The study demonstrated that %FF measurements obtained from both LP1 and LP2 protocols were in agreement with the reference values of the phantom, confirming the accuracy of the proposed methodology. The FF-MRI phantom successfully simulated a broad range of fat fraction values, reinforcing its utility as a valuable testbed for MRI-based FF quantification.

The in-house software, qMRI Utilities-X, seamlessly embedded into the existing EVORAD PACS/Workstation system, proved to be a robust and efficient tool for %FF quantification, offering a fast and reliable measurements, eliminating the need for external software. High concordance with reference values further supports the validity of this approach, making it a promising solution for clinical and research applications. The LP-1 protocol exhibited advantages in terms of faster acquisition and post-processing times compared to LP-2, making it a preferred choice for streamlined clinical workflows.

This study highlights also the added value of using the in-house PACS-embedded tool for liver fat fraction estimation in clinical and research applications, ensuring accuracy and accessibility. Future work should focus on expanding validation through a multi-center, multivendor study to assess the robustness of the approach across different MRI platforms and imaging environments.