Correlation of Functional Liver Imaging Score from Gadoxetic Acid–Enhanced MRI with Clinical Markers in Chronic Liver Disease

doi:10.21203/rs.3.rs-8359744/v1

Objectives

To evaluate the correlation between Functional Liver Imaging Score (FLIS), derived from gadoxetic acid–enhanced MRI, and established clinical/laboratory parameters (Child-Pugh, FIB-4, Relative Liver Enhancement [RLE], Liver-to-Spleen Index (LSI), and spleen diameter) in individuals with chronic liver disease (CLD).

Materials and Methods

We retrospectively analyzed 94 patients with chronic liver disease (CLD) who underwent gadoxetic acid-enhanced MRI between January 2023 and June 2025 in our hospital. FLIS, RLE, and LSI were calculated based on hepatobiliary phase imaging features. Patients were categorized into non-ACLD, cACLD, or dACLD, and classified by Child–Pugh and FIB-4 scores. ROC analysis was used to evaluate the diagnostic performance of RLE, LSI, spleen sizes and FLIS for distinguishing CP classes and FIB-4 scores.

Results

A total of 94 patients were categorized into non-ACLD, cACLD, and dACLD groups. Both Child–Pugh and FIB-4 scores were significantly associated with disease severity (p < 0.001). Total FLIS scores demonstrated a statistically significant, yet moderate, correlation with clinical severity, particularly with Child–Pugh class (p< 0.05). Among FLIS components, hepatobiliary phase (HBP) parenchymal enhancement was significantly lower in cACLD and dACLD compared to non-ACLD. FIB-4 correlated significantly with spleen size, RLE, and LSI (p < 0.05)

Conclusion

FLIS showed a significant association with disease severity and may serve as a supportive imaging biomarker for liver function. Child–Pugh and FIB-4 scores demonstrated stronger and more consistent associations and remain key non-invasive tools in CLD evaluation. Additionally, RLE, LSI, and spleen size appear useful in capturing functional and structural changes, especially in conjunction with clinical indices.

FLIS

gadoxetic acid

chronic liver disease

Child-Pugh

FIB-4

Question:
Can the Functional Liver Imaging Score (FLIS) derived from Gd-EOB-DTPA-enhanced MRI reflect the clinical severity of chronic liver disease in patients with cirrhosis?

Findings:
FLIS showed a statistically significant correlation with Child–Pugh class and FIB-4 index, although the strength of correlation was moderate.

Clinical Relevance Statement:
FLIS may serve as a simple, reproducible imaging-based parameter for estimating disease severity in cirrhotic patients, potentially aiding clinical assessment and stratification

Chronic liver disease (CLD) represents a progressive and multifactorial condition that can lead to cirrhosis, hepatic decompensation, and hepatocellular carcinoma.[1] Timely and accurate evaluation of liver function is essential for prognosis, therapeutic decision-making, and risk stratification—particularly in patients being considered for hepatic surgery or liver transplantation.[2–4] However, conventional imaging techniques such as ultrasound, CT, and standard MRI largely provide morphological data and often fail to reflect early functional impairments in liver parenchyma.[5]

In recent years, the introduction of gadoxetic acid-enhanced magnetic resonance imaging (GA-MRI) has provided a more comprehensive approach by allowing simultaneous morphological and functional assessment. Gadoxetic acid, a hepatocyte-specific contrast agent, is actively taken up by functional hepatocytes via organic anion transporting polypeptides (OATP1B1/3) and subsequently excreted into bile through multidrug resistance-associated protein 2 (MRP2).[6, 7] This dual pathway enables GA-MRI—especially in the hepatobiliary phase (HBP)—to serve as a surrogate marker of hepatocellular function and viability.[8, 9]

Several quantitative and semi-quantitative MRI-based methods, including relative liver enhancement (RLE) and contrast enhancement indices, have been developed to assess liver function.[4, 10–12] However, these techniques often require complex calculations, are susceptible to technical variations across imaging platforms, and may not be practical for routine clinical use. To overcome these limitations, the Functional Liver Imaging Score (FLIS) was introduced as a simple, reproducible, and vendor-independent scoring system. FLIS is derived from visual evaluation of three HBP features on GA-MRI: hepatic enhancement, biliary excretion, and portal vein signal intensity, each scored from 0 to 2, for a total score ranging from 0 to 6 (Fig. 1).[13]

Emerging studies have demonstrated FLIS to be a promising non-invasive biomarker, correlating with clinical outcomes such as hepatic decompensation, mortality, and graft survival post-transplantation.(2–4) Notably, FLIS has been reported to outperform conventional laboratory indices such as the Child-Pugh and MELD scores in some prognostic settings.(14) However, although several studies have evaluated the association between FLIS and various clinical and laboratory parameters of liver function, its relationship with comprehensive indices such as the Child-Pugh score, FIB-4 index, spleen diameter, RLE, and liver-to-spleen index (LSI) has not been systematically characterized.

The aim of this study is to investigate the correlation between the Functional Liver Imaging Score (FLIS) and both clinical and laboratory markers of hepatic function in patients with chronic liver disease. By evaluating this relationship, we aim to clarify the potential role of FLIS as a practical, imaging-based tool for functional liver assessment in routine clinical settings.

For the study, patient data were collected after obtaining approval from the institutional clinical research ethics committee. All patients were informed about the purpose of the study in accordance with the principles of the Declaration of Helsinki, and written/oral consent was obtained for their participation.

A total of 94 patients (25 women, 69 men; mean age 57,65 ± 14,12 years) diagnosed with liver cirrhosis (LC) or chronic liver disease (CLD) who underwent gadoxetic acid-enhanced MRI between January 2023 and May 2025 were retrospectively analyzed. The Functional Liver Imaging Score (FLIS) was derived by assigning scores from 0 to 2 for each of three hepatobiliary phase features—hepatic enhancement, biliary excretion, and portal vein signal intensity—and summing the total (Fig. 1) (12). Inclusion criteria were as follows:

Availability of gadoxetic acid-enhanced liver MRI (GA-MRI) with 20-minute hepatobiliary-phase (HBP) images acquired using a standardized protocol;

Clinical or histopathological diagnosis of chronic liver disease (CLD) or liver cirrhosis;

Availability of routine laboratory data (albumin, total bilirubin, INR, AST, ALT, platelet count) obtained within two weeks of the MRI.

Patients were excluded if they had portal vein thrombosis, obstructive biliary pathology, or malignancy.

MRI Protocol

All MRI examinations were conducted using 3.0-T scanners (Magnetom Skyra or Trio, Siemens Healthineers, Germany) equipped with phased-array abdominal coils. A standard intravenous dose of gadoxetic acid (0.025 mmol/kg; Primovist®, Bayer) was injected at a rate of 1.0 mL/s, followed by a 20 mL saline flush. The imaging protocol included: T1-weighted in-phase and opposed-phase imaging, T2-weighted turbo spin-echo and HASTE sequences, Diffusion-weighted imaging (b-values: 0, 500, 1000 s/mm²), 3D fat-suppressed T1-weighted gradient-echo imaging, MR cholangiopancreatography (MRCP), Hepatobiliary phase imaging acquired 20 minutes after contrast injection.

Clinical and Laboratory Data

Age, sex, laboratory markers (albumin, bilirubin, AST, ALT, platelet count, INR), and Child-Pugh classification were obtained from electronic health records. Hepatic decompensation signs (ascites, variceal bleeding, encephalopathy) were used solely for staging (dACLD), not for outcome tracking.

The Relative Liver Enhancement (RLE) was calculated using the formula: RLE= [hepatobiliary phase liver signal (SIL HBP20)-precontrast liver signal (SIL pre)] /SIL pre x 100 where SILHBP20 refers to the liver signal intensity during the hepatobiliary phase, and SILpre is the pre-contrast liver signal. The Liver-to-Spleen Index (LSI) was calculated as: LSI = hepatobiliary phase liver signal (SIL HBP20) × hepatobiliary phase spleen signal (SIS HBP20) [9] Patients were grouped based on liver fibrosis severity and the presence or history of hepatic decompensation into three categories: non-advanced chronic liver disease, compensated ACLD, and decompensated ACLD. Patients were categorized into three groups according to disease severity:[13]

Non-advanced chronic liver disease (non-ACLD): Patients with imaging findings of liver cirrhosis but without ascites, splenomegaly, or varices.
Compensated advanced chronic liver disease (cACLD): Patients with ascites, splenomegaly, and radiologically detectable varices.
Decompensated advanced chronic liver disease (dACLD): Patients with a history of variceal bleeding, hepatic encephalopathy, splenorenal shunting, or recurrent paracentesis.

According to the Child–Pugh (CP) classification, 56 patients were categorized as class A, 26 as class B, and 12 as class C. FIB-4 scores were calculated for all patients to assess liver fibrosis.[15] The FIB-4 score was calculated as follows: FIB-4 = (Age [years] × AST [U/L]) / [Platelet count (10⁹/L) × √ALT (U/L)].Patients with a FIB-4 score below 1.45 and imaging findings lacking typical features of cirrhosis were classified as having chronic liver disease (CLD), rather than advanced forms.[16, 17]

Receiver operating characteristic (ROC) curve analysis was conducted to identify optimal cutoff values of RLE, LSI, and FLIS for differentiating between Child–Pugh classes. For RLE and FLIS, the area under the curve (AUC), as well as corresponding sensitivity, specificity, and accuracy, were determined in relation to Child–Pugh classification and FIB-4 scores.

Image Analysis and FLIS Assessment

Two experienced abdominal radiologists, blinded to all clinical and laboratory information, independently reviewed the hepatobiliary-phase images. The Functional Liver Imaging Score (FLIS) was calculated for each patient based on three qualitative parameters: (1) Liver parenchymal enhancement relative to the right kidney; (2) Biliary contrast excretion; (3) Portal vein signal intensity relative to the liver parenchyma. Each feature was assigned a score between 0 and 2. The total FLIS ranged from 0 to 6, with higher scores indicating better hepatocellular function. Discrepancies were resolved by consensus. (Fig. 2–3).

Statistical Analysis

All statistical analyses were performed using SPSS version 26.0 (IBM Corp., Armonk, NY, USA). Continuous variables were summarized as mean ± standard deviation or median (IQR), while categorical variables were expressed as counts and percentages.

The relationships between FLIS and clinical parameters (Child-Pugh, FIB-4, RLE, spleen diameter) were assessed using Spearman’s rank correlation and Kruskal–Wallis tests.
Interobserver agreement for FLIS was assessed using Cohen’s kappa (κ).

Pearson correlation analysis was used to assess the relationships between RLE, LSI, and FLIS with both Child–Pugh class and FIB-4 scores. A p-value < 0.05 was considered statistically significant.

The group means of the quantitative measurements and the significance of differences among these means were analyzed using one-way analysis of variance (ANOVA). Post hoc analysis with Tukey’s test was then performed to determine which groups accounted for these differences

Interobserver agreement for the FLIS and its three individual parameters was excellent. The inter-reader agreement for liver parenchymal enhancement, biliary contrast excretion, portal vein sign, and the overall FLIS were 0.99, 0.98, 0.97, and 0.99 respectively.

Characteristics of the study population

A total of 94 patients were included (25 women, 69 men; mean age, 57,65 ± 14,12 years; range, 18–83 years). The etiologies of CLD and LC were distributed as follows: hepatitis B virus in 40 (42.5%), NASH in 19 (20.2%), primary biliary cirrhosis in 12 (12.7%), cryptogenic in 17 (18%), and hepatitis C virus in 6 patients (0.6%). The baseline characteristics of the study population are presented in Table 1.

Variable	n / % or Mean ± SD
Gender (M/F) Total	69 / 25 94
Age, mean ± SD	57.65 ± 14.12
Etiology (n/%)
- HBV - HCV - NASH - PBC - Cryptogenic	40 (42.5%) 6 (0.6%) 19 (20.2%) 12 (12.7%) 17 (18%)
Child-Pugh Score (n/%) - A - B - C	56 (59.5%) 26 (27.6%) 12 (12.7%)
FIB-4 score, mean ± SD	4.38 ± 3.15

Analysis of the associations between disease severity and categorical variables revealed a statistically significant relationship between the Child-Pugh score and 20-minute parenchymal enhancement (p < 0.05). However, no significant associations were observed between disease severity and sex or 20-minute biliary excretion. In cACLD and dACLD cases, HBP parenchymal enhancement was observed at a lower rate compared to non-ACLD, and this difference was statistically significant (p < 0.05). (Table 2).

Table 2

Distribution of demographic, etiological, and imaging characteristics across disease severity group
		Disease Severity						p
		Non-ACLD		cACLD		dACLD
		n	%	n	%	n	%
Sex	Men	26	66.7%	33	80.5%	10	71.4%	0.370
Sex	Women	13	33.3%	8	19.5%	4	28.6%	0.370
Etiology	HBV	22	56.4%	12	29.3%	6	42.9%	0.035
	NASH	3	7.7%	11	26.8%	5	35.7%
	PBC	6	15.4%	4	9.8%	2	14.3%
	HCV	4	10.3%	2	4.9%	0	0%
	Cryptogenic	4	10.3%	12	29.3%	1	7.1%
Child-Pugh Score	A	35	89.7%	18	43.9%	3	21.4%	< 0.001
	B	4	10.3%	17	41.5%	5	35.7%
	C	0	0%	6	14.6%	6	42.9%
20-min parenchymal contrast enhancement	Hypointense	0	0%	4	9.8%	0	0%	0.002
	Isointense	13	33.3%	19	46.3%	12	85.7%
	Hyperintense	26	66.7%	18	43.9%	2	14.3%
20-min bile excretion	absent	2	5.1%	3	7.3%	1	7.1%	0.632
	Hepatoduodenal	4	10.3%	6	14.6%	0	0%
	Choledoch or duodenum	33	84.6%	32	78.0%	13	92.9%

The mean values of the quantitative measurements and the significance of intergroup differences were assessed using one-way analysis of variance. According to the results, RLE, LSI, spleen size, FIB-4 score and FLIS score differed significantly among the groups (p < 0.05). For FLIS, RLE, LSI measurements, the mean value in the NA group was significantly higher than that in the DA and CA group (p < 0.05). For spleen size, the mean values in the CA and DA groups were significantly higher than in the NA group (p < 0.001). (Table 3) Effect size analysis further supported these findings. According to eta-squared (η²) and Cohen’s f values, spleen size (η² = 0.224, f = 0.54) and FIB-4 score (η² = 0.192, f = 0.49) had large effect sizes, indicating a strong discriminatory power across severity categories. RLE (η² = 0.086, f = 0.31), LSI (η² = 0.100, f = 0.33), and FLIS (η² = 0.082, f = 0.30) demonstrated moderate effect sizes, suggesting that these imaging-derived parameters are also useful, though slightly less powerful, in reflecting disease burden.

Table 3

Comparison of clinical and imaging parameters including Child–Pugh score, FIB-4 index, liver-spleen intensity ratio (LSI), spleen size, relative liver enhancement (RLE), and Functional Liver Imaging Score (FLIS) across disease severity groups
		N	Mean	Std. Deviation	p
Age	non-ACLD	39	59.82	12.27	0.450
	cACLD	41	55.88	15.00
	dACLD	14	56.79	16.41
	Total	94	57.65	14.12
RLE	non-ACLD	39	73.46	34.87	0.017
	cACLD	41	58.37	34.42
	dACLD	14	44.93	27.49
	Total	94	62.63	34.88
LSI	non-ACLD	38	191.87	47.76	0.009
	cACLD	41	165.39	60.04
	dACLD	14	140.44	61.43
	Total	93	172.45	57.90
Spleen size (mm)	non-ACLD	39	125.41	26.08	< 0.001
	cACLD	41	156.56	33.16
	dACLD	14	156.14	22.28
	Total	94	143.57	32.51
FIB-4 score	non-ACLD	39	2.83	2.14	< 0.001
	cACLD	41	5.16	3.47
	dACLD	14	6.43	2.66
	Total	94	4.38	3.15
FLIS score	non-ACLD	39	5.38	1.02	0.019
	cACLD	41	4.78	1.24
	dACLD	14	4.57	1.02
	Total	94	5.00	1.15

FIB-4 also showed a moderate positive correlation with spleen size (r = 0.293, p < 0.05), negative correlation with relative liver enhancement (RLE) (r = -0,213, p < 0.05) and the liver-to-spleen index (LSI) (r = -0,241, p < 0.05 ). There was no statistically significant correlation between spleen size and RLE (r = − 0.193, p : 0.063). In addition, RLE was positively and significantly correlated with LSI (r = 0.440, p < 0.001). (Table 4)

Table 4

Correlation between FIB-4 and imaging parameters
		FIB-4 score	Spleen size (mm)	RLE	LSI
FIB-4 score	r	1	0.293^**	-0.213^*	-0.241^*
FIB-4 score	p	1	0.004	0.039	0.020
Spleen size (mm)	r	0.293^**	1	-0.193	0.015
Spleen size (mm)	p	0.004	1	.063	0.890
RLE	r	-0.213^*	-0.193	1	0.440^**
RLE	p	0.039	0.063	1	< 0.001
LSI	r	-0.241^*	0.015	0.440^**	1
LSI	p	0.020	0.890	< 0.001	1

FLIS score showed a significant positive correlation with RLE (r = 0.497, p < 0.001) and LSI (r = 0.547, p < 0.001). Additionally, there was a significant positive correlation between RLE and LSI (r = 0.440, p < 0.001). (Table 5) Both FLIS and FIB-4 scores showed statistically significant differences across Child–Pugh classes (p < 0.001). Post hoc Tukey analysis revealed that the mean FLIS score in Class A was significantly higher than in Classes B and C.

Table 5

Correlation between FLIS and imaging parameters
		FLIS score	Spleen size (mm)	RLE	LSI
FLIS score	r	1	-0.189	0.497^**	0.547^**
FLIS score	p		0.068	< 0.001	<0.001
Spleen size (mm)	r	-0.189	1	-0.193	0.015
Spleen size (mm)	p	0.068		0.063	0.890
RLE	r	0.497^**	-0.193	1	0.440^**
RLE	p	< 0.001	0.063		< 0.001
LSI	r	0.547^**	0.015	0.440^**	1
LSI	p	< 0.001	0.890	< 0.001

The Functional Liver Imaging Score (FLIS), derived from gadoxetic acid–enhanced MRI, is a reproducible and non-invasive tool for assessing hepatic function in chronic liver disease (CLD). Our findings demonstrated that while FLIS scores were significantly associated with clinical severity, the moderate effect size suggests its role is complementary rather than standalone in clinical evaluation. These findings suggest that FLIS can complement established laboratory indices such as FIB-4 in assessing liver disease burden.

Our findings showed that both FLIS and FIB-4 scores significantly differed across Child–Pugh classes, with FLIS scores being higher in Class A, although FIB-4 significantly differed across Child–Pugh classes. These results align partially with Lee et al., who reported strong correlations between FLIS and Child–Pugh scores, and supported FLIS as a reliable stratification tool for hepatic function and decompensation risk [14]. However, similar to Zou et al., who observed only moderate correlations and identified spleen size and SPSS as stronger predictors of decompensation, our findings also emphasized that FIB-4 and spleen size showed greater discriminatory power than FLIS [18]. This suggests that while FLIS reflects hepatic function, its performance may vary depending on disease stage and structural parameters, and may be less sensitive in advanced fibrosis or portal hypertension contexts.

Validation studies by Bastati et al. and Lee et al. showed strong correlations between FLIS and clinical severity scores like Child–Pugh and MELD, and its value in predicting outcomes such as decompensation and mortality [13, 14]. Similarly, FLIS was shown to predict graft survival in liver transplant patients [4]. Our findings support these results, as we also found a significant correlation between FLIS and both Child–Pugh class. This suggests FLIS is useful for assessing liver function in a broader CLD population, not just in advanced or surgical cases.

Impaired biliary excretion of gadoxetic acid has been identified as a strong predictor of mortality in previous work [3]. In our study, however, only parenchymal enhancement demonstrated significant association with Child–Pugh scores, whereas biliary excretion and portal vein signs did not show significant correlation. These differences may be attributable to heterogeneity of the study population and inclusion of earlier disease stages, where biliary impairment is less prominent.

FLIS has previously been shown to predict postoperative liver failure and graft survival after transplantation[4]. Our study, however, focused on non-surgical CLD subgroups, limiting direct comparison with surgical or transplant populations. Still, these findings emphasize the broader relevance of FLIS in liver function assessment and perioperative risk stratification.

Most previous studies evaluated FLIS in patients with advanced cirrhosis or transplant candidates. In contrast, our cohort included a broader range of CLD etiologies such as viral hepatitis and NASH, spanning various stages of disease. This heterogeneity may explain why FLIS was less consistent in reflecting severity, particularly in early-stage cases. Effect size analysis showed that FIB-4 and spleen size had strong discriminatory power, supporting their value in assessing fibrosis and portal hypertension. Although FLIS demonstrated statistical significance, the effect size was moderate, indicating it may be less discriminative, especially in early-stage or compensated disease.

Recent expert statements, including Baveno VII and the 8th International Forum on Liver Imaging, highlight the potential of gadoxetic acid–enhanced MRI in non-invasive liver function assessment, while also emphasizing the need for further validation before clinical integration [1]. Our findings support this view, suggesting that FLIS performance may vary based on patient characteristics and disease stage.

A recent meta-analysis confirmed that FLIS and its subcomponents have excellent inter-reader reliability, regardless of MRI technique or reader experience [19]. This supports FLIS as a reproducible imaging tool. In our study, while total FLIS scores correlated with clinical severity, hepatobiliary parenchymal enhancement stood out as the most informative subcomponent. This suggests that individual FLIS parameters may better reflect liver function than the composite score alone, especially in heterogeneous CLD populations.

Eryuruk et al. demonstrated that the Relative Enhancement Index (REI) derived from gadoxetic acid-enhanced MRI outperformed FLIS in predicting ALBI grades, showing stronger correlations and higher diagnostic accuracy[20]. Consistently, our findings suggest that conventional indices such as FIB-4 may better reflect disease severity in heterogeneous CLD populations. RLE values were highest in patients with non-advanced CLD and showed inverse correlations with FIB-4 and spleen size, further underscoring its potential functional relevance. These findings indicate that RLE, as a quantitative imaging parameter, may provide valuable functional insight—potentially exceeding composite visual scores like FLIS in certain clinical contexts.

Aslan et al. reported very strong correlations between FLIS (and its subcomponents) and ALBI grades, along with excellent intra- and inter-observer agreement, confirming its reproducibility in clinical practice [10]. Consistent with these findings, our study demonstrated a significant association between total FLIS scores and clinical severity indicators such as Child-Pugh class and FIB-4 category. Among the individual FLIS components, hepatobiliary parenchymal enhancement remained the most informative, supporting its particular relevance in non-invasive liver function assessment.

While the prognostic value of FLIS has been widely recognized in the literature, our results further support its utility by demonstrating a significant correlation between FLIS and clinical severity in patients with chronic liver disease. However, it is important to note that in heterogeneous populations—especially those including patients at earlier disease stages—FLIS alone may not fully capture the complexity of liver dysfunction. Therefore, FLIS should be interpreted alongside established clinical and laboratory parameters to ensure a more comprehensive assessment of hepatic function.

Our results showed that higher FIB-4 categories were significantly associated with disease severity, consistent with previous reports highlighting its utility as a non-invasive marker of advanced fibrosis [17]. The positive correlation between FIB-4 and spleen size further reflects its link to portal hypertension, while the absence of significant associations with RLE and LSI suggests that imaging-derived parameters capture different functional aspects. The observed negative correlation between spleen size and RLE, and positive correlation between RLE and LSI, support prior findings that gadoxetic acid–enhanced MRI primarily reflects parenchymal function rather than structural changes [10, 20]

This study is subject to several limitations. Its retrospective design and single-center setting may limit generalizability. Although the sample size was relatively robust, power for certain subgroup analyses remains limited. Additionally, we did not assess long-term outcomes such as hepatic decompensation, transplant-free survival, or mortality—parameters that have been used in prior FLIS validation studies to demonstrate prognostic value.

FLIS showed significant association with clinical severity, particularly with Child–Pugh class. Its correlation with FIB-4 was observed when analyzed as a continuous variable, though not across categorical thresholds. However, among FLIS components, hepatobiliary parenchymal enhancement was the primary driver of this correlation. RLE, LSI and spleen size also demonstrated meaningful associations with FIB-4, indicating their complementary value in evaluating fibrosis and portal hypertension. Together, these findings suggest that integrating FLIS with other imaging and clinical markers may enhance the assessment of CLD severity.

Author Contribution

YC, BK and OK were responsible for the acquisition and interpretation of MRI data, including calculation of FLIS, RLE, and LSI parameters. They jointly evaluated all imaging studies, contributed to study design and methodology, and participated in the critical revision of the manuscript for important intellectual content. EK contributed to the clinical interpretation of patient data, particularly in relation to liver disease severity classification. She also provided expert guidance on the clinical relevance of imaging and laboratory findings within the context of chronic liver disease management All authors read and approved the final manuscript.

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No competing interests reported.

Correlation of Functional Liver Imaging Score from Gadoxetic Acid–Enhanced MRI with Clinical Markers in Chronic Liver Disease

Status:

Version 1

Abstract

Figures

Key Points and Clinical Relevance Statement

1. Introduction

2. Materials and Methods

3. Results

4. Discussion

5. Conclusion

Declarations

Author Contribution

References

Additional Declarations

Status:

Version 1