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. 2021 May;11(5):1701-1709.
doi: 10.21037/qims-20-873.

Longitudinal changes on liver proton density fat fraction differ between liver segments

Jan Syväri  1 , Daniela Junker  1 , Lisa Patzelt  1 , Katharina Kappo  2 , Loubna Al Sadat  2 , Sonia Erfanian  2 , Marcus R Makowski  1 , Hans Hauner  2   3 , Dimitrios C Karampinos  1
Affiliations

Longitudinal changes on liver proton density fat fraction differ between liver segments

Jan Syväri et al. Quant Imaging Med Surg. 2021 May.

Abstract

Background: To study the spatial heterogeneity of liver fat fraction changes during a long-term lifestyle intervention study using magnetic resonance imaging (MRI).

Methods: Thirty-two subjects underwent two MRI-scans in a span of one year. A chemical shift encoding-based water-fat separation method was applied to measure liver proton density fat fraction (PDFF) maps. The PDFF changes in the two liver lobes and the Couinaud segments were compared with the mean liver PDFF change.

Results: The slope of the relationship between mean liver PDFF changes and PDFF liver lobe changes was higher in the right compared to the left lobe (slopemean PDFF whole liver ~ mean PDFF right lobe =1.08, slopemean PDFF whole liver ~ mean PDFF left lobe =0.93, P<0.001). The highest slope of agreement between PDFF changes in each specific liver segment and mean liver PDFF changes was observed in segment VII (slope =1.12). The lowest slope of agreement between PDFF changes in each specific liver segment and mean liver PDFF changes was observed in segment I (slope =0.77).

Conclusions: Larger PDFF changes in the right liver lobe were observed compared to PDFF changes in the left liver lobe (LLL) in subjects with both increasing and decreasing mean liver PDFF after one year. The results are in line with the existing literature reporting a heterogeneous spatial distribution of liver fat and highlight the need to spatially resolve liver fat fraction changes in longitudinal studies.

Keywords: Dixon MRI; Lifestyle intervention study; liver fat fraction spatial heterogeneity; proton density fat fraction (PDFF); quantitative MRI.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/qims-20-873). Dr. HH reports grants from German Ministry of Education and Research, during the conduct of the study; Dr. DCK reports grants from European Research Council, grants from Philips Healthcare, during the conduct of the study; Dr. DCK reports grants from European Research Council (No. 677661), grants from Philips Healthcare, grants from German Research Foundation (DFG-SFB824/A9), during the conduct of the study; grants from Philips Healthcare, outside the submitted work. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Liver PDFF maps at two time points (A, C at baseline and B, D after one year) for (A,B) one subject with increasing liver PDFF (weight gain of 5.9 kg) and (C,D) one subject with decreasing liver PDFF (weight loss of 7.1 kg). (A) shows higher PDFF in the right lobe compared to the left lobe. (B) shows the same subject after one year with strongly increasing mean liver PDFF and a larger PDFF change in the right lobe compared to the left lobe (ΔPDFFleft lobe =7.4%, ΔPDFFright lobe =8.2%). The same effect of larger changes of liver PDFF in the right lobe compared to the left lobe can also be detected in the subject with decreasing mean liver PDFF (ΔPDFFleft lobe =−2.7%, ΔPDFFright lobe =−4.0%) (C,D). PDFF, proton density fat fraction.
Figure 2
Figure 2
Changes of the liver PDFF in the LLL (A) and the RLL (B) as a function of mean liver PDFF change. The right lobe shows larger liver PDFF changes compared to the left lobe, visualized by the slopes of the regression line. PDFF, proton density fat fraction; LLL, left liver lobe; RLL, right liver lobe.
Figure 3
Figure 3
Changes of the liver PDFF for each by Couinaud segment (A,B,C,D,E,F,G,H,I) as a function of mean liver PDFF change. PDFF changes in segments V and VII show the strongest influence on the mean liver PDFF change (highest slope). PDFF changes in segment I show the weakest influence on the mean liver PDFF change (lowest slope). PDFF, proton density fat fraction.
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