Radiologic and Pathologic Discordance in Hepatocellular Carcinoma: More Than a Mismatch, with Prognostic Significance

Background/Aims : Magnetic resonance imaging (MRI) with a proton density fat fraction (PDFF) sequence is the most accurate, noninvasive method for assessing hepatic steatosis. However, manual measurement on the PDFF map is time-consuming. This study aimed to validate automated whole-liver fat quanti...

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Main Author: Ijin Joo
Format: Article
Language:English
Published: Gastroenterology Council for Gut and Liver 2025-07-01
Series:Gut and Liver
Online Access:http://gutnliver.org/journal/view.html?doi=10.5009/gnl250293
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author Ijin Joo
author_facet Ijin Joo
author_sort Ijin Joo
collection DOAJ
description Background/Aims : Magnetic resonance imaging (MRI) with a proton density fat fraction (PDFF) sequence is the most accurate, noninvasive method for assessing hepatic steatosis. However, manual measurement on the PDFF map is time-consuming. This study aimed to validate automated whole-liver fat quantification for assessing hepatic steatosis with MRI-PDFF. Methods : In this prospective study, 80 patients were enrolled from August 2020 to January 2023. Baseline MRI-PDFF and magnetic resonance spectroscopy (MRS) data were collected. The analysis of MRI-PDFF included values from automated whole-liver segmentation (autoPDFF) and the average value from measurements taken from eight segments (avePDFF). Twenty patients with ≥10% autoPDFF values who received 24 weeks of exercise training were also collected for the chronologic evaluation. The correlation and concordance coefficients (r and ρ) among the values and differences were calculated. Results : There were strong correlations between autoPDFF versus avePDFF, autoPDFF versus MRS, and avePDFF versus MRS (r=0.963, r=0.955, and r=0.977, all p<0.001). The autoPDFF values were also highly concordant with the avePDFF and MRS values (ρ=0.941 and ρ=0.942). The autoPDFF, avePDFF, and MRS values consistently decreased after 24 weeks of exercise. The change in autoPDFF was also highly correlated with the changes in avePDFF and MRS (r=0.961 and r=0.870, all p<0.001). Conclusions : Automated whole-liver fat quantification might be feasible for clinical trials and practice, yielding values with high correlations and concordance with the time-consuming manual measurements from the PDFF map and the values from the highly complex processing of MRS (ClinicalTrials.gov identifier: NCT04463667).
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spelling doaj-art-cb6c8a90d79b4b8e8ee622fd5c0049ad2025-08-20T02:39:09ZengGastroenterology Council for Gut and LiverGut and Liver1976-22832025-07-0119447747810.5009/gnl250293gnl250293Radiologic and Pathologic Discordance in Hepatocellular Carcinoma: More Than a Mismatch, with Prognostic SignificanceIjin Joo0Department of Radiology, Seoul National University Hospital, KoreaBackground/Aims : Magnetic resonance imaging (MRI) with a proton density fat fraction (PDFF) sequence is the most accurate, noninvasive method for assessing hepatic steatosis. However, manual measurement on the PDFF map is time-consuming. This study aimed to validate automated whole-liver fat quantification for assessing hepatic steatosis with MRI-PDFF. Methods : In this prospective study, 80 patients were enrolled from August 2020 to January 2023. Baseline MRI-PDFF and magnetic resonance spectroscopy (MRS) data were collected. The analysis of MRI-PDFF included values from automated whole-liver segmentation (autoPDFF) and the average value from measurements taken from eight segments (avePDFF). Twenty patients with ≥10% autoPDFF values who received 24 weeks of exercise training were also collected for the chronologic evaluation. The correlation and concordance coefficients (r and ρ) among the values and differences were calculated. Results : There were strong correlations between autoPDFF versus avePDFF, autoPDFF versus MRS, and avePDFF versus MRS (r=0.963, r=0.955, and r=0.977, all p<0.001). The autoPDFF values were also highly concordant with the avePDFF and MRS values (ρ=0.941 and ρ=0.942). The autoPDFF, avePDFF, and MRS values consistently decreased after 24 weeks of exercise. The change in autoPDFF was also highly correlated with the changes in avePDFF and MRS (r=0.961 and r=0.870, all p<0.001). Conclusions : Automated whole-liver fat quantification might be feasible for clinical trials and practice, yielding values with high correlations and concordance with the time-consuming manual measurements from the PDFF map and the values from the highly complex processing of MRS (ClinicalTrials.gov identifier: NCT04463667).http://gutnliver.org/journal/view.html?doi=10.5009/gnl250293
spellingShingle Ijin Joo
Radiologic and Pathologic Discordance in Hepatocellular Carcinoma: More Than a Mismatch, with Prognostic Significance
Gut and Liver
title Radiologic and Pathologic Discordance in Hepatocellular Carcinoma: More Than a Mismatch, with Prognostic Significance
title_full Radiologic and Pathologic Discordance in Hepatocellular Carcinoma: More Than a Mismatch, with Prognostic Significance
title_fullStr Radiologic and Pathologic Discordance in Hepatocellular Carcinoma: More Than a Mismatch, with Prognostic Significance
title_full_unstemmed Radiologic and Pathologic Discordance in Hepatocellular Carcinoma: More Than a Mismatch, with Prognostic Significance
title_short Radiologic and Pathologic Discordance in Hepatocellular Carcinoma: More Than a Mismatch, with Prognostic Significance
title_sort radiologic and pathologic discordance in hepatocellular carcinoma more than a mismatch with prognostic significance
url http://gutnliver.org/journal/view.html?doi=10.5009/gnl250293
work_keys_str_mv AT ijinjoo radiologicandpathologicdiscordanceinhepatocellularcarcinomamorethanamismatchwithprognosticsignificance