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Quantitative MRI in cardiometabolic disease: From conventional cardiac and liver tissue mapping techniques to multi-parametric approaches

Research output: Contribution to journalReview articlepeer-review

Original languageEnglish
Article number991383
JournalFrontiers in Cardiovascular Medicine
Early online date23 Jan 2023
Accepted/In press29 Dec 2022
E-pub ahead of print23 Jan 2023
Published23 Jan 2023

Bibliographical note

Funding Information: The authors acknowledge financial support from the BHF PG/18/59/33955 and RG/20/1/34802, EPSRC EP/P001009, EP/P032311/1, EP/P007619/1, and EP/V044087/1, Wellcome EPSRC Centre for Medical Engineering (NS/A000049/1), ICN2021_004, Fondecyt 1210637, Fondecyt 1210638, ANID Basal FB210024, and Millennium Nucleus NCN19_161. Publisher Copyright: Copyright © 2023 Fotaki, Velasco, Prieto and Botnar.


King's Authors


Cardiometabolic disease refers to the spectrum of chronic conditions that include diabetes, hypertension, atheromatosis, non-alcoholic fatty liver disease, and their long-term impact on cardiovascular health. Histological studies have confirmed several modifications at the tissue level in cardiometabolic disease. Recently, quantitative MR methods have enabled non-invasive myocardial and liver tissue characterization. MR relaxation mapping techniques such as T 1, T , T 2 and T 2* provide a pixel-by-pixel representation of the corresponding tissue specific relaxation times, which have been shown to correlate with fibrosis, altered tissue perfusion, oedema and iron levels. Proton density fat fraction mapping approaches allow measurement of lipid tissue in the organ of interest. Several studies have demonstrated their utility as early diagnostic biomarkers and their potential to bear prognostic implications. Conventionally, the quantification of these parameters by MRI relies on the acquisition of sequential scans, encoding and mapping only one parameter per scan. However, this methodology is time inefficient and suffers from the confounding effects of the relaxation parameters in each single map, limiting wider clinical and research applications. To address these limitations, several novel approaches have been proposed that encode multiple tissue parameters simultaneously, providing co-registered multiparametric information of the tissues of interest. This review aims to describe the multi-faceted myocardial and hepatic tissue alterations in cardiometabolic disease and to motivate the application of relaxometry and proton-density cardiac and liver tissue mapping techniques. Current approaches in myocardial and liver tissue characterization as well as latest technical developments in multiparametric quantitative MRI are included. Limitations and challenges of these novel approaches, and recommendations to facilitate clinical validation are also discussed.

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