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MRI as the new reference standard in quantifying liver steatosis: the need for international guidelines
  1. Boris Guiu1,2,
  2. Jean-Pierre Cercueil1,2
  1. 1INSERM U866, University of Burgundy, Dijon, France
  2. 2Department of Radiology, CHU (University Hospital), Dijon, France
  1. Correspondence to Dr Boris Guiu, Department of Radiology, CHU (University Hospital), 2 boulevard Maréchal de Lattre de Tassigny, BP 77908, F-21079 Dijon, France; boris.guiu{at}

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We read with great interest the paper by Raptis et al1 regarding the quantification of liver steatosis by chemical-shift MRI. Chemical-shift imaging takes advantage of the difference in resonance frequency between water and fat (more precisely methylene, the most abundant group in triglycerides) to differentiate them. The dual-echo (in-phase/out-of-phase) MR technique used by the authors and derived from one of their previously published papers2 neglects T2* decay and assumes that the signal difference is due to fat–water interference alone.3 Yet, liver iron …

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.