Hepatic PDFF quantification using phase-cycled bSSFP: First-in-patient study

Motivation: Phase-cycled bSSFP-based fat fraction mapping has yet to be evaluated in a clinical setting involving patients. Goal(s): To evaluate the feasibility of phase-cycled bSSFP-based fat fraction mapping in liver disease patients, assessing its capabilities and potential in clinical practice. Approach: 2D golden angle radial phase-cycled bSSFP data were prospectively acquired in liver patients during a single breath hold. Obtained fat fraction maps were compared with Dixon-based clinical standard maps. Results: Bland-Altman analyses with limits of agreement (LOA) of -2.5%±1.96×2.8%, and linear regression fitted lines y=1.18x+2.5 with R²=0.72, demonstrated a good agreement between phase-cycled bSSFP-based fat fraction and reference maps. Impact: Fat fraction mapping with phase-cycled bSSFP is feasible in patients, presenting a non-invasive alternative to biopsy and MRS. Its high SNR and robustness against T1 bias might make it a powerful alternative to existing methods in liver steatosis assessment.