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Hepatic fat quantification in dual-layer computed tomography using a three-material decomposition algorithm

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

The purpose of this study was to evaluate a three-material decomposition algorithm for hepatic fat quantification using a dual-layer computed tomography (DL-CT) and MRI as reference standard on a large patient cohort.

Method

A total of 104 patients were retrospectively included in our study, i.e., each patient had an MRI exam and a DL-CT exam in our institution within a maximum of 31 days. Four regions of interest (ROIs) were positioned blindly and similarly in the liver, by two independent readers on DL-CT and MRI images. For DL-CT exams, all imaging phases were included. Fat fraction agreement between CT and MRI was performed using intraclass correlation coefficients (ICC), determination coefficients R2, and Bland–Altman plots. Diagnostic performance was determined using sensitivity, specificity, and positive and negative predictive values. The cutoff for steatosis was 5%.

Results

Correlation between MRI and CT data was excellent for all perfusion phases with ICC calculated at 0.99 for each phase. Determination coefficients R2 were also good for all perfusion phases (about 0.95 for all phases). Performance of DL-CT in the diagnosis of hepatic steatosis was good with sensitivity between 89 and 91% and specificity ranging from 75 to 80%, depending on the perfusion phase. The positive predictive value was ranging from 78 to 93% and the negative predictive value from 82 to 86%.

Conclusion

Multi-material decomposition in DL-CT allows quantification of hepatic fat fraction with a good correlation to MRI data.

Clinical relevance statement

The use of DL-CT allows for detection of hepatic steatosis. This is especially interesting as an opportunistic finding CT performed for other reasons, as early detection can help prevent or slowdown the development of liver metabolic disease.

Key Points

• Hepatic fat fractions provided by the dual-layer CT algorithm is strongly correlated with that measured on MRI.

• Dual-layer CT is accurate to detect hepatic steatosis ≥ 5%.

• Dual-layer CT allows opportunistic detection of steatosis, on CT scan performed for various indications.

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Abbreviations

BMI:

Body mass index

DE-CT:

Dual-energy computed tomography

DL-CT:

Dual-layer computed tomography

NAFLD:

Non-alcoholic fatty liver disease

NASH:

Non-alcoholic steatohepatitis

VNC:

Virtual non-contrast

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Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Medical Imaging Department, Lille University Hospital, 2 Avenue Oscar-Lambret, Lille, France

    Emilie Demondion, Olivier Ernst & Mathilde Vermersch

  2. Department of Gastroenterology and Hepatology, Lille University Hospital, 2 Avenue Oscar-Lambret, Lille, France

    Alexandre Louvet

  3. CT Clinical Science, Philips Healthcare, Paris, France

    Benjamin Robert

  4. CT Clinical Science, Philips Healthcare, Haifa, Israel

    Galit Kafri & Eran Langzam

  5. Medical Imaging Department, Valenciennes Hospital Center, 114 Avenue Desandrouin, Valenciennes, France

    Mathilde Vermersch

Authors
  1. Emilie Demondion
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  2. Olivier Ernst
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  3. Alexandre Louvet
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  4. Benjamin Robert
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  5. Galit Kafri
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  6. Eran Langzam
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  7. Mathilde Vermersch
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Corresponding author

Correspondence to Emilie Demondion.

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Guarantor

The scientific guarantor of this publication is Dr Mathilde Vermersch.

Conflict of interest

The authors of this manuscript declare relationships with the following companies:

Benjamin Robert with Philips Healthcare as Clinical Scientist.

Garit Kafri and Eran Langzam as Clinical Scientists at Philips Healthcare. They both developed the software for intrahepatic fat quantification but did not have access to patient data and intrahepatic fat measurements were performed blind to the gold standard.

The other authors of this manuscript declare no relationships with any companies.

Statistics and biometry

One of the authors has significant statistical expertise (Dr Mathilde Vermersch).

No complex statistical methods were necessary for this paper.

Informed consent

This study met the criteria of non-interventional, retrospective research and was approved by international review board (CERIM) (IRB CRM 2201-222). Inform consent for all patients was waived by IRB.

Ethical approval

Institutional Review Board approval was obtained: IRB CRM 2201–222.

Methodology

• retrospective

• observational

• performed at one institution at CHU de Lille

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Demondion, E., Ernst, O., Louvet, A. et al. Hepatic fat quantification in dual-layer computed tomography using a three-material decomposition algorithm. Eur Radiol (2023). https://doi.org/10.1007/s00330-023-10382-z

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  • DOI: https://doi.org/10.1007/s00330-023-10382-z

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