Comparison of Manual Multi-ROI, Single-Location, and Volumetric Fat Fraction Measurements for Hepatic Steatosis Using MRI

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dc.contributor.authorDag, Nurullah
dc.contributor.authorBilaloglu, Muhammed Kursat
dc.contributor.authorKutlu, Ramazan
dc.date.accessioned2026-04-04T13:31:09Z
dc.date.available2026-04-04T13:31:09Z
dc.date.issued2026
dc.departmentİnönü Üniversitesi
dc.description.abstractBackground/Objectives: To comparatively evaluate the clinical reliability of automated single-location MRI-proton density fat fraction (PDFF), single-voxel magnetic resonance spectroscopy (MRS), and volumetric MRI-PDFF measurements for quantitative assessment of hepatic steatosis, using manual multi-regions of interest (ROI) MRI-PDFF as the reference standard. Methods: In this retrospective single-center study, adult patients who underwent liver MRI with both MRI-PDFF and MRS between December 2024 and January 2026 were included. Manual multi-ROI MRI-PDFF measurements were obtained from eight Couinaud segments and served as the reference standard. Automated single-location MRI-PDFF, single-voxel MRS, and volumetric MRI-PDFF measurements were extracted from system-generated reports. Fat fraction values and steatosis grades were compared using non-parametric tests, Spearman correlation coefficients, exact agreement rates, weighted Cohen's kappa statistics, and Bland-Altman analysis. Intra- and inter-observer reliability of manual multi-ROI measurements was assessed using intraclass correlation coefficients (ICC). Results: A total of 490 patients were included. Single-location MRI-PDFF and single-voxel MRS demonstrated high exact agreement with manual multi-ROI MRI-PDFF in steatosis grading (86.9% and 87.4%, respectively), with near-perfect agreement (weighted kappa = 0.82-0.83). Volumetric MRI-PDFF showed lower exact agreement (76.1%) and a systematic tendency toward overestimation, with more frequent upward shifts in steatosis grade. All techniques showed strong correlations with manual measurements (rho = 0.72-0.75). Manual multi-ROI MRI-PDFF demonstrated excellent inter- and intra-observer reliability (ICC > 0.97). Conclusions: Automated single-ROI MRI-PDFF and single-voxel MRS provide clinically reliable and time-efficient alternatives for hepatic steatosis assessment, while automated volumetric MRI-PDFF may introduce systematic bias toward overestimation.
dc.description.sponsorshipInonu University Scientific Research Projects Coordination Unit [2026/4500]
dc.description.sponsorshipThe research was financially supported by the Inonu University Scientific Research Projects Coordination Unit (Grant No: 2026/4500).
dc.identifier.doi10.3390/diagnostics16050716
dc.identifier.issn2075-4418
dc.identifier.issue5
dc.identifier.pmid41827992
dc.identifier.scopus2-s2.0-105032682434
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://doi.org/10.3390/diagnostics16050716
dc.identifier.urihttps://hdl.handle.net/11616/108600
dc.identifier.volume16
dc.identifier.wosWOS:001714568800001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherMdpi
dc.relation.ispartofDiagnostics
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250329
dc.subjectliver fat quantification
dc.subjecthepatic steatosis
dc.subjectmagnetic resonance imaging
dc.subjectproton density fat fraction
dc.subjectmagnetic resonance spectroscopy
dc.titleComparison of Manual Multi-ROI, Single-Location, and Volumetric Fat Fraction Measurements for Hepatic Steatosis Using MRI
dc.typeArticle

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