Dixon-based magnetic resonance imaging (MRI) intramuscular proton density fat fraction (PDFF) is a potentially useful imaging biomarker of muscle quality. However, multi-vendor, multi-site reproducibility of intramuscular PDFF quantification, required for large clinical studies, can be strongly dependent on acquisition and processing. The purpose of this study was (I) to develop a 6-point Dixon MRI-based acquisition and processing technique for reproducible multi-vendor, multi-site quantification of thigh intramuscular PDFF; and (II) to evaluate the ability of the technique to detect differences in thigh muscle status between operated