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Article History

Received: 3 January 2020

Revised: 11 March 2020

Accepted: 1 April 2020

First Online: 21 April 2020

Compliance with ethical standards

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: The scientific guarantor of this publication is Dr. Claude B. Sirlin.

: The authors of this manuscript declare relationships with the following companies: Effort by Dr. Luke M. Funk on this study was made possible by a VA Career Development Award (CDA 015-060). The views presented are those of the authors and not those of the DVA or the US Government. There are no relevant conflicts of interest or industry support.Dr. Sirlin consults and advises for Alexion, AstraZeneca, Bioclinica, BMS, Fibrogen, Galmed, Genzyme, Gilead, Icon, Intercept, Isis, Janssen, NuSirt, Perspectum, Pfizer, Profil, Sanofi, Shire, Synageva, Tobira, Takeda, and Virtualscopics. He received grants from Siemens, GE, and Guerbet.Dr. Middleton consults for Kowa, Median, and Novo Nordisk, and has been involved in university service contracts with Alexion, AstraZeneca, Bristol-Myers Squibb, Enanta, Gilead, Guerbet, Intercept, Pfizer, Roche, Shire, and Synageva.Dr. Reeder consults for ArTara Therapeutics, and has ownership interests in Calimetrix, Reveal Pharmaceuticals, Cellectar Biosciences, and Elucent Medical. The University of Wisconsin receives research support from GE Healthcare and Bracco Diagnostics.Dr. Schwimmer consults for Novo Nordisk, and has received grant support from Galmed and Intercept.All other authors report no conflict of interest, and no relationships with any companies, whose products or services may be related to the subject matter of the article.Each of my co-authors and I have made substantial contributions to all phases of manuscript development. We have all approved the final version prior to submission.

: Dr. Anthony Gamst and Tanya Wolfson kindly provided statistical advice for this manuscript, and were included as authors, and kindly provided statistical advice for this manuscript.

: Written informed consent was obtained from all subjects (patients) in this study.

: Institutional Review Board approval was obtained.

: Some study subjects or cohorts have been previously reported in:We have previously published two papers (PDFs attached) based on data from the parent weight loss surgery (WLS) program, with different aims from our current aims. Those papers were:1. Fazeli Dehkordy S, Fowler KJ, Mamidipalli A, et al Hepatic steatosis and reduction in steatosis following bariatric weight loss surgery differs between segments and lobes. Eur Radiol. 2018; 13. [PMID: 30547206] [Epub ahead of print] [reference #24 in this paper; details redacted in the references section]This paper looked at segmental PDFF (proton density fat fraction) values estimated by (only) MRI-M in 118 adults undergoing bariatric surgery. The aims were to evaluate PDFF distribution estimated using MRI-M across liver segments at baseline and compare longitudinal segmental PDFF changes across time points.2. Pooler BD, Wiens CN, McMillan A, et al Monitoring fatty liver disease with MRI following bariatric surgery: a prospective, dual-center study. Radiology. 2018; 290:682-69018 [Epub ahead of print] [PMID: 30561273] [reference #25 in this paper; details redacted in the references section]This paper looked at whole-liver PDFF values estimated using (only) MRI-C in 50 adults undergoing bariatric surgery. The aims were to longitudinally monitor PDFF estimated using MRI-C, taking into account possible effects of changes in BMI, weight, and waist circumference.This current analysis included 54 adults from the parent WLS who had whole-liver PDFF 5% estimated by both MRI-M and MRI-C, and compared the rate of change of PDFF with these two MRI techniques (MRI-M and MRI-C), which was not reported in the two prior papers.

: • Retrospective• Observational• Multi-center study