ArticleCurrent medical imaging2026
Feasibility of Predicting the Triglyceride/High-Density Lipoprotein Cholesterol Ratio using Spectral Imaging with a Multi-Material Decomposition Technique on Fast kVp-Switching Dual-Energy CT
Article in Current medical imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction/ Background: Non-alcoholic fatty liver disease (NAFLD) is closely associated with increased cardiovascular risk, and the triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio is a reliable predictor of cardiometabolic disorders. Dual-energy CT with Multi-Material Decomposition (MMD) enables non-invasive quantification of liver Fat Fraction (FF), but its value in predicting TG/HDL-C ratio remains unexplored. To investigate the correlation between the triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio, and spectral parameters, liver Fat Fraction (FF) measured by Multi-Material Decomposition (MMD), and to validate their predictive value. MATERIALS AND
methodsA total of 96 subjects (50 Non-Alcoholic Fatty Liver Disease (NAFLD) patients, 46 healthy individuals) were divided into low-ratio (TG/HDL-C ≤1.5, n=56) and high-ratio (TG/HDL-C >1.5, n=40) groups. Abdominal fast kVp-switching dual-energy CT was performed to measure FF (left lobe (FFL), right anterior lobe (FFRA), right posterior lobe (FFRP)), visceral fat content (FV), virtual monochromatic CT values (HU50-100keV), and liver/spleen CT value ratio (HUL/S). Correlation and ROC analyses were conducted.
resultsTG/HDL-C ratio was positively correlated with FFL, FFRA, FFRP, FV (r=0.7514–0.3787, p<0.001) and negatively correlated with HU50-100keV and HUL/S (r=-0.4171–-0.7513, p<0.001). The high-ratio group had higher FF and FV, lower HU50-100keV and HUL/S (p<0.05). ROC analysis showed the highest AUC was 0.884 (FFRP), followed by FFRA (0.880), FFL (0.872), HUL/S (0.837), and HU100keV (0.835). DISCUSSION: MMD-derived FF (especially FFRP) exhibited superior predictive performance for TG/HDL-C ratio compared to spectral CT parameters and visceral fat content. This advantage stems from FF’s direct quantification of intrahepatic fat (pathological basis of NAFLD-metabolic interplay), while HU-based parameters are confounded by non-fat tissue components. The study establishes a novel imaging-metabolic association, extending dual-energy CT’s utility from NAFLD diagnosis to cardiovascular risk stratification.
conclusionMMD-measured FF and dual-energy CT spectral parameters are correlated with TG/HDL-C ratio, and FF exhibits the best predictive performance for TG/HDL-C in NAFLD patients.
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