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The effect of hepatic steatosis on liver volume determined by proton density fat fraction and deep learning–measured liver volume

European Radiology volume 33, pages 5924–5932 (2023)Cite this article

Abstract

Objectives

We aimed to evaluate the effect of hepatic steatosis (HS) on liver volume and to develop a formula to estimate lean liver volume correcting the HS effect.

Methods

This retrospective study included healthy adult liver donors who underwent gadoxetic acid–enhanced MRI and proton density fat fraction (PDFF) measurement from 2015 to 2019. The degree of HS was graded at 5% PDFF intervals from grade 0 (no HS; PDFF < 5.5%). Liver volume was measured with hepatobiliary phase MRI using deep learning algorithm, and standard liver volume (SLV) was calculated as the reference lean liver volume. The association between liver volume and SLV ratio with PDFF grades was evaluated using Spearman’s correlation (ρ). The effect of PDFF grades on liver volume was evaluated using the multivariable linear regression model.

Results

The study population included 1038 donors (mean age, 31 ± 9 years; 689 men). Mean liver volume to SLV ratio increased according to PDFF grades (ρ = 0.234, p < 0.001). The multivariable analysis indicated that SLV (β = 1.004, p < 0.001) and PDFF grade*SLV (β = 0.044, p < 0.001) independently affected liver volume, suggesting a 4.4% increase in liver volume per one-point increment in the PDFF grade. PDFF-adjusted lean liver volume was estimated using the formula, liver volume/[1.004 + 0.044 × PDFF grade]. The mean estimated lean liver volume to SLV ratio approximated to one for all PDFF grades, with no significant association with PDFF grades (p = 0.851).

Conclusion

HS increases liver volume. The formula to estimate lean liver volume may be useful to adjust for the effect of HS on liver volume.

Key Points

• Hepatic steatosis increases liver volume.

• The presented formula to estimate lean liver volume using MRI-measured proton density fat fraction and liver volume may be useful to adjust for the effect of hepatic steatosis on measured liver volume.

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Abbreviations

HBP:

Hepatobiliary phase

HS:

Hepatic steatosis

LDLT:

Living donor liver transplantation

PDFF:

Proton density fat fraction

SLV:

Standard liver volume

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Funding

This research was supported by a National Research Foundation of Korea (NRF) grant, funded by the Korean Government (MSIT) (2020R1F1A1048826). National Research Foundation of Korea,2020R1F1A1048826,Seung Soo Lee

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea

    Ji Young Choi, Seung Soo Lee, Hyo Jung Park & Yu Sub Sung

  2. Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea

    Ji Young Choi

  3. Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea

    Na Young Kim

  4. Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea

    Yedaun Lee

  5. Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea

    Jee Seok Yoon & Heung-Il Suk

  6. Department of Artificial Intelligence, Korea University, Seoul, Republic of Korea

    Heung-Il Suk

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Correspondence to Seung Soo Lee.

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The authors declare that they have no conflict of interest.

Statistics and biometry

Na Young Kim kindly provided statistical advice for this manuscript.

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Choi, J.Y., Lee, S.S., Kim, N.Y. et al. The effect of hepatic steatosis on liver volume determined by proton density fat fraction and deep learning–measured liver volume. Eur Radiol 33, 5924–5932 (2023). https://doi.org/10.1007/s00330-023-09603-2

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