Reproducibility of ROI methods and reliability of conventional versus chemical shift-encoded MRI for hepatic fat and iron quantification.

Hilton Leao Filho, Virginia Goncalves, Nathalia Mendonca, Rafael Sachetin, Abdalla Skaf

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Article in Abdominal radiology (New York), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 authors.

Hilton Leao FilhoRadiology Department, Hospital do Coração, São Paulo, Brazil. hleao@hcor.com.br.

Virginia GoncalvesRadiology Department, Hospital do Coração, São Paulo, Brazil.

Nathalia MendoncaRadiology Department, Hospital do Coração, São Paulo, Brazil.

Rafael SachetinRadiology Department, Hospital do Coração, São Paulo, Brazil.

Abdalla SkafRadiology Department, Hospital do Coração, São Paulo, Brazil.

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6 · The paper itself

Abstract

purposeTo compare the inter-reader reproducibility of two ROI placement strategies (circular versus freehand geographic) for hepatic PDFF and R2* quantification, and determine R2* thresholds above which conventional techniques show increasing disagreement relative to confounder-corrected chemical shift-encoded (CSE) methods, used as the reference technique. MATERIALS AND

methodsIn this retrospective study, consecutive adults underwent abdominal MRI at 1.5 T with CSE and conventional sequences. Four radiologists (two seniors, two fellows) independently measured PDFF and R2* using both strategies. Inter-reader agreement was assessed using ICC; conventional-CSE agreement was evaluated with MAE stratified by R2* thresholds.

resultsExcellent interreader agreement was observed for all strategies: PDFF ICCs were 0.974 (five-ROI mean) and 0.975 (geographic); R2* ICCs were 0.983 for both. Correlation between strategies was near-perfect (PDFF: r = 0.995; R2*: r = 0.991). No significant differences were found between experience levels. A sliding threshold analysis identified conventional R2* = 45 s

conclusionBoth ROI strategies yield excellent, comparable reproducibility regardless of reader experience. A proposed exploratory three-zone framework using conventional R2* (GREEN < 45 s

Indexed as

Hepatic steatosisIron overloadMagnetic resonance imagingProton density fat fractionR2* relaxometryRegion of interestReproducibility

Identifiers

PMID41998421

DOI10.1148/radiol.2017161786

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