{"doi":"10.1016/j.ebiom.2025.105982","title":"Opportunistic hepatic steatosis assessment in low-dose coronary artery calcium CT using liver adipose-radiomic index (LARI)","abstract":"Hepatic Steatosis (HS), a key cardiometabolic risk marker, demands accurate, non-invasive diagnosis. Coronary artery calcium scans (CAC) may opportunistically detect HS. This study aims to a) develop a liver adipose-radiomic index (LARI) and b) compare LARI with clinical- and CT-based indices to assess early-grade HS using 1 H MRS as the reference standard (HS + defined as ≥5.56% liver fat) c) validate LARI against liver biopsy. We identified 700 Dallas Heart Study 2 participants (NCT00344903) with CAC + 1 H MRS and 159 participants with CAC + liver-biopsy from University Hospital, Cleveland. A previously developed pipeline (DeHFt) segmented liver in these CTs; texture-based radiomic features were extracted from it. A logistic regression classifier was trained on D 1 (N t = 350, 122 HS+) to obtain LARI, subsequently evaluating its performance on the independent D 2 cohort (N v = 350, 125 HS+). LARI was also validated against liver biopsy D 3 (N e = 159, 121 HS+). The diagnostic performance was evaluated via areas under the receiver operating characteristic curve (AUC), net reclassification index (NRI), and decision curve analysis (DCA). LARI improved discrimination (AUC: 0.91 (95% CI 0.87–0.94)) as compared to clinical- and CT-based indices (via human expert and DeHFt pipeline) (P < 0.05 for each). NRI ranged between 0.05 and 0.45, and DCA showed that LARI outperformed all other indices across probability thresholds. LARI also outperformed CT-based index when examined in liver-biopsy cohort, D 3 (P < 0.05). LARI, a noninvasive CT-based index, outperforms existing methods for early HS detection, paving the way for improved cardiometabolic interventions. For a full list of funding bodies, please see the Acknowledgements.","journal":"EBioMedicine","year":2025,"id":529155,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9542,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1407410,"name":"Rohan Dhamdhere","orcid":"0000-0001-5213-3313","position":1,"is_corresponding":false},{"id":103416,"name":"Sanjay Rajagopalan","orcid":"0000-0001-6669-8163","position":2,"is_corresponding":false},{"id":1054830,"name":"Jonathan R. Walker","orcid":"0000-0002-2995-0398","position":3,"is_corresponding":false},{"id":27292,"name":"Amit V. Khera","orcid":"0000-0001-6535-5839","position":4,"is_corresponding":false},{"id":331315,"name":"James A. de Lemos","orcid":"0000-0003-2211-7261","position":5,"is_corresponding":false},{"id":1407411,"name":"Ronald M. Peshock","orcid":"0000-0003-3217-1966","position":6,"is_corresponding":false},{"id":634882,"name":"Jeffrey L. Browning","orcid":"0000-0001-9168-5233","position":7,"is_corresponding":false},{"id":293937,"name":"Parag H. Joshi","orcid":"0000-0001-7863-2794","position":8,"is_corresponding":false},{"id":36534,"name":"Ian J. Neeland","orcid":"0000-0003-2831-3618","position":9,"is_corresponding":false},{"id":295888,"name":"Sadeer Al‐Kindi","orcid":"0000-0002-1122-7695","position":10,"is_corresponding":false},{"id":237305,"name":"Anant Madabhushi","orcid":"0000-0002-5741-0399","position":11,"is_corresponding":false},{"id":1407409,"name":"Gourav Modanwal","orcid":"0000-0001-6215-4687","position":0,"is_corresponding":true}],"reference_count":42,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:50:52.565868Z","pmid":"41135173","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}