Diagnosis of Cirrhosis with Mri: Is Magnetization Transfer Contrast worth Pursuing?

Introduction: Liver biopsy, which serves as the clinical standard for the detection and surveillance of liver fibrosis and cirrhosis, is an invasive procedure that is prone to sampling error and interobserver variability. Magnetization-transfer contrast (MTC) imaging employs off-resonance radio-frequency pulses to selectively pre-saturate signal from macromolecule-bound protons via chemical exchange with free water and may offer a non-invasive means of detecting the collagen and other macromolecules deposited in the extracellular matrix of the liver in the setting of fibrosis and cirrhosis. While several studies have previously examined the utility of MTC imaging in this setting, these studies used differing imaging parameters for the magnetization transfer (MT) pre-pulse and have achieved variable and inconclusive results [1-5]. In this study, we attempt to optimize the ability of MTC imaging to separate healthy and cirrhotic livers via the use of an MTC sequence with adjustable MT pulse parameters.