Related Experiment Video
Updated: Apr 12, 2026
Author Spotlight: A Non-Invasive Tool to Assess and Differentiate Fat Patterns in Liver Using 3D Dixon MRI
Published on: October 20, 2023
Hepatic fat quantification using the proton density fat fraction (PDFF): utility of free-drawn-PDFF with a large
Kun Young Kim1, Ji Soo Song2, Stephan Kannengiesser3
1Department of Radiology, Chonbuk National University Medical School and Hospital, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju-Si, Chonbuk, 561-712, Korea.
Purpose:
To evaluate the diagnostic performance of magnetic resonance imaging-estimated proton density fat fraction (MRI-PDFF) using a free-drawn region-of-interest (ROI) measurement of hepatic fat deposition compared to MR spectroscopy (MRS) as the reference standard.
Materials And Methods:
A total of 156 patients underwent 3T MR imaging with a multi-step adaptive fitting approach, multi-echo volume interpolated breath-hold examination (VIBE) acquisition and single-voxel high-speed T2-corrected multiple-echo (1)H-MR spectroscopy (SVS). Seven ROI measurements were performed in each segment of the fat percentage maps ("segmental-PDFF"). Three ROIs were placed at the same level as the SVS ("VOI-PDFF"). Free-hand-drawn ROIs were placed at three different levels along the entire liver ("free-drawn-PDFF") and separately along the right and left lobes ("free-drawn-PDFF-2").
Results:
A strong correlation was found between VOI-PDFF and SVS (r = 0.977). The right lobe had greater fat content than the left lobe (p < 0.001). After image analysis, 54 and 46 patients were classified as having steatosis using SVS and free-drawn-PDFF as a reference standard, respectively. The diagnostic performance of free-drawn-PDFF was significantly different from SVS (p < 0.05).
Conclusion:
Free-drawn-PDFF provides accurate and generalized information regarding hepatic fat deposition. It is a useful method, particularly if fat deposition is heterogeneous, and should be considered as a new reference standard.
