Comparison of CT Methods for Determining the Fat Content of the Liver

Kodama, Yoshihisa; Ng, Chaan S.; Wu, Tsung Teh; Ayers, Gregory D.; Curley, Steven A.; Abdalla, Eddie K.; Vauthey, Jean Nicolas; Charnsangavej, Chusilp

doi:10.2214/ajr.06.0992

Cited by 444 publications

(456 citation statements)

References 33 publications

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“…It is recognized that chemotherapy can induce toxic injury to the liver, primarily steatohepatitis and sinusoidal injury. Noncontrast CT and MRI may be used to assess steatosis [12][13][14], but steatohepatitis cannot be diagnosed with imaging. Sinusoidal injury can be judged by indirect signs of portal hypertension, particularly spleen size [15], or by using the liver-specific MRI contrast agent gadoxetic acid [16].…”

Section: Role Of Imaging In the Diagnosis Of Liver Metastasesmentioning

confidence: 99%

The Oncosurgery Approach to Managing Liver Metastases from Colorectal Cancer: A Multidisciplinary International Consensus

et al. 2012

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ABSTRACTpatients receive in different centers. Based on current evidence, the group agreed on a number of issues including the following: (a) the primary aim of treatment is achieving a long disease-free survival (DFS) interval following resection; (b) assessment of resectability should be performed with high-quality cross-sectional imaging, staging the liver with magnetic resonance imaging and/or abdominal computed tomography (CT), depending on local expertise, staging extrahepatic disease with thoracic and pelvic CT, and, in selected cases, fluorodeoxyglucose positron emission tomography with ultrasound (preferably contrastenhanced ultrasound) for intraoperative staging; (c) optimal first-line chemotherapy-doublet or triplet chemotherapy regimens combined with targeted therapy-is advisable in potentially resectable patients; (d) in this situation, at least four courses of first-line chemotherapy should be given, with assessment of tumor response every 2 months; (e) response assessed by the Response Evaluation Criteria in Solid Tumors (conventional chemotherapy) or nonsize-based morphological changes (antiangiogenic agents) is clearly correlated with outcome; no imaging technique is currently able to accurately diagnose complete pathological response but high-quality imaging is crucial for patient management; (f) the duration of chemotherapy should be as short as possible and resection achieved as soon as technically possible in the absence of tumor progression; (g) the number of metastases or patient age should not be an absolute contraindication to surgery combined with chemotherapy; (h) for synchronous metastases, it is not advisable to undertake major hepatic surgery during surgery for removal of the primary CRC; the reverse surgical approach (liver first) produces as good an outcome as the conventional approach in selected cases; (i) for patients with resectable liver metastases from CRC, perioperative chemotherapy may be associated with a modestly better DFS outcome; and (j) whether initially resectable or unresectable, cure or at least a long survival duration is possible after complete resection of the metastases, and MDT treatment is essential for improving clinical and survival outcomes. The group proposed a new system to classify initial unresectability based on technical and oncological contraindications.

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Section: Role Of Imaging In the Diagnosis Of Liver Metastasesmentioning

confidence: 99%

The Oncosurgery Approach to Managing Liver Metastases from Colorectal Cancer: A Multidisciplinary International Consensus

et al. 2012

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“…Mean splenic attenuation was also calculated by three random area ROI values of attenuation measurement on three transverse sections at different splenic levels. The size of each ROI was defined as 1.0-1.1 cm 2 (20). With splenic attenuation acting as a control or reference value, the liver attenuation index (LAI), defined as the difference between mean hepatic attenuation and mean splenic attenuation, was used as an indicator of the degree of hepatic steatosis.…”

Section: Ct Imagingmentioning

confidence: 99%

Improvement of Nonalcoholic Fatty Liver Disease With Carnitine-Orotate Complex in Type 2 Diabetes (CORONA): A Randomized Controlled Trial

et al. 2015

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OBJECTIVEWe aimed to evaluate the effects of carnitine-orotate complex in patients with nonalcoholic fatty liver disease (NAFLD) and diabetes. RESEARCH DESIGN AND METHODSEight hospitals in Korea participated in this randomized, controlled, double-blind trial of patients with diabetes and NAFLD. Seventy-eight patients were randomly assigned in a 1:1 ratio to receive carnitine-orotate complex (824 mg, three times daily) or matching placebo. The primary study outcome was decline in alanine aminotransferase (ALT) to the normal range. Secondary study outcomes were change in ALT, radiological hepatic steatosis, parameters for anthropometry, liver function, lipid profiles, and glycemic control. Hepatic steatosis was assessed using Hounsfield units on noncontrast computed tomography (CT) imaging with hepatic attenuation. RESULTSAfter 12 weeks of treatment, compared with placebo group, carnitine-orotate complex-treated participants had a significantly higher rate of normalization of serum ALT level (17.9% vs. 89.7%, P < 0.001). On hepatic CT analysis, participants treated with carnitine-orotate complex showed an increased liver attenuation index (0.74 6 8.05 vs. 6.21 6 8.96, P < 0.008). A significant decrease in HbA 1c was observed in the carnitine-orotate complex group (20.33 6 0.82% [23.6 6 9.0 mmol/mol], P = 0.007), but no significant change was seen in the placebo group. CONCLUSIONSTreatment with carnitine-orotate complex improves serum ALT and may improve hepatic steatosis as assessed by CT in patients with diabetes and NAFLD. Further studies using more advanced magnetic resonance imaging and liver histology as an end point are needed to assess its efficacy in NAFLD.Ectopic fat accumulation in a visceral organ is associated with insulin resistance (1). As an example of such ectopic fat accumulation, nonalcoholic fatty liver disease (NAFLD) is now recognized as the hepatic component of metabolic syndrome and is even reportedly associated with insulin resistance independent of obesity and other metabolic components. Therefore, NAFLD can be a major determinant of insulin

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“…Glycogenosis promotes the increase of hepatic radiodensity, as has been verified in human patients (Tsujimoto et al, 2006;Kodama et al, 2007;Kishnani et al, 2011) and rats (Leander et al, 2000). The accumulation of hepatic glycogen is the main cause for dense livers in human patients.…”

Section: Discussionmentioning

confidence: 79%

“…Some authors (Ohlerth and Sharf, 2007) verified a significant reduction of hepatic radiodensity in cats with lipidosis when compared with the control group. According to reports, there is a decrease in hepatic radiodensity of approximately 1.0 to 1.5 HU for each 1% increase in the concentration of lipids in the organ (Leander et al, 2000;Kodama et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…The evaluation of abdominal organs' radiodensity is widely performed in human patients (Leander et al, 2000;Tsujimoto et al, 2006, Kodama et al, 2007 and can be employed with high precision and reproducibility in animals, helping in the diagnosis of alterations in several organs (Ohlerth andSharf, 2007, Teixeira et al, 2007;Costa et al, 2010). A recent study demonstrated the occurrence of steroid hepatopathy in a dog subjected to prolonged corticosteroid therapy, with an increase of the parenchymal liver radiodensity (Costa et al, 2011).…”

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confidence: 99%

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Quantitative computed tomography of the liver in dogs submitted to prednisone therapy

Costa

Oliveira

Lopes

et al. 2013

Arq. Bras. Med. Vet. Zootec.

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The aim of this study is to evaluate the possible alterations in radiodensity of the hepatic parenchyma and spleen resulting from the corticotherapy with prednisone, correlating these findings with serum biochemical hepatic transaminase activity. A clinical trial was performed on eight healthy dogs with the intent of evaluating possible hepatic alterations after prednisone therapy using quantitative computed tomography. All animals received prednisone orally at a dose of 2mg/kg of weight for 30 days. The radiodensity of the liver and spleen was determined before and after the period that the medication was administered. An increase in the radiodensity of the hepatic parenchyma between the initial and final experimental stages was observed. In the present study the existence of early hepatic alterations were verified, which are compatible with glycogen storage.

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Comparison of CT Methods for Determining the Fat Content of the Liver

Abstract: Measurement of attenuation of liver only on unenhanced CT scans is best for prediction of pathologic fat content.

Cited by 444 publications

References 33 publications

The Oncosurgery Approach to Managing Liver Metastases from Colorectal Cancer: A Multidisciplinary International Consensus

The Oncosurgery Approach to Managing Liver Metastases from Colorectal Cancer: A Multidisciplinary International Consensus

Improvement of Nonalcoholic Fatty Liver Disease With Carnitine-Orotate Complex in Type 2 Diabetes (CORONA): A Randomized Controlled Trial

Quantitative computed tomography of the liver in dogs submitted to prednisone therapy

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