Evaluation of a Vendor-Agnostic, Free-Breathing Fat and Iron Quantification Technique in Adults and Children

Motivation: Flip-angle modulation (FAM) for motion-robust fat and iron quantification was recently implemented in the vendor-neutral platform Pulseq and demonstrated free-breathing feasibility in two healthy volunteers at 3T. Larger-scale evaluation in patients and in multiple field strengths is needed to validate Pulseq-FAM. Goal(s): Validation of free-breathing Pulseq-FAM against product breath-held 3D-CSE and vendor-platform free-breathing FAM methods. Approach: Prospective in vivo studies in adult liver steatosis/iron overload patients, and children with normal and elevated BMI. Results: Pulseq-FAM shows strong agreement with product 3D-CSE and vendor-platform FAM. Pulseq-FAM shows similar repeatability as vendor-platform FAM, and both FAM methods show superior repeatability to product 3D-CSE. Impact: Free-breathing Pulseq-FAM has excellent performance in adults and children, and is easily deployable across multiple vendors. Therefore, Pulseq-FAM may enable cross-center studies and clinical trials for which sequence harmonization is crucial, and may encourage additional vendor-native implementations for clinical use.