Assessment of relevant hepatic steatosis in obese adolescents by rapid fat-selective GRE imaging with spatial-spectral excitation: a quantitative comparison with spectroscopic findings

Springer, Fabian; Ehehalt, Stefan; Sommer, Julia; Ballweg, Verena; Machann, Jürgen; Binder, Gerhard; Claussen, Claus D.; Schick, Fritz

doi:10.1007/s00330-010-1975-4

Cited by 9 publications

(14 citation statements)

References 25 publications

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“…Springer and colleagues studied 29 obese adolescents in Tubingen, Germany. [21] All exams were performed at 1.5 Tesla. Spectroscopy was performed using the stimulated echo acquisition mode (STEAM) technique without T2 correction.…”

Section: Resultsmentioning

confidence: 99%

“…Both clinicians and radiologists need to be aware that – due to the presence of confounding factors such as T1 relaxation, T2(*) decay, multi-frequency interference effects of protons in fat [6, 7, 18, 20, 21], noise bias[22], and eddy currents[23] – conventional MRS and MRI methods may be inaccurate, non-robust, and non-reproducible. Advanced MRS and MRI methods address these confounders to estimate the proton density fat fraction, a standardized biomarker of liver fat content that is accurate[5, 7, 36] reproducible across different scanners[37, 38] and field strengths[37, 38], and robust to routine acquisition parameter changes that are common in clinical practice and may occur in clinical trials.…”

Section: Discussionmentioning

confidence: 99%

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Evidence and Recommendations for Imaging Liver Fat in Children, Based on Systematic Review

Awai

Newton

Sirlin

et al. 2014

Clinical Gastroenterology and Hepatology

115

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Background & Aims Fatty liver is a common problem in children, and increases their risk for cirrhosis, diabetes, and cardiovascular disease. Liver biopsy is the clinical standard for diagnosing and grading fatty liver. However, non-invasive imaging modalities are needed to assess liver fat in children. We performed a systematic review of studies that evaluated imaging of liver fat in children. Methods We searched PubMed for original research articles in peer-reviewed journals from January 1, 1982 through December 31, 2012 using the key words “imaging liver fat.” Studies included those in English, and those performed in children from birth to 18 y of age. To be eligible for inclusion, studies were required to measure hepatic steatosis via an imaging modality and a quantitative comparator as the reference standard. Results We analyzed 9 studies comprising 610 children; 4 studies assessed ultrasonography and 5 assessed magnetic resonance imaging (MRI). Ultrasonography was used in the diagnosis of fatty liver with positive predictive values of 47–62%. There was not a consistent relationship between ultrasound steatosis score and the reference measurement of hepatic steatosis. Liver fat as measurements by MRI or by spectroscopy varied with the methodologies used. Liver fat measurements by MRI correlated with results from histologic analyses, but sample size did not allow for assessment of diagnostic accuracy. Conclusions Available evidence does not support the use of ultrasonography for the diagnosis or grading of fatty liver in children. Although MRI is a promising approach, the data are insufficient to make evidence-based recommendations regarding its use in children for assessment of hepatic steatosis.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evidence and Recommendations for Imaging Liver Fat in Children, Based on Systematic Review

Awai

Newton

Sirlin

et al. 2014

Clinical Gastroenterology and Hepatology

115

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“…Data from adolescents and adults, who participated in two studies in Tübingen, Germany, were included in this analysis. The adolescents participated in the Tübingen DISKUS study in which subjects were enrolled when having either a body mass index (BMI) > 99.5th percentile or > 90th percentile and at least one of the following metabolically relevant conditions: family history of type 2 diabetes, impaired glucose tolerance, or acanthosis nigricans . Adults participated in the Tübingen Lifestyle Intervention Program (TULIP), which was designed as a longitudinal intervention study for adult subjects at risk of developing insulin resistance and type 2 diabetes.…”

Section: Methodsmentioning

confidence: 99%

Relationships of body composition and liver fat content with insulin resistance in obesity‐matched adolescents and adults

Linder

Springer

Machann

et al. 2014

Obesity

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Objective: While in adults not total body-or visceral fat mass, but liver fat content was found to independently determine insulin resistance, it is unclear whether these relationships are already present in obese adolescents. Methods: Thirty-nine overweight/obese adolescents were matched for sex and BMI with 39 adults. To compare the age-and sex-specific BMI values of adolescents and adults, the percentile value of each adolescent was projected to the age of 18. Body fat depots were quantified by whole-body magnetic resonance (MR) imaging. Liver fat content was measured with 1 H-MR spectroscopy. Insulin resistance was estimated from the homeostasis model assessment of insulin resistance (HOMA-IR).Results: Compared to overweight and obese adults, adolescents had higher HOMA-IR (P < 0.001) and lower lean body mass (P 5 0.002). Furthermore, they had higher total body-(P 5 0.02), but lower visceral-(P < 0.001) fat mass, while liver fat content was not significantly different between the groups (P 5 0.16). In both groups liver fat content (both P 0.007), but not total body-or visceral fat mass (all P 0.64) was an independent predictor of insulin resistance. Conclusions: Having lower visceral fat mass, overweight and obese adolescents are more insulin resistant than sex-and BMI-matched adults. Liver fat content, but not total body-or visceral fat mass, is an independent determinant of insulin resistance in adolescents.

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“…Various imaging modalities, including magnetic resonance imaging, computed tomography, and US, have been used to assess patients with hepatic steatosis in a noninvasive fashion, with magnetic resonance imaging validated as the most accurate and effective method and US as the most cost‐effective . Although studies in children have shown that magnetic resonance imaging measurements were strongly correlated with the histologic grades of fat in liver with high sensitivity and specificity, its applicability in the pediatric population is limited because of the high cost and the requirement for sedation . Computed tomography, on the other hand, is not widely accepted as a method of choice because of the ionizing radiation.…”

Section: Discussionmentioning

confidence: 99%

A Practical Approach to Quantitative Grayscale Ultrasound Analysis of Hepatic Steatosis in Pediatric Patients Using a Picture Archiving and Communication System–Based Tool

Toslak

Lim-Dunham

Joyce

et al. 2018

J of Ultrasound Medicine

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Assessment of relevant hepatic steatosis in obese adolescents by rapid fat-selective GRE imaging with spatial-spectral excitation: a quantitative comparison with spectroscopic findings

Abstract: Fat-selective MR imaging provides both a reliable and a convenient method of rapidly quantifying IHL content in obese adolescents.

Cited by 9 publications

References 25 publications

Evidence and Recommendations for Imaging Liver Fat in Children, Based on Systematic Review

Evidence and Recommendations for Imaging Liver Fat in Children, Based on Systematic Review

Relationships of body composition and liver fat content with insulin resistance in obesity‐matched adolescents and adults

A Practical Approach to Quantitative Grayscale Ultrasound Analysis of Hepatic Steatosis in Pediatric Patients Using a Picture Archiving and Communication System–Based Tool

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