NATIVE T1 MAPPING OF THE LIVER AS A QUANTITATIVE MAGNETIC RESONANCE
BIOMARKER OF FIBROSIS: CLINICAL SIGNIFICANCE AND LIMITATIONS
Savchenkov Yu.N.1,2, Trufanov G.E.3, Fokin V.A.3, Ionova E.A.2, Arakelov S.E.1,4
1 – V.P. Demikhov City Clinical Hospital. Moscow, Russia.
2 – State Research Center of the Russian Federation, A.I. Burnazyan Federal Medical Biophysical Center, Federal Medical Biological Agency of Russia. Moscow, Russia.
3 – V.A. Almazov National Medical Research Center. Saint Petersburg, Russia.
4 – Patrice Lumumba Peoples’ Friendship University of Russia named after. Moscow, Russia.
Purpose. To evaluate the diagnostic performance of native liver T1 mapping for fibrosis staging and to assess the impact of steatosis on its accuracy.
Materials and methods. This retrospective study included patients with chronic liver diseases who underwent multiparametric abdominal MRI. The study protocol included native liver T1 mapping using the Modified Look-Locker Inversion Recovery (MOLLI) technique with a 5(3)3 scheme, performed with pulse-triggered cardiac synchronization during a single breath-hold. The reference fibrosis stage was determined according to the METAVIR classification based on combined clinical, laboratory, and instrumental data. Stratification was performed according to the presence of hepatic steatosis based on proton density fat fraction measurements. Patients with evidence of hepatic iron overload were not included in the study. Correlation analysis and intergroup comparisons were conducted to assess the relationship between native T1 values and fibrosis stage. ROC analysis was performed to evaluate diagnostic performance for clinically significant fibrosis (≥F2), advanced fibrosis and cirrhosis (≥F3), and cirrhosis (F4). Statistical analysis was performed using nonparametric tests with multiple comparison correction according to the Benjamini-Hochberg method. Statistical significance was defined as FDR < 0.05.
Results. A statistically significant positive association was found between native liver T1 values and fibrosis stage (ρ = 0.77; p < 0.001; FDR < 0.05). Median T1 values increased progressively with advancing fibrosis, from 496.0 ms [450.0; 518.2] at F0 to 757.7 ms [682.0; 860.7] at F4. Differences between all adjacent stages remained statistically significant after FDR correction (p < 0.05 for all pairwise comparisons).
According to ROC modeling, native T1 mapping demonstrated high diagnostic performance for fibrosis staging. In the subgroup without steatosis (S0), the area under the ROC curve (AUROC) for detecting clinically significant fibrosis (≥F2) was 0.900, for advanced fibrosis and cirrhosis (≥F3) 0.937, and for cirrhosis (F4) 0.970. In the subgroup with steatosis (S1–S3), the corresponding AUROC values were 0.804, 0.862, and 0.966, respectively. In the presence of steatosis, diagnostic performance decreased for the ≥F2 threshold (p = 0.029, DeLong test), whereas no statistically significant differences between subgroups were observed for the ≥F3 and F4 thresholds (p = 0.064 and p = 0.878, respectively).
Discussion. The findings confirm that native liver T1 mapping is an informative quantitative biomarker of fibrosis, demonstrating a strong positive correlation with fibrosis stage and high diagnostic accuracy, particularly at advanced stages (≥F3 and F4). The observed reduction in diagnostic performance in the presence of steatosis for the ≥F2 threshold indicates the modifying effect of fat infiltration on measured T1 relaxation values. With progression to ≥F3 stages, the contribution of fibrotic tissue becomes predominant, and the influence of steatosis diminishes, explaining the absence of significant AUROC differences at advanced stages. Native T1 mapping may be recommended as a component of multiparametric MRI for noninvasive assessment of liver fibrosis; however, its interpretation should account for the presence of steatosis, especially in early disease stages.
Conclusion. Native liver T1 mapping is an informative quantitative MRI technique for fibrosis staging. Its diagnostic performance is most pronounced in the absence of steatosis, whereas accuracy decreases in its presence. The results delineate the scope of applicability of native T1 mapping and support its use as a component of multiparametric MRI evaluation of liver fibrosis.
Keywords: native T1 mapping, biomarker, quantitative assessment, liver fibrosis, chronic liver diseases, magnetic resonance imaging, MRI.
Corresponding author: Savchenkov Yu.N., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript .
For citation: Savchenkov Yu.N., Trufanov G.E., Fokin V.A., Ionova E.A., Arakelov S.E. Native T1 mapping of the liver as a quantitative magnetic resonance biomarker of fibrosis: clinical significance and limitations. REJR 2026; 16(2):108-122. DOI: 10.21569/2222-7415-2026-16-2-108-122.
Received: 19.03.26 Accepted: 01.08.26