| Title: | Refined liver MRI-derived cT1 thresholds capturing hepatic fat fraction enhance mortality risk prediction |
| Journal: | JHEP Reports |
| Published: | 17 Jun 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42309239/ |
| DOI: | https://doi.org/10.1016/j.jhepr.2026.101927 |
Publication 20599
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Abstract
BACKGROUND & AIMS: Corrected T1 (cT1), measured by liver MRI, enables non-invasive evaluation of hepatic water content. Although a threshold of ≥800 ms has been proposed to identify individuals at risk of MASH with poor outcomes, it captures only a small proportion (∼5%) and may fail to account for risk below this level. We aimed to evaluate whether cT1 values below 800ms are associated with mortality and whether hepatic steatosis, assessed by MRI-derived proton density fat fraction (PDFF), modifies this relationship.</p>
METHODS: We analyzed 29,597 UK Biobank participants with liver MRI-derived cT1 values. Participants were categorized into three groups (<700, 700-799, and ≥800 ms) based on penalized spline analysis. Outcomes included all-cause, cause-specific mortality, and liver-related events. Cox models were adjusted for demographic, lifestyle, and cardiometabolic factors.</p>
RESULTS: Approximately 40% of participants had cT1 700-799 and 5% had ≥800ms. Over a median follow-up of 5.3 years, the 700-799ms group showed increased risks of all-cause mortality (adjusted hazard ratio [95% CI]: 1.21 [1.02-1.43]) and cardiovascular mortality (1.54 [1.04-2.28]) compared with <700ms. The risks were even higher in the cT1 ≥800ms group. Clinically significant hepatic steatosis (PDFF≥10%) had interaction on the association between cT1 and all-cause mortality (P<0.05). cT1 significantly increased all-cause mortality only in participants with PDFF<10% (1.25 [1.06-1.49] in the cT1 700-799ms group and 2.20, [1.40-3.48] in the cT1 ≥ 800ms group, compared to the cT1 < 700ms group), but not in those with PDFF ≥ 10%.</p>
CONCLUSION: cT1 values between 700 and 799ms were independently associated with increased mortality risk. Notably, this association was modified by the presence of significant hepatic steatosis as assessed by PDFF.</p>
IMPACT AND IMPLICATIONS: Using liver MRI to measure cT1, we demonstrated that a cT1 value of 700-799 ms (lower than the traditional cut-off value of 800 ms) was associated with an increased risk of all-cause and cardiovascular mortality. Additionally, the association between cT1 and mortality was evident only among participants with PDFF <10%, not in those with PDFF ≥ 10%. These findings suggest that cT1 can predict all-cause and cardiovascular mortality only in participants without clinically significant hepatic steatosis. In participants with clinically significant hepatic steatosis, cT1 was not associated with increased mortality.</p>
16 Authors
- Minsun Kwak
- Abdelrahman M Attia
- Mohammad Saeid Rezaee-Zavareh
- Yufeng Wang
- Lixia Wang
- Walid S Ayoub
- Alexandar Kuo
- Paul Martin
- Hirsh D Trivedi
- Aarshi Vipani
- Yun Wang
- Stephen Pandol
- Debiao Li
- Shelly C Lu
- Hyun-Seok Kim
- Ju Dong Yang
1 Application
| Application ID | Title |
|---|---|
| 132578 | The Relationship Between Liver and Pancreas Magnetic Resonance Imaging Characteristics with Metabolic Dysfunction-Associated Steatohepatitis, Fatty Pancreas, and Various Related Health Outcomes |
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