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Updated: Oct 28, 2025
Author Spotlight: A Non-Invasive Tool to Assess and Differentiate Fat Patterns in Liver Using 3D Dixon MRI
Published on: October 20, 2023
Quantification of liver and muscular fat using contrast-enhanced Dual Source Dual Energy Computed Tomography compared
Sebastian Gassenmaier1, Karin Kähm1, Sven S Walter1
1Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Tuebingen, Germany.
Purpose:
To investigate the feasibility of liver fat quantification in contrast-enhanced dual source dual energy computed tomography (DECT) using multi-echo Dixon magnetic resonance imaging (MRI) as reference standard.
Method:
Patients who underwent MRI of the liver including a multi-echo Dixon sequence for estimation of proton density fat fraction in 2017 as well as contrast-enhanced DECT imaging of the abdomen were included in this retrospective, monocentric IRB approved study. Furthermore, patients with a hepatic fat amount >5% who were examined in 2018 with MRI and DECT were included. The final study group consisted of 81 patients with 90 pairs of examinations. Analysis of parameter maps was performed manually using congruent regions of interest which were placed in the liver parenchyma, in the erector spinae muscles, and psoas major muscles.
Results:
Mean patient age was 61 ± 13 years. Median time between MRI and DECT was 48 days. MRI liver fat quantification resulted in a median of 3.8% (IQR: 2.2-8.2%) compared to 1.8% (IQR: 0-6.3%) in DECT (p < 0.001), with a Spearman correlation of 0.73. Bland-Altman analysis resulted in a systematic underestimation of liver fat in DECT, with a mean difference of -1.7%. Fat quantification in the erector spinae muscles (p = 0.257) and the psoas major muscles (p = 0.208) was not significantly different in DECT compared to MRI.
Conclusions:
Liver and muscular fat quantification in portal-venous phase DECT is feasible with good to excellent correlation compared to a multi-echo Dixon MRI sequence analysis. While there is an underestimation of the liver fat content in DECT, there are no significant differences between DECT and MRI fat quantification of the erector spinae and psoas major muscles.
