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Simultaneous assessment of liver volume and whole liver fat content: a step towards one-stop shop preoperative MRI protocol

  • Magnetic Resonance
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European Radiology Aims and scope Submit manuscript

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).

Conclusion

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.

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Acknowledgements

This work was supported by a clinical research scholarship to G.S. from Fonds de la recherche en santé du Québec (FRSQ) and to G.A. from the Société Française de Radiologie.

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Authors and Affiliations

  1. 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, H2X 3J4

    Gaspard d’Assignies, Yvan Boulanger & An Tang

  2. Department of Radiology, Beaujon Hospital, Université Paris VII, 100 Bd du Général Leclerc, 92118, Clichy, France

    Gaspard d’Assignies & Valérie Vilgrain

  3. Department of Medical Imaging, University of Montreal and CRCHUM, Hôpital Notre-Dame, 1560 rue Sherbrooke Est, Montréal, Québec, Canada

    Claude Kauffmann & Gilles Soulez

  4. Department of Gastroenterology and Hepatology, University of Montreal and CRCHUM, Hôpital Saint-Luc, 1058 rue Saint-Denis, Montréal, Québec, Canada

    Marc Bilodeau

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  1. Gaspard d’Assignies
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  2. Claude Kauffmann
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  3. Yvan Boulanger
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  4. Marc Bilodeau
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  7. An Tang
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Corresponding author

Correspondence to An Tang.

Appendix: T1 and T2 correction on single-voxel proton MRS data

Appendix: T1 and T2 correction on single-voxel proton MRS data

T2 corrections were performed using the equation \( {\hbox{SI}} = {\hbox{SI}}_0\,{ \exp }\left( { - {\hbox{TE}}/{\hbox{T2}}} \right) \), SI and SI0 being the corrected and uncorrected signal intensities, respectively, TE the echo time and T2 the reported transverse relaxation times of 60 ms for lipids and 50 ms for water [20]. The T1 correction was performed using the equation \( {\hbox{SI}} = {\hbox{SI}}_0\,({1}/\left( {{1} - { \exp }\left( { - {\hbox{TR}}/{\hbox{T1}}} \right)} \right) \), TR being the repetition time and T1 the reported longitudinal relaxation time of 663 ms for water and 236 ms for lipids [29]. Data were also corrected for (1) the ratio of the number of lipid protons evaluated by MRS relative to the total number of lipid protons (0.85), (2) the proton densities of fat (110 mol/l) and water (111 mol/l), (3) the fat/water weight ratio in the liver (0.711 g fat/g water) and (4) the density of liver tissue (1.051 g/l) and the density of liver fat (0.90 g/l) using the method described by Longo et al. to yield fat fractions expressed in relative volumes[29]. The fat fraction (FF) determined by MRS corresponds to the corrected L/(L+W) ratio.

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d’Assignies, G., Kauffmann, C., Boulanger, Y. et al. Simultaneous assessment of liver volume and whole liver fat content: a step towards one-stop shop preoperative MRI protocol. Eur Radiol 21, 301–309 (2011). https://doi.org/10.1007/s00330-010-1941-1

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  • DOI: https://doi.org/10.1007/s00330-010-1941-1

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