Clinical value of hepatic extracellular volume fraction derived from dual-layer detector spectral CT in assessing non-alcoholic fatty liver disease

ZHANG Tao; MENG Qinglin; TIAN Yazhong; CHEN Zhiye

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Medical Journal of the Chinese People Armed Police Forces ›› 2025, Vol. 36 ›› Issue (10) : 877-880.

Clinical value of hepatic extracellular volume fraction derived from dual-layer detector spectral CT in assessing non-alcoholic fatty liver disease

ZHANG Tao, MENG Qinglin, TIAN Yazhong, CHEN Zhiye

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Abstract

Objective To investigate the correlation between hepatic extracellular volume fraction (fECV) derived from dual-layer detector spectral CT (DLCT) and the liver fat content (Fat%) measured by quantitative CT (QCT), and to verify the feasibility of using fECV to assess the stages of non-alcoholic fatty liver disease (NAFLD). Methods A total of 165 NAFLD patients (87 males and 78 females) in Hainan Hospital of PLA General Hospital from January 2022 to December 2024 were included and categorized into mild (<14% Fat%, 115 ROIs), moderate (14%-28% Fat%, 528 ROIs), and severe (≥28% Fat%, 347 ROIs) groups based on QCT measurement. fECV was obtained using DLCT (Philips IQon Spectral CT), and its diagnostic efficacy was evaluated via one-way ANOVA, Pearson correlation, and ROC curve. Results Significant negative correlations were observed between fECV and Fat% across all groups, with Fat% (0.10±0.04) and fECV(0.29±0.04) in the mild group, Fat%(0.21±0.08) and fECV(0.24±0.05) in the moderate group, Fat%(0.37±0.06) and fECV(0.14±0.06) in the severe group. The differences were statistically significant. Linear regression equation was Fat%=0.36-0.58×fECV (R²=0.668), indicating that for every 0.1 decrease in fECV, Fat% increased by 5.8%. ROC analysis showed that fECV had excellent diagnostic efficacy for moderate and above (AUC=0.873) and severe fatty liver (AUC=0.918), with a sensitivity>78% and specificity>81%. Conclusions The fECV derived from DLCT can be used as a reliable quantitative indicator for noninvasive staging of NAFLD, providing a new imaging strategy for clinical precision management.

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spectral CT / quantitative CT / dual-layer detector spectral CT / extracellular volume fraction / fatty liver

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ZHANG Tao, MENG Qinglin, TIAN Yazhong, CHEN Zhiye. Clinical value of hepatic extracellular volume fraction derived from dual-layer detector spectral CT in assessing non-alcoholic fatty liver disease[J]. Medical Journal of the Chinese People Armed Police Forces. 2025, 36(10): 877-880

References

[1] Cataldo I,Sarcognato S,Sacchi D,et al.Pathology of non-alcoholic fatty liver disease [J]. Pathologica,2021,113(3):194-202.
[2] O’Reilly E M,Yu K H,Lamarre N,et al.Real-world overall survival of patients diagnosed with recurrent versus de novo metastatic pancreatic ductal adenocarcinoma (PDAC) [J].J Clin Oncol,2021,39(15 suppl):e16250.
[3] Leitão H S,Paulino C,Rodrigues D,et al.MR fat fraction mapping: a simple biomarker for liver steatosis quantification in nonalcoholic fatty liver disease patients[J].Acad Radiol,2013,20(8):957-961.
[4] Shi Y W,Fan J G.Surveillance of the progression and assessment of treatment endpoints for nonalcoholic steatohepatitis[J].Clin Mol Hepatol,2023,29(Suppl):S228-S243.
[5] Chalasani N,Younossi Z,Lavine J E,et al.The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American association for the study of liver diseases [J].Hepatology,2018,67(1):328-357.
[6] Ooi G J,Clouston A,Johari Y,et al.Evaluation of the histological variability of core and wedge biopsies in nonalcoholic fatty liver disease in bariatric surgical patients[J].Surg Endosc,2021,35(3):1210-1218.
[7] 陈白如,郭鸣周,屈敏,等.应用定量CT测量肝脏脂肪含量的可重复性分析[J].中华健康管理学杂志,2020,14(4):318-321.
[8] 徐黎,端木羊羊,张勇,等.定量CT测量动物肝脏脂肪含量的实验研究[J].放射学实践,2017,18(5):466-470.
[9] 陈刚,索方方,陈少武,等.QCT和MR在非酒精性脂肪肝诊断中的应用价值[J].中国CT和MRI杂志,2018,16(8):93-95,103.
[10] Goertz R S,Zopf Y,Jugl V,et al.Measurement of liver elasticity with acoustic radiation force impulse (ARFI) technology: an alternative noninvasive method for staging liver fibrosis in viral hepatitis[J].Ultraschall Med,2010,31(2):151-155.
[11] Cosgrove D,Piscaglia F,Bamber J, et al.EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography.Part 2: clinical applications[J].Ultraschall Med,2013,34(3):238-253.
[12] Popescu A,Bota S,Sporea I,et al.The influence of food intake on liver stiffness values assessed by acoustic radiation force impulse elastography-preliminary results[J].Ultrasound Med Biol,2013,39(4):579-584.
[13] Bandula S,Punwani S,Rosenberg W M,et al.Equilibrium contrast-enhanced CT imaging to evaluate hepatic fibrosis: initial validation by comparison with histopathologic sampling[J].Radiology,2015,275(1):136-143.
[14] Guzmán-Aroca F,Frutos-Bernal M D,Bas A,et al.Detection of non-alcoholic steatohepatitis in patients with morbid obesity before bariatric surgery: preliminary evaluation with acoustic radiation force impulse imaging[J].Eur Radiol,2012,22(11):2525-2532.
[15] 徐馨炀,王可欣,李忠.基于影像学的细胞外体积分数的研究进展[J].中国现代医生,2024,33(10):135-138,146.
[16] Abdelmalek M F.Nonalcoholic fatty liver disease: another leap forward[J].Nat Rev Gastroenterol Hepatol,2021,18(2):85-86.
[17] Guo Z,Blake G M,Li K,et al.Liver fat content measurement with quantitative CT validated against MRI proton density fat fraction: a prospective study of 400 healthy volunteers[J].Radiology,2020,294(1):89-97.
[18] Swets J A.Measuring the accuracy of diagnostic systems[J].Science,1988,240(4857):1285-1293.
[19] Bohte A E,van Werven J R,Bipat S,et al.The diagnostic accuracy of US, CT, MRI and 1H-MRS for the evaluation of hepatic steatosis compared with liver biopsy: a meta-analysis[J].Eur Radiol,2011,21(1):87-97.
[20] Cheng X,Blake G M, Brown J K,et al.The measurement of liver fat from single-energy quantitative computed tomography scans[J].Quant Imaging Med Surg,2017,7(3):281-291.
[21] Xu L,Duanmu Y, Blake G M,et al.Validation of goose liver fat measurement by QCT and CSE-MRI with biochemical extraction and pathology as reference[J].Eur Radiol,2018,28(5):2003-2012.
[22] Varenika V,Fu Y,Maher J J, et al.Hepatic fibrosis: evaluation with semiquantitative contrast-enhanced CT[J].Radiology,2013,266(1):151-158.
[23] Zissen M H,Wang Z J,Yee J,et al.Contrast-enhanced CT quantification of the hepatic fractional extracellular space: correlation with diffuse liver disease severity[J].AJR Am J Roentgenol,2013,201(6):1204-1210.
[24] 苏李娜,郭顺林,王莉莉,等.肝细胞外基质体积分数定量评价肝纤维化的诊断价值[J].临床放射学杂志,2016(8):1195-1198.
[25] Shi W,Liang X,Wu N,et al.Assessment of split renal function using a combination of contrast-enhanced CT and serum creatinine values for glomerular filtration rate estimation[J].AJR Am J Roentgenol,2020,215(1):142-147.
[26] Bak S,Kim J E,Bae K,et al.Quantification of liver extracellular volume using dual-energy CT: utility for prediction of liver-related events in cirrhosis[J].Eur Radiol,2020,30(10):5317-5326.
[27] Tamaki N,Ajmera V,Loomba R.Non-invasive methods for imaging hepatic steatosis and their clinical importance in NAFLD[J].Nat Rev Endocrinol,2022,18(1):55-66.
[28] Chen H,Tan H,Wan J,et al.PPAR-γ signaling in nonalcoholic fatty liver disease: pathogenesis and therapeutic targets[J].Pharmacol Ther,2023,245:108391.