RPS 401 - Estimation of liver fat and stiffness with imaging

Author Block: R. Cannella, A. A. Blandino, A. Tulone, S. Petta, T. V. Bartolotta; Palermo/IT
Purpose: To investigate the performance of quantitative ultrasound with US Fat Fraction (USFF) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).
Methods or Background: This study included consecutive patients with MASLD who prospectively underwent MRI and quantitative ultrasound on the same day. MRIs were acquired on a 3T scanner and the fat fraction quantification was obtained with mDixonQuant sequence. Quantitative ultrasound consisted of Tissue Attenuation Imaging (TAI), Tissue Scatter-distribution Imaging (TSI), and US Fat Fraction (USFF) acquired by two operators (a radiologist and a radiology resident) to evaluate the inter-reader reliability. Spearman's rank-order correlation was calculated between USFF and MRI fat fraction. The diagnostic performance was investigated with the area under the receiver operating characteristics curve (AUC), sensitivity and specificity according to the optimal cutoff.
Results or Findings: Fifty-nine patients (40 males, median age of 60 years) were enrolled. Among them, 47 (79.7%) had grade≥1 steatosis and 23 (39.0%) had grade≥2 steatosis. There was a high positive correlation between USFF and MRI fat fraction (rho: 0.877, p<0.001). For the diagnosis of grade≥1 steatosis the AUCs were 0.959 (95%CI: 0.778, 0.999) for TAI, 0.847 (95%CI: 0.631, 0.963) for TSI, and 0.988 (95%CI: 0.825, 1.000) for USFF. An USFF >10.0 had a sensitivity 94.1% and a specificity of 100% for grade≥1 steatosis. For the diagnosis of grade≥2 steatosis, the AUCs were 0.958 (95%CI: 0.777, 0.999) for TAI, 0.858 (95%CI: 0.757, 0.916) for TSI, and 0.958 (95%CI: 0.777, 0.999) for USFF. An USFF >11.8 had a sensitivity 100% and a specificity of 83.3% for grade≥2 steatosis. The reproducibility of USFF was excellent (ICC of 0.98; 95%CI: 0.95, 0.98).
Conclusion: USFF provides an excellent performance and reproducibility for the quantification of hepatic steatosis in patients with MASLD.
Limitations: Lack of liver biopsy.
Funding for this study: Study supported by Samsung.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: All participants provided written informed consent.

Author Block: G. Daccordi, P. Sacco, F. Lazzeretti, G. De Filippo, C. Tucci, M. A. Mazzei; Siena/IT
Purpose: This study evaluates the effectiveness of bempedoic acid in improving hepatic steatosis using multiparametric ultrasound and serum lipid levels, comparing results with a control group.
Methods or Background: Background:
Hepatic steatosis is associated with dyslipidemia and liver dysfunction. Multiparametric ultrasound, using techniques like shear-wave elastography and attenuation imaging (ATI), offers a non-invasive assessment of liver fibrosis and steatosis. Bempedoic acid is a potential therapy to reduce liver fat and improve lipid profiles.

Materials and methods:
We enrolled 100 patients with hepatic steatosis: 50 received bempedoic acid therapy, and 50 served as controls. Ultrasound was performed using the Canon Aplio i800, evaluating fibrosis via shear-wave elastography, and steatosis using ATI and dispersion imaging. Two operators with different experience levels performed the exams at baseline and after treatment. Serum cholesterol, triglycerides, and liver enzymes were also monitored.
Results or Findings: Significant improvements in fibrosis, steatosis, and dispersion were observed in the treatment group (p < 0.001). No significant changes were found in the control group (p > 0.05), highlighting the utility of multiparametric ultrasound for follow-up. Good inter-operator agreement was noted for ATI (ICC = 0.96), with slight discordance in fibrosis evaluation (ICC = 0.88), likely due to experience differences.
Conclusion: Multiparametric ultrasound plays a fundamental role for the non-invasive follow-up of hepatic fibrosis and steatosis during therapy. This approach is a valuable tool for assessing patient response, aiding in informed clinical decisions.
Limitations: Ongoing single-center study
Funding for this study: Not addictional funding
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: University of Siena

Author Block: A. Kristic, L. Balcar, A. Ba-Ssalamah, T. Reiberger, M. Mandorfer, N. Bastati-Huber, R. Ambros, L. Beer, S. Pötter-Lang; Vienna/AT
Purpose: The Functional Liver Imaging Score (FLIS) derived from gadoxetic acid (GA)-enhanced MRI is a prognostic biomarker in patients with advanced chronic liver disease (ACLD). The aim of this study was to investigate whether FLIS, as well as quantitative imaging parameters, including the relative liver enhancement (RLE), relative enhancement ratio of the biliary system (REB), and liver-to-portal vein contrast ratio (LPC), can predict acute-on-chronic liver failure (ACLF; a syndrome defined by extrahepatic organ failure and high short-term mortality) in patients with an acute decompensation (AD) of cirrhosis, i.e., the main at-risk population.
Methods or Background: We included 322 ACLD patients with GA-MRI-derived, semi-quantitative FLIS, in whom the RLE, REB, and LPC were also computed by two independent radiologists. Patients were stratified into stable ACLD (compensated or non-hospitalized/electively hospitalized/non-liver-related hospitalized decompensated ACLD patients) and acutely decompensated (AD) patients (non-elective liver-related hospitalization). The predictive values of semi-quantitative FLIS and quantitative GA-MRI parameters for ACLF development were investigated by Cox regression analyses.
Results or Findings: The FLIS was lower in AD (vs. stable ACLD) patients. Furthermore, low FLIS was an independent risk factor for ACLF development/liver-related death in AD patients (adjusted hazard ratio [aHR]: 2.26; 95%CI: 1.08-4.71; P=0.03), as well as in clinically stable ACLD patients (aHR: 2.35; 95%CI: 1.21-4.55; P=0.01).
Conversely, while RLE, REB, and LPC distinguished between AD and clinically stable ACLD patients (P<0.001), they failed to predict ACLF/liver-related death.
Conclusion: The FLIS is a simple prognostic imaging biomarker in AD patients in whom ACLF risk stratification is important to identify patients who may benefit from intensified monitoring or timely liver transplant evaluation.
Limitations: The retrospective design could have led to a selection bias; however, the study allowed for a long clinical follow-up and a high number of endpoints.
Funding for this study: No funding was received for this study.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Received approval EK 2023/2017.

Author Block: P. N. Kaposi-Novák, B. Zsély, Z. Zsombor, M. Himsel, V. Bérczi, G. Györi, P. Maurovich-Horvat, A. D. Rónaszéki; Budapest/HU
Purpose: The ultrasound-estimated fat-fraction (UEFF) is new biomarker that can facilitate the diagnosis and follow-up of liver steatosis. Different models have been devised to calculate UEFF, but these have yet to be compared side-by-side.
Methods or Background: We retrospectively collected ultrasound parameters from sixty patients with various grades (S0-S3) of metabolic dysfunction-associated steatotic liver disease (MASLD), including attenuation coefficient (AC), backscatter-distribution coefficient (BSC), and liver capsule-to-skin distance (CSD). The training set had balanced distribution of steatosis grades (S0, S1, S3 - 16 cases each, S2 - 12 cases). Univariable and multivariable linear and exponential models were trained to predict the MRI proton density fat-fraction (PDFF) using repeated cross-validation. The models were tested on fifty cases for which the scanner’s application calculated an ultrasound fat-fraction (USFF). We compared the R-squared (R2) and the one-way random effect intraclass correlation coefficients (ICC) among the models.
Results or Findings: In low-grade steatosis (≤ S1), the linear model using AC and BSC achieved the best fit (R2= 0.379, p<0.002), and USFF had the best agreement (ICC=0.538, p<0.003) with PDFF. In high-grade steatosis (≥ S2), the ASC and BSC-based multi-exponential model performed best (R2= 0.252, p<0.008, ICC=0.422, p<0.012). The fit could be improved by including CSD in the model (R2=0.263, p<0.007). The univariable nonlinear AC model resulted in a slightly weaker agreement in both low-grade (ICC=0.236, p<0.019) and high-grade (ICC=0.227, p<0.012) steatosis. A compound model using linear regression in low-grade or nonlinear regression in high-grade steatosis outperformed (R2= 0.6, p<0.001, ICC=0.849, p<0.001) other models in predicting the test cases.
Conclusion: The UEFF is a robust method to diagnose liver steatosis across all stages. The compound model substantially improves the fit and the agreement between UEFF and PDFF.
Limitations: Single center study.
Funding for this study: Pál Novák Kaposi was recipient of a research grant from Samsung Medison Ltd. (Contract number: SE4K/2023/195).

Zita Zsombor was recipent of a resarch scholarship from the New National Excellence Program (ÚNKP-23-3-I-SE-23) of the Hungarian Ministry of Culture and Innovation.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Semmelweis University’s Regional and Institutional Science and Research Ethics Committee (Protocol number: SE RKEB 140/2020, 16 July 2020, and SE RKEB 6/2023, 9 February 2023)

Author Block: J. Erley, J. Breckow, K. Roedl, A. Duoerkongjiang, G. De Heer, E. Tahir, J. Yamamura, G. Adam, I. Molwitz; Hamburg/DE
Purpose: This study aimed to evaluate the association between liver fat content, assessed using dual-energy computed tomography (DECT) material decomposition, in immobilized intensive care unit (ICU) patients with in-hospital mortality, length of ICU stay, and indicators of morbidity (need for tracheotomy and renal replacement therapy).
Methods or Background: ICU patients who received a DECT upon ICU admission between November 2019 and December 2022 were retrospectively investigated. DECT liver fat fraction (DECT-FF) was determined by material decomposition for fat, liver tissue, and iodine by combining two regions of interest (ROI) in the right and one ROI in the left liver lobe (min. size 3.6 cm2). Cox proportional hazard models were employed, including DECT-FF, sex, age, body mass index, ICU scoring systems for disease prediction, reason for admission, pre-existing malignancies, chronic diseases, and inflammatory diseases.
Results or Findings: In total 76 patients were included (33 female, mean age 61±12 years, of which 59% died in the hospital. DECT-FF at CT1 was 3.3±5.4%. DECT-FF was associated with in-hospital mortality (hazard ratio 1.09 [95% confidence interval 1.03; 1.15], p=0.004), with the length of ICU-stay (odds ratio (OR) -4.28 [-6.64; -1.92], p=0.001) and with the need for a tracheotomy (OR: 0.90 [0.80; 0.99], p=0.039). No association was observed between DECT-FF and ICU scoring systems or renal replacement therapy.
Conclusion: A higher liver DECT-FF upon ICU admission was associated with in-hospital mortality and, probably as a consecutive effect/bias, with a decreased length of ICU stay and a lower likelihood of tracheotomy in surviving patients. The liver DECT-FF may serve as a predictive imaging biomarker of mortality in critically ill patients.
Limitations: The sample size and its heterogeneity.
Funding for this study: Not applicable.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: The study has been approved by the ethics committee of the medical association in Hamburg.

Author Block: M-N. Von Itter¹, T. Nonnenmacher², T. Norajitra², S. Rospleszcz¹, J. Machann³, F. Bamberg¹, J. Nattenmüller¹; ¹Freiburg/DE, ²Heidelberg/DE, ³Tübingen/DE
Purpose: The rising prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), formerly NAFLD, makes it a leading liver disease and a risk factor for steatohepatitis, cirrhosis, and hepatocellular carcinoma. As it is potentially reversible, early detection is key.
Methods or Background: A validated nnU-Net liver segmentation model processed 10,636 MRI scans from NAKO participants using 2-point- (2p) and multi-echo- (me) Dixon data. Samples with significant mask mismatches were excluded. The segmentation masks were used to calculate mean liver fat content (LFC) from 2p-Dixon data, which was then compared to the me-Dixon proton density fat fraction.
Results or Findings: The overall mean difference between the fat fraction from me-Dixon measurements and the 2p-Dixon fat estimation is -1.101±0.012%. 95% of the measured differences are within the range of -3.8% and 1.4%. Mean LFCs from 2p-Dixon data overestimate the fat content compared to me-Dixon, especially for higher fat deposition. Liver iron content did not lead to a systemic offset in our cohort, though only participants with mild to moderate liver iron content were part of our sample.
Conclusion: As the 2p-Dixon sequence is often acquired for various clinical questions beyond specific liver imaging, assessment of 2p-Dixon-based LFC can identify individuals with MASLD in possible screening programs or MRI studies for other reasons and guide them to the complementary acquisition of a me-Dixon sequence. This could benefit individuals by initiating preventive measures and reduce the socio-economic burden of MASLD caused by its complications.
Limitations: No histological confirmation was performed.
Funding for this study: Funding was received from the German Research Foundation (Deutsche Forschungsgemeinschaft, grant number: 428224476). The NAKO is funded by the Federal Ministry of Education and Research (BMBF) [project funding reference numbers: 01ER1301A/B/C and 01ER1511D], the federal states and the Helmholtz Association, with additional financial support by the participating universities and the institutes of the Leibniz association.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: The study received institutional review board approval and written informed consent was obtained from all participants.

Author Block: M. Jung¹, L. Michel², M. Reisert², S. Jäck², S. Rospleszcz², M. T. Lu¹, F. Bamberg², V. Raghu¹, J. Weiß²; ¹Boston, MA/US, ²Freiburg/DE
Purpose: Steatotic liver disease (SLD) is a major public health concern with a global prevalence of 32.4% and an independent risk factor for cardiometabolic and liver disease. We used a deep learning framework to quantify liver volume and SLD from MRI in a large Western European population to calculate reference curves and investigate their prognostic value.
Methods or Background: We developed a deep-learning model that takes an MRI as input and outputs liver volume (L) and fat fraction (FF, %) using data from the UK Biobank (UKBB) and German National Cohort (NAKO). Established FF-thresholds were used to define mild(5%), moderate(15%), and severe(25%) SLD. We computed age-, sex-, and height-normalized reference curves and assessed the prognostic value of liver volume z-score (z<1; z=1-2; z>2) and SLD-categories for incident outcomes (diabetes; liver disease; all-cause mortality) in the UKBB (n=35,002). Cox regression assessed the association between volume z-score and SLD categories with outcomes after adjustment for age, sex, BMI, race, and cardiometabolic risk factors (serum glucose, Hb1Ac, lipid panel, prevalent hypertension, history of cancer, alcohol consumption, smoking status).
Results or Findings: Among 66,664 individuals from the general population (57.7±12.9 years; BMI: 26.2±4.5 kg/m2, 48.3% female), SLD was high with a prevalence of 80.4%. In the UKBB, multivariable-adjusted Cox regression showed that severe steatotic liver disease (SLD) was associated with an increased risk of incident diabetes (adjusted hazard ratio [aHR] 2.66) and liver disease (aHR 6.34) compared with no SLD. A liver volume z-score >2 was associated with higher all-cause mortality (aHR 2.25) compared with a z-score <1.
Conclusion: SLD and normalized liver volume categories predicted outcomes beyond traditional risk factors. We will release open-source reference curves to enhance clinical liver risk assessment and improve comparability in research.
Limitations: Predominantly white population.
Funding for this study: This project was conducted with data from the German National Cohort (NAKO) (www.nako.de). The NAKO is funded by the Federal Ministry of Education and Research (BMBF) [project funding reference numbers: 01ER1301A/B/C, 01ER1511D, and 01ER1801A/B/C/D], federal states of Germany, and the Helmholtz Association, the participating universities and the institutes of the Leibniz Association. This research has been conducted using the UK Biobank Resource under Application Number 80337. We thank all participants who took part in the NAKO and UKBB study and the staff of these research initiatives. MJ was funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) - 518480401. VKR was funded by Norn Group Longevity Impetus Grant, NHLBI K01HL168231, and AHA Career Development Award 935176.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Informed consent was obtained from all participants in the UK Biobank and the German National Cohort study. In addition, we received local IRB approval (IRB of the University of Freiburg: 23-1316-S1-retro and 24-1099-S1-retro).

Author Block: T. B. Rodrigues¹, M. D. Santana¹, V. Hérida¹, N. Almeida¹, T. Castela¹, R. C. Semelka², M. Ramalho¹; ¹Lisbon/PT, ²Chapel Hill, NC/US
Purpose: To evaluate and compare liver fat fraction measurements derived from a free-breathing radial sequence with those obtained from reference cartesian breath-hold techniques in an intra-individual fashion.
Methods or Background: The study included 40 subjects (19 males, 21 females; mean age 60.5 ± 13.2) who underwent MRI examinations.Three T1-weighted sequences were used: Cartesian 2D-FLASH dual gradient-echo(2D-GRE), Cartesian 3D-GRE with Dixon technique, and free-breathing 3D-GRE with radial data sampling(Radial 3D-GRE). Two independent readers measured the mean region of interest (ROI) values of the liver for in-phase (IP) and out-of-phase (OP) images for each sequence with an equal ROI and similar location. Quantitative liver fat fractions (FF) were calculated using ((SI(IP)−SI(OP))/(2 × SI(IP))×100. The liver FF were compared across sequences. The inter-reader agreement was assessed using the intraclass correlation coefficient (ICC).Pearson correlation and regression analyses examined relationships among different measurement techniques. P-value of <0.05 was considered significant.
Results or Findings: The study found strong correlations between liver FF measurements across 2D-GRE, 3D-GRE, and radial 3D-GRE sequences. Pearson correlation coefficients were 0.9788 for 2D-GRE vs.3D-GRE, 0.9506 for 3D-GRE vs.Radial 3D-GRE, and 0.9478 for 2D-GRE vs.Radial 3D-GRE (p<0.0001). Regression analyses confirmed strong agreement between methods. ICC was 0.9489 (95%CI=0.9279 to 0.9637).
Conclusion: Our findings underscore the promising potential of the new IP/OP free-breathing Radial 3D-GRE sequence as a reliable alternative to traditional breath-hold techniques for liver FF in patients who cannot hold their breath. The excellent correlation between Radial 3D-GRE and the cartesian methods should recommend its use for patients incapable of suspending breathing.
Limitations: Measurement values may be affected by variations in fat distribution within the liver and small sample size.These factors may impact accuracy and reproducibility and introduce selection bias. However, identical ROI and matched locations were used in all patients.
Funding for this study: No funding was received for this study
Has your study been approved by an ethics committee? Not applicable
Ethics committee - additional information: Retrospective study

Author Block: V. Atamaniuk, M. Obrzut, L. Hanczyk, M. Cholewa, B. Obrzut; Rzeszów/PL
Purpose: Magnetic resonance elastography (MRE) has become the gold standard for non-invasive assessment of liver stiffness, especially in patients with liver fibrosis, replacing liver biopsy. While guidelines for MRE protocols and interpretation have been standardized by the Quantitative Imaging Biomarkers Alliance (QIBA), the impact of vibration amplitude and slice thickness on hepatic stiffness measurements remains uncertain. This study aims to evaluate the reliability of MRE under varying vibration amplitudes and slice thicknesses.
Methods or Background: Twenty volunteers (10 men, 10 women), aged 18–68, underwent MRE on a 1.5 T whole-body scanner using a 2D GRE sequence. The Resoundant system delivered vibrations at 60 Hz with amplitudes of 25%, 50%, 75%, and 100%. Standard slice thickness was 10 mm, and an additional scan was performed at 75% amplitude with a 5 mm slice thickness. Regions of interest (ROIs) were manually drawn per QIBA guidelines to ensure consistent location for stiffness measurements across tested conditions. Statistical analyses included repeated measures ANOVA and intraclass correlation coefficients (ICC).
Results or Findings: The effects of both vibration amplitude (p = 0.11) and slice thickness (p = 0.69) on hepatic stiffness were not statistically significant. The ICC for different amplitudes was 0.92, and for slice thickness, it was 0.95, indicating excellent agreement across conditions.
Conclusion: MRE provides reliable liver stiffness measurements, with no significant influence from changes in vibration amplitude or slice thickness. Given the excellent agreement across varying imaging parameters, MRE can be considered a stable and reproducible method for assessing liver stiffness. Further multicentre studies with larger samples and 3D MRE may help confirm these findings and expand clinical applications of this technique.
Limitations: The study's limitations include the small sample size and the use of 2D MRE.
Funding for this study: No external funding was obtained for this study.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Approved by the Regional Medical Chamber ethics committee (Resolution No 60/2022/B); informed consent was obtained from all participants.

Author Block: M-N. Von Itter¹, T. Nonnenmacher², E. Grune¹, J. Machann³, J. Weiß¹, J. Nattenmüller¹, T. Norajitra², S. Rospleszcz¹, N. Consortium¹; ¹Freiburg/DE, ²Heidelberg/DE, ³Tübingen/DE
Purpose: Steatotic liver disease (SLD) and its subtype, metabolic dysfunction-associated steatotic liver disease (MASLD), are risk factors for cardiometabolic disease, liver cirrhosis, and hepatocellular carcinoma, and represent a major public health burden. Using magnetic resonance imaging in Germany’s largest population-based study (NAKO), we describe the frequency of SLD and MASLD, and evaluate the distribution according to sex, age, BMI, geographic region, and socio-economic status.
Methods or Background: A validated nnU-Net liver segmentation model processed 29,842 MRI scans from NAKO participants (44.1% women) using T1-weighted 6-point Dixon data. The segmentation masks were used to calculate mean liver fat content (LFC). SLD was defined as LFC ≥ 5.56%, and MASLD according to established criteria.
Results or Findings: Overall frequency of SLD and MASLD was 37.6% and 31.8% in men, and 20.3% and 18.6% in women, respectively. Frequency increased with increasing BMI and age, with different patterns in men and women. Geographically, the highest frequency of SLD was found in Eastern Germany (40.6%). Frequency was higher in individuals with low socio-economic status, and this difference was more pronounced in women (frequency for high vs. low socio-economic status: 35.7% vs. 47.2% in men, and 17.1% vs. 37.9% in women).
Conclusion: Frequency of SLD and MASLD in Germany is high, with pronounced differences according to sex, age, BMI, geographic region, and socio-economic status. Our findings provide a robust basis to estimate the public health impact of these liver diseases in Germany.
Limitations: Ultrasound for diagnosis of SLD was not available.
Funding for this study: Funding was received from the German Research Foundation (Deutsche Forschungsgemeinschaft, grant number: 428224476). The NAKO is funded by the Federal Ministry of Education and Research (BMBF) [project funding reference numbers: 01ER1301A/B/C and 01ER1511D], the federal states and the Helmholtz Association, with additional financial support by the participating universities and the institutes of the Leibniz association.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: The study received institutional review board approval and written informed consent was obtained from all participants.

Author Block: M. W. Yang, W. J. Shao; KunMing/CN
Purpose: To investigate the capability of intravoxel incoherent motion (IVIM), diffusion kurtosis imaging (DKI)and diffusion tensor imaging (DTI) to assess the renal function changes of type 2 diabetes.
Methods or Background: Prospectively included 46 patients diagnosed with T2MD, and divided them into three groups based on estimated glomerular filtration rate (eGFR) and the presence of diabetic nephropathy: the simple diabetes group (DM), the early diabetic nephropathy group (e-DKD), and the middle-to-late diabetic nephropathy group (m- DKD). At the same time, 33 volunteers（control group,CG） were recruited and underwent MRI examinations to collect images from various sequences. The true diffusion coefficient D, pseudo-diffusion coefficient D*, perfusion fraction f, mean diffusion kurtosis MK, mean diffusivity MD, fractional anisotropy FA, and apparent diffusion coefficient ADC of the renal cortex and medulla of the subjects were measured and statistically analyzed.
Results or Findings: In the e-DKD and m-DKD groups, ACR increased while eGFR decreased. The ACR of the e-DKD group significantly differed from the DM group and CG (P<0.05). IVIM values, DKI (cortical and medullary MD), and DTI (cortical and medullary ADC) values from all four groups showed a declining trend with disease progression, while cortical and medullary MK values from DKI showed an increasing trend. The cortical MK value of the DM group significantly differed from the CG (P<0.05). Medullary MK value effectively distinguished the CG and e-DKD groups (AUC=0.881, cutoff=0.593, sensitivity=76.9%, specificity=95.0%).
Conclusion: IVIM、DKI、DTI Sequences can be used to supplement renal dysfunction assessment. Different magnetic resonance parameters(IVIM, DKI, and DTI Sequences) identify different renal impairment changes in type 2 diabetic patients.Cortical MK value has higher diagnostic efficiency in the early detection of renal damage in DM patients.
Limitations: The sample size needs to be increased.Further multicenter studies are needed to supplement .
Funding for this study: The "SKY Imaging Research Fund" by the China International Medical Exchange Foundation.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Chinese Ethics Review Number:2020143

Author Block: M. Nowak¹, L. M. Nunez¹, C. Hill¹, S. Marriage¹, R. Salvati¹, M. Pansini², H. B. Thomaides-Brears¹, M. Robson¹; ¹Oxford/UK, ²Lugano/CH
Purpose: Accurate body composition tools are important for assessing adipose and muscle tissue in both clinical and research settings, including obesity management, sarcopenia, and weight loss trials. The use of whole-body MRI is limited by cost and processing demands, while single-slice MRI offers a more efficient alternative. This study evaluated the correlations between single-slice and volumetric assessments of visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and muscle tissue, and their associations with cardiometabolic risk factors.
Methods or Background: We analyzed data from a subset of 67,509 individuals from the UK Biobank with water and fat MRI scans (mean age: 66, 51% male, BMI 26.7). A single axial slice at the L3 vertebra was used to measure VAT, SAT, and skeletal muscle via semi-automatic segmentations. These were compared with volumetric assessments of VAT, SAT, total lean tissue, and thigh fat-free muscle. Correlation coefficients were used to assess the relationship between the two methods, and their associations with cardiometabolic risk factors.
Results or Findings: Single-slice L3 measurements of SAT and VAT demonstrated very strong correlations with SAT (rho=0.94, p<0.001) and VAT volume (rho=0.97, p<0.001), independent of sex, age, BMI, waist circumference, diabetes status, and liver tissue characteristics (SAT: median rho 0.93, VAT: median rho 0.96, all p<0.001). Both body composition assessments showed similar correlations with cardiometabolic risk factors (all p<0.01 for HbA1c, triglycerides, high-density lipoprotein, systolic blood pressure, liver cT1, and liver fat content). Strong correlations were also observed between single-slice skeletal muscle and both total lean tissue (r=0.90, p<0.001) and thigh fat-free muscle volume (r=0.91, p<0.001).
Conclusion: Single-slice L3 measurements of VAT, SAT, and muscle CSA metrics show robust correlations with volumetric assessments across individuals with diverse cardiometabolic profiles, while exhibiting comparable associations with cardiometabolic risk factors.
Limitations: N/A
Funding for this study: Perspectum Ltd.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: In UK Biobank, ethical approval for data collection was received from the North-West Multi-centre Research Ethics Committee and the research was carried out in accordance with the Declaration of Helsinki of the World Medical Association.