This study aims to determine sampling strategy (SS) with the fewest regions of interest (ROIs) that could diagnose hepatic steatosis (HS) as reliably as the 9-ROI strategy before liver transplantation in ex vivo. All strategies with ≥5 ROIs had an intraclass correlation coefficients(ICC) ≥ 0.995 and limit of agreement (|LOA|)≤ 1.5%. The average proton density fat-fraction (PDFF) was moderately correlated with the histological diagnosis. The 5-ROI SS obtains similar PDFF results as the 9-ROI strategy before liver transplantation in ex vivo. After further verification, this method may become an available standard to assess HS before liver transplantation in ex vivo.
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