title: Simultaneous assessment of liver volume and whole liver fat content: a step towards one-stop shop preoperative MRI protocol.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the ability of a whole liver volume (WLV) segmentation algorithm to measure fat fraction (FF).
  
  
  METHODS
  Twenty consecutive patients with histologically proven fatty liver disease underwent dual-echo in-phase/out-of-phase MRI and magnetic resonance spectroscopy (MRS) at 1.5 T. Two readers independently performed semiautomatic 3D liver segmentation on the out-of-phase sequences using an active contour model. FF was calculated for voxels, segments and WLV. Segmentation inter-observer reproducibility was assessed by intra-class correlation coefficient (ICC) for WLV and FF. Fat fraction correlation and agreement as determined by histology, MRS and MRI were determined.
  
  
  RESULTS
  ICC was 0.999 (95% CI: 0.999-1, P < 0.001) for WLV FF calculation and 0.996 (95% CI: 0.990-0.998, P < 0.001) for whole liver volume calculations. Strong correlations were found between FF measured by histology, MRS and WLV-MRI. A Bland-Altman analysis showed a good agreement between FF measured by MRS and WLV-MRI. No systematic variations of FF was found between segments when analyzed by ANOVA (F = 1.78, P = 0.096).
  
  
  CONCLUSIONS
  This study shows that a reproducible whole liver volume segmentation method to measure fat fraction can be performed. This strategy may be integrated to a "one-stop shop" protocol in liver surgery planning.
authors.affiliation: Department of Medical Imaging, University of Montreal and Centre de recherche, Centre hospitalier de l'Université de Montréal (CRCHUM), Hôpital Saint-Luc, 1058 rue Saint-Denis, Montréal, Québec, Canada.
authors.forename: Gaspard
authors.initials: G
authors.lastname: d'Assignies
authors.forename: Claude
authors.initials: C
authors.lastname: Kauffmann
authors.forename: Yvan
authors.initials: Y
authors.lastname: Boulanger
authors.forename: Marc
authors.initials: M
authors.lastname: Bilodeau
authors.forename: Valérie
authors.initials: V
authors.lastname: Vilgrain
authors.forename: Gilles
authors.initials: G
authors.lastname: Soulez
authors.forename: An
authors.initials: A
authors.lastname: Tang
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000328:Adult; D000368:Aged; D000465:Algorithms; D005234:Fatty Liver / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008099:Liver / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011300:Preoperative Care / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
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