Marked difference in liver fat measured by histology vs. magnetic resonance-proton density fat fraction: A meta-analysis
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Background & Aims: Pathologists quantify liver steatosis as the fraction of lipid droplet-containing hepatocytes out of all hepatocytes, whereas the magnetic resonance-determined proton density fat fraction (PDFF) reflects the tissue triacylglycerol concentration. We investigated the linearity, agreement, and correspondence thresholds between histological steatosis and PDFF across the full clinical spectrum of liver fat content associated with non-alcoholic fatty liver disease. Methods: Using individual patient-level measurements, we conducted a systematic review and meta-analysis of studies comparing histological steatosis with PDFF determined by magnetic resonance spectroscopy or imaging in adults with suspected non-alcoholic fatty liver disease. Linearity was assessed by meta-analysis of correlation coefficients and by linear mixed modelling of pooled data, agreement by Bland-Altman analysis, and thresholds by receiver operating characteristic analysis. To explain observed differences between the methods, we used RNA-seq to determine the fraction of hepatocytes in human liver biopsies. Results: histology. Conclusions: Histological steatosis and PDFF have non-perfect linearity and fundamentally different scales of measurement. Liver fat values obtained using these methods may be rendered comparable by conversion equations or threshold values. Impact and implications: Magnetic resonance-proton density fat fraction (PDFF) is increasingly being used to measure liver fat in place of the invasive liver biopsy. Understanding the relationship between PDFF and histological steatosis fraction is important for preventing misjudgement of clinical status or treatment effects in patient care. Our analysis revealed that histological steatosis fraction is often significantly higher than PDFF, and their association varies across the spectrum of fatty liver severity. These findings are particularly important for physicians and clinical researchers, who may use these data to interpret PDFF measurements in the context of histologically evaluated liver fat content.
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The percentage of PDFF is not directly comparable to the percentage of steatosis on histology.
“It is important to note that the percentage of PDFF is not directly comparable to the percentage of steatosis on histology.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [164]
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Point-of-care ultrasound of the inflammatory bowel disease
Aliyeva, N. Z., & Kazimov, I. L. (2024) · Український радіологічний та онкологічний журнал · doi:10.46879/ukroj.3.2024.333-344 · Cited by 1 · see citing works
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Mathematical Modelling of MASLD ‐ Towards Digital Twins in Liver Disease
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Magnetic Resonance Imaging Quantification of Steatosis, Iron, and Fibrosis in Chronic Liver Disease
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An Invisible Early Steatosis Phenotype Defined for a Large Population-Based Cohort
Poynard, T., Deckmyn, O., Peta, V., Pais, R., BEERS, B. E. V., Castéra, L., Charlotte, F., Paradis, V., Bédossa, P., & Valla, D. C. (2025) · Biomedicines · doi:10.3390/biomedicines13123045
Николаевич, С. Ю., Труфанов, Г., Фокин, В. А., Ionova, E. A., Savchenkova, A. P., Робертовна, М. А., Галян, Т., & Аракелов, С. (2026) · Cifra LLC Journals · doi:10.60797/irj.2026.166.114.2
Николаевич, С. Ю., Труфанов, Г., Фокин, В. А., Ionova, E. A., Savchenkova, A. P., Робертовна, М. А., Галян, Т., & Аракелов, С. (2026) · Cifra LLC Journals · doi:10.60797/irj.2026.166.114.5
Пример измерений протонной плотности жировой фракции в S1, S3, S4b, S5 и S6 печени
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- Authors
- Qadri, S., Vartiainen, E., Lahelma, M., Porthan, K., Tang, A., Idilman, I. S., Runge, J. H., Juuti, A., Penttilä, A. K., Dabek, J., Lehtimäki, T. E., Seppänen, W., Arola, J., Arkkila, P., Stoker, J., Karcaaltincaba, M., Pavlides, M., Loomba, R., Sirlin, C. B., Tukiainen, T., & Yki-Järvinen, H.
- Affiliations
- University of Helsinki (FI)
- Centre Hospitalier de l’Université de Montréal (CA)
- Amsterdam UMC Location University of Amsterdam (NL)
- Helsinki University Hospital (FI)
- University of Oxford (GB)
- University of California San Diego (US)
- Corresponding author
- Qadri, Sami
- ORCID
- Venue
- JHEP Reports
- Publisher
- Elsevier BV
- Published
- 2024-01
- Volume
- 6
- Issue
- 1
- Pages
- 100928
- ISSN
- 2589-5559 (ISSN-L)
- PMC
- PMC10711480
- OpenAlex
- W4387534095
- Cited by
- 55
- References
- 50
- Citations by year
- 2026: 20 · 2025: 18 · 2024: 17
- FWCI
- 2.19
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- JHEP Reports (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Työväentutkimus Vuosikirja (submittedVersion)
- Pure Amsterdam UMC (submittedVersion, cc-by)
- Funders
- Novo Nordisk Fonden (NNF19OC0057503)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK120515)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
- Keywords
- liver fat, proton density fat fraction, non-alcoholic fatty liver disease, magnetic resonance spectroscopy, liver biopsy, triglycerides, measurement agreement, conversion equations
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