease burden. Novel imaging biomarkers such as MRI-PDFF for fat, R2 and R2* for iron, and liver stiffness for fibrosis provide important information for diagnosis, surveillance, risk stratification, and treatment. In this article, we provide a concise overview of the MR concepts and techniques involved in the detection and quantification of liver fat, iron, and fibrosis including their relative strengths and limitations and discuss a practical abbreviated MR protocol for clinical use that integrates these three MR biomarkers into a single simplified MR assessment. Multiparametric MR techniques provide accurate and reliable non-invasive detection and quantification of liver fat, iron, and fibrosis. These techniques can be combined in a single abbreviated MR “Triple Screen” assessment to offer a more complete metabolic imaging profile of CLD.

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  1. Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, WMC 2B2.41 8440-112 ST, Edmonton, AB, T6G2B7, Canada

    Gavin Low, Craig Ferguson, Stephanie Locas, Wendy Tu, Florin Manolea, Medica Sam & Mitchell P. Wilson

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Low, G., Ferguson, C., Locas, S. et al. Multiparametric MR assessment of liver fat, iron, and fibrosis: a concise overview of the liver “Triple Screen”. Abdom Radiol 48, 2060–2073 (2023). https://doi.org/10.1007/s00261-023-03887-0

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