Water T1 Values Derived from MR Spectroscopy: A Novel Biomarker for Liver Fibrosis Assessment

Motivation: While MRI offers non-invasive alternatives to biopsy, conventional MOLLI T1 mapping is affected by hepatic fat content, limiting accurate fibrosis assessment in clinical practice. Goal(s): To evaluate water T1 values from MR spectroscopy as a fat-independent biomarker for comprehensive liver fibrosis assessment using standard MR systems. Approach: We compared water T1 values from MR spectroscopy with MOLLI T1 mapping in 102 patients at 3T, before and after Gd-EOB-DTPA administration. Results: Pre-water T1 values showed stage-dependent differences (F0: 971.62±166.70ms vs F4: 1314.62±302.39ms; P<0.01, r=0.63). For diagnosing advanced fibrosis (≥ F3), pre-water T1 values achieved robust diagnostic performance (AUC: 0.81). Impact: Pre-water T1 values enable non-invasive liver fibrosis assessment using conventional MR systems without contrast agents or specialized elastography hardware. This accessible approach could revolutionize clinical practice by providing accurate fibrosis evaluation with minimal technical requirements.