Agreement between region-of-interest- and parametric map-based hepatic proton density fat fraction estimation in adults with chronic liver disease.
To compare agreement between region-of-interest (ROI)- and parametric map-based methods of hepatic proton density fat fraction (PDFF) estimation in adults with known or suspected hepatic steatosis secondary to chronic liver disease over a range of imaging and analysis conditions.



In this IRB approved HIPAA compliant prospective single-site study, 31 adults with chronic liver disease undergoing clinical gadoxetic acid-enhanced liver magnetic resonance imaging at 3 T were recruited. Multi-echo gradient-echo imaging at flip angles of 10° and 50° was performed before and after administration of gadoxetic acid. Six echoes were acquired at successive nominally out-of-phase and in-phase echo times. PDFF was estimated with a nonlinear fitting algorithm using the first two, three, four, five, and (all) six echoes. Hence, 20 different imaging and analysis conditions were used (pre/post contrast x low/high flip angle x 2/3/4/5/6 echoes). For each condition, PDFF estimation was done in corresponding liver locations using two methods: a region-of-interest (ROI)-based method in which mean signal intensity values within ROIs were run through the fitting algorithm, and a parametric map-based method in which individual signal intensities were run through the fitting algorithm pixel by pixel. Agreement between ROI- and map-based PDFF estimation was assessed by Bland-Altman and intraclass correlation (ICC) analysis.



Depending on the condition and method, PDFF ranged from -2.52% to 45.57%. Over all conditions, mean differences between ROI- and map-based PDFF estimates ranged from 0.04% to 0.24%, with all ICCs ≥0.999.



Agreement between ROI- and parametric map-based PDFF estimation is excellent over a wide range of imaging and analysis conditions.
Liver Imaging Group, Department of Radiology, University of California at San Diego, 408 Dickinson Street, San Diego, CA, 92103-8226, USA. pmanning@ucsd.edu.
Paul M
PM
Manning
Liver Imaging Group, Department of Radiology, University of California at San Diego, 408 Dickinson Street, San Diego, CA, 92103-8226, USA.
Gavin
G
Hamilton
Liver Imaging Group, Department of Radiology, University of California at San Diego, 408 Dickinson Street, San Diego, CA, 92103-8226, USA.
Kang
K
Wang
Liver Imaging Group, Department of Radiology, University of California at San Diego, 408 Dickinson Street, San Diego, CA, 92103-8226, USA.
Chulhyun
C
Park
Liver Imaging Group, Department of Radiology, University of California at San Diego, 408 Dickinson Street, San Diego, CA, 92103-8226, USA.
Jonathan C
JC
Hooker
Computational and Applied Statistics Laboratory (CASL), SDSC, University of California, San Diego, La Jolla, CA, USA.
Tanya
T
Wolfson
Computational and Applied Statistics Laboratory (CASL), SDSC, University of California, San Diego, La Jolla, CA, USA.
Anthony
A
Gamst
Liver Imaging Group, Department of Radiology, University of California at San Diego, 408 Dickinson Street, San Diego, CA, 92103-8226, USA.
William M
WM
Haufe
Liver Imaging Group, Department of Radiology, University of California at San Diego, 408 Dickinson Street, San Diego, CA, 92103-8226, USA.
Alex N
AN
Schlein
Liver Imaging Group, Department of Radiology, University of California at San Diego, 408 Dickinson Street, San Diego, CA, 92103-8226, USA.
Michael S
MS
Middleton
Liver Imaging Group, Department of Radiology, University of California at San Diego, 408 Dickinson Street, San Diego, CA, 92103-8226, USA.
Claude B
CB
Sirlin
D000328:Adult; D000368:Aged; D000465:Algorithms; D002908:Chronic Disease; D003287:Contrast Media; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000000981:diagnostic imaging*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
Analysis methods; Fat quantification; Hepatic steatosis; MRI; PDFF; Proton density fat fraction; QIB; Quantitative imaging biomarker
Magn Reson Med. 2007 Aug;58(2):354-64
17654578
Magn Reson Imaging. 2008 Apr;26(3):347-59
18093781
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18581393
Magn Reson Med. 2008 Nov;60(5):1122-34
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Radiology. 2009 Apr;251(1):67-76
19221054
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21212366
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21769986
NMR Biomed. 2011 Aug;24(7):784-90
21834002
J Magn Reson Imaging. 2011 Oct;34(4):729-749
22025886
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22777847
J Magn Reson Imaging. 2013 Jun;37(6):1359-70
23172799
Radiology. 2013 May;267(2):422-31
23382291
J Magn Reson Imaging. 2014 Mar;39(3):567-75
23720420
J Magn Reson Imaging. 2014 May;39(5):1265-71
24136736
J Magn Reson Imaging. 2014 Jun;39(6):1525-32
24987758
Radiology. 2015 Feb;274(2):416-25
25247408
Hepatology. 2015 Apr;61(4):1239-50
25482832
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25620624
Med Phys. 1985 Mar-Apr;12(2):232-3
4000083