Evaluating the diagnostic performance of Dixon and MRS based proton density fat fraction (PDFF) in hepatic steatosis

Motivation: Steatosis is the histopathologic hallmark of NAFLD. Liver histology is currently the standard for hepatic steatosis diagnosis, which is invasive. Several MRI methods have been validated to accurately measure hepatic fat content. Goal(s): To evaluate diagnostic performance of different hepatic fat quantification methods. Approach: We compared hepatic fat content calculated by Dixon MRI and MRS with histology results as reference. Results: The outcomes show that the fat fraction measured by these two methods highly correlated with steatosis degrades measured by histology. Compared with MRS, fat fraction calculated by Dixon MRI performed better diagnostic capacity in hepatic steatosis. Impact: Our study demonstrates that the Dixon-based method outperforms the MRS. The use of whole liver automatic segmentation improves diagnostic efficiency, and its performance is comparable to the ROI-based method, making it a promising hepatic fat fraction detection approach in clinic.