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Updated: Sep 6, 2025
Author Spotlight: Advancing Hepatic Fibrosis Diagnosis Using Magnetic Resonance Elastography and AI
Published on: July 21, 2023
Detecting Early-Stage Liver Fibrosis Using Macromolecular Proton Fraction Mapping Based on Spin-Lock MRI: Preliminary
Jian Hou1, Vincent W-S Wong2,3,4, Yurui Qian1
1Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong.
Background:
Liver fibrosis is characterized by macromolecule depositions. Recently, a novel technology termed macromolecular proton fraction quantification based on spin-lock magnetic resonance imaging (MPF-SL) is reported to measure macromolecule levels.
Hypothesis:
MPF-SL can detect early-stage liver fibrosis by measuring macromolecule levels in the liver.
Study Type:
Retrospective.
Subjects:
Fifty-five participants, including 22 with no fibrosis (F0) and 33 with early-stage fibrosis (F1-2), were recruited.
Field Strength/Sequence:
3 T; two-dimensional (2D) MPF-SL turbo spin-echo sequence, 2D spin-lock T1rho turbo spin-echo sequence, and multi-slice 2D gradient echo sequence.
Assessment:
Macromolecular proton fraction (MPF), T1rho, liver iron concentration (LIC), and fat fraction (FF) biomarkers were quantified within regions of interest.
Statistical Tests:
Group comparison of the biomarkers using Mann-Whitney U tests; correlation between the biomarkers assessed using Spearman's rank correlation coefficient and linear regression with goodness-of-fit; fibrosis stage differentiation using receiver operating characteristic curve (ROC) analysis. P-value < 0.05 was considered statistically significant.
Results:
Average T1rho was 41.76 ± 2.94 msec for F0 and 41.15 ± 3.73 msec for F1-2 (P = 0.60). T1rho showed nonsignificant correlation with either liver fibrosis (ρ = -0.07; P = 0.61) or FF (ρ = -0.14; P = 0.35) but indicated a negative correlation with LIC (ρ = -0.66). MPF was 4.73 ± 0.45% and 5.65 ± 0.81% for F0 and F1-2 participants, respectively. MPF showed a positive correlation with liver fibrosis (ρ = 0.59), and no significant correlations with LIC (ρ = 0.02; P = 0.89) or FF (ρ = 0.05; P = 0.72). The area under the ROC curve was 0.85 (95% confidence interval [CI] 0.75-0.95) and 0.55 (95% CI 0.39-0.71; P = 0.55) for MPF and T1rho to discriminate between F0 and F1-2 fibrosis, respectively.
Data Conclusion:
MPF-SL has the potential to diagnose early-stage liver fibrosis and does not appear to be confounded by either LIC or FF.
Level Of Evidence:
3 TECHNICAL EFFICACY STAGE: 3.
Insights
Macromolecular proton fraction (MPF) using spin-lock MRI shows promise for detecting early liver fibrosis. This novel technique accurately differentiates fibrosis stages without confounding factors like iron or fat concentration.
Area of Science:
- Biomedical Imaging
- Magnetic Resonance Imaging
- Hepatology
Background:
- Liver fibrosis is characterized by macromolecule deposition.
- Macromolecular proton fraction quantification based on spin-lock MRI (MPF-SL) is a novel technology for measuring macromolecule levels.
Purpose of the Study:
- To evaluate the potential of MPF-SL in detecting early-stage liver fibrosis.
- To assess if MPF-SL measurements are confounded by liver iron concentration (LIC) or fat fraction (FF).
Main Methods:
- A retrospective study involving 55 participants (22 with no fibrosis, 33 with early fibrosis).
- Utilized 3T MRI with 2D MPF-SL turbo spin-echo, 2D spin-lock T1rho turbo spin-echo, and multi-slice 2D gradient echo sequences.
- Quantified macromolecular proton fraction (MPF), T1rho, LIC, and FF biomarkers.
Main Results:
- MPF was significantly higher in participants with early fibrosis (F1-2) compared to those without (F0) (5.65% vs 4.73%).
- MPF demonstrated a positive correlation with liver fibrosis (ρ=0.59) and showed good diagnostic performance (AUC=0.85).
- T1rho did not show significant differences or correlations with fibrosis, LIC, or FF.
Conclusions:
- MPF-SL is a promising technique for diagnosing early-stage liver fibrosis.
- MPF-SL measurements are not significantly confounded by LIC or FF, suggesting its specificity for fibrosis detection.
