MRI Quantification of Liver Fibrosis Using Diamagnetic Susceptibility: An Ex Vivo Validation Study

BACKGROUND/OBJECTIVES: Liver fibrosis, if left untreated, can lead to cirrhosis and cancer. The current standard liver biopsy for fibrosis staging is invasive and prone to risks of complication. The objective of this study was to develop a new noninvasive method to quantify fibrosis using diamagnetic susceptibility sources generated from multi-echo gradient echo (mGRE) data with both magnitude decay R2* modeling and phase QSM modeling. METHODS: mGRE data of ex vivo liver explants was processed with fat-water separation and then susceptibility source separation. Negative susceptibility was used to measure diamagnetic fibrosis. In 20 formalin-fixed liver explant sections, negative susceptibility maps were compared with other MRI parameters against pathology for fibrosis staging. RESULTS: = 0.0017). CONCLUSIONS: For staging fibrosis, negative susceptibility was superior to other MRI parameters, including R2*, QSM, and PDFF. Negative susceptibility sources were positively correlated with the fibrosis stage (r = 0.60). Negative susceptibility could be valuable for MRI staging in liver fibrosis.