Normative values for quantitative MRI biomarkers of the liver in collegiate athletes

Quantitative MRI biomarkers are increasingly used to assess liver health; however, athlete-specific normative values are lacking. This study aimed to establish liver-specific normative values for proton density fat fraction (PDFF), R2*-based liver iron concentration (LIC), and T1 and T2 relaxation times in collegiate athletes.

In this retrospective single-center study, collegiate athletes undergoing return-to-play cardiac MRI (1.5 T/3.0 T) following Coronavirus Disease 2019 recovery were identified. Whole-liver PDFF and R2* were obtained from chemical shift-encoded MRI, T1 and T2 relaxation times were derived from cardiac mapping with partial liver coverage. LIC was calculated from R2*. PDFF and LIC were considered field-strength-independent, whereas R2*, T1, and T2 were analyzed by field strength. Biomarkers are reported as median (interquartile range).

A total of 211 athletes (64.0% males; median age 19.9 years) were included. PDFF and LIC were 2.2% (1.7, 2.8) and 0.67 mg/g (0.58, 0.74) in males and 1.8% (1.5, 2.3) and 0.57 mg/g (0.50, 0.67) in females. At 1.5 T, R2*, T1 and T2 were 34.0 s^-1 (31.9, 36.4), 571 ms (552, 593), and 45.4 ms (43.3, 47.0) in males and 32.0 s^-1 (29.5, 34.6), 588 ms (577, 600), and 49.4 ms (46.4, 52.2) in females. At 3.0 T, values were 44.1 s^-1 (41.8, 48.8), 755 ms (727, 783), and 40.9 ms (38.3, 43.4) in males and 41.6 s^-1 (37.7, 44.0), 806 ms (791, 822), and 42.8 ms (38.9, 44.3) in females.

We established sex- and field strength-specific normative values for quantitative liver MRI biomarkers in collegiate athletes, providing a foundation for baseline clinical interpretation and longitudinal monitoring of liver health.