Magnetic Resonance Fat Quantification in Living Donor Liver Transplantation

Chiang, Hsien-Wen; Lin, Li; Li, C.-W.; Lin, Chih‐Che; Chiang, Hsing-I; Huang, Tung‐Liang; Chen, C.-L.; Cheng, Yu‐Fan

doi:10.1016/j.transproceed.2013.11.050

Cited by 31 publications

(35 citation statements)

References 14 publications

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“…Interestingly, as noted in our study, they reported low PPVs with MRI for the detection of hepatic steatosis. Joe et al and Chiang et al also used IDEAL‐reported high specificity and sensitivity of MRI for the detection of hepatic steatosis among donors with a more restrictive threshold of >5%. To our knowledge, only 3 studies have examined the use of multiecho Dixon techniques for the assessment of hepatic fat among donor candidates …”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, only 3 studies have examined the use of multiecho Dixon techniques for the assessment of hepatic fat among donor candidates. (29,30,33) A number of earlier studies have also validated the role of MRI in noninvasive hepatic steatosis quantification outside of the transplant assessment setting. (34)(35)(36)(37) Van Werven et al (34) demonstrated high sensitivity and specificity of MRI and MRS-PDFF for identifying hepatic steatosis among patients undergoing liver resection with a histopathology cutoff value of 5%.…”

Section: Discussionmentioning

confidence: 99%

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Can negligible hepatic steatosis determined by magnetic resonance imaging–proton density fat fraction obviate the need for liver biopsy in potential liver donors?

et al. 2018

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The purpose of this study is to determine whether magnetic resonance (MR)-proton density fat fraction (PDFF) estimate of negligible hepatic fat percentage (<5%) can exclude significant hepatic steatosis (≥10%) in living liver donor candidates obviating the need for liver biopsy and to perform intraindividual comparisons between MR-PDFF techniques for hepatic steatosis quantification. In an ethics-approved retrospective study, 144 liver donor candidates with magnetic resonance spectroscopy (MRS) and 6-echo Dixon magnetic resonance imaging (MRI) between 2013 and 2015 were included. A subset of 32 candidates underwent liver biopsy. Hepatic fat percentage was determined using MR-PDFF and histopathology-determined fat fraction as the reference standard. A receiver operating characteristic analysis with positive predictive value, negative predictive value (NPV), sensitivity, and specificity was performed to discriminate between clinically significant steatosis (≥10%) or not (<10%) at MRS-PDFF and MRI-PDFF thresholds of 5% and 10%. Pearson correlation and Bland-Altman analyses between MRS-PDFF and MRI-PDFF were performed for intraindividual comparison of hepatic steatosis estimation. There was significant association between MRS-PDFF and MRI-PDFF with HP-FP. High NPV of 95% (95% confidence interval [CI], 78%-99%) and 100% (95% CI, 76%-100%) as well as an area under the curve of 0.90 (95% CI, 0.79-1.0) and 0.93 (95% CI, 0.84-1.0) were obtained with a cutoff threshold of 5% MRI-PDFF and MRS-PDFF, respectively, to exclude clinically significant steatosis (≥10%). Intraindividual comparison between MRS-PDFF and MRI-PDFF showed a Pearson correlation coefficient of 0.83. Bland-Altman analysis showed a mean difference of 1% with 95% limits of agreement between -1% and 3%. MR-PDFF estimate of negligible hepatic fat percentage (<5%) has sufficient NPV for excluding clinically significant hepatic steatosis (≥10%) in living liver donor candidates obviating the need for liver biopsy. It may be sufficient to acquire only the multiecho Dixon MRI-PDFF for hepatic steatosis estimation. Liver Transplantation 24 470-477 2018 AASLD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Can negligible hepatic steatosis determined by magnetic resonance imaging–proton density fat fraction obviate the need for liver biopsy in potential liver donors?

et al. 2018

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“…Chemical shift imaging and iterative decomposition of water and fat with echo asymmetry and least squares estimation fat fraction imaging can obtain liver fat fraction for quantification of hepatic steatosis in the liver [17], but this is only the ratio not the fat concentration. MRS is the only noninvasive modality that can be used to determine the absolute liver fat concentration in liver.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Spectroscopy in Living-Donor Liver Transplantation

Chiang

Chang

Lazo

et al. 2016

Transplantation Proceedings

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“…Simpler lipid-to-water resonance ratios have been used to compare hepatic steatosis between obese and lean individuals and have demonstrated a change in intrahepatic lipid in response to dietary intervention[102-104]. 1 H MRS also has also been applied to the assessment of steatosis in living-donor liver transplantation[105] and for quantification of steatosis in HIV mono-infected individuals who are at greater risk of liver fibrosis and cirrhosis[106]. …”

Section: Imaging-based Modalities As Alternatives To Biopsymentioning

confidence: 99%

Hepatic steatosis and fibrosis: Non-invasive assessment

Karanjia¹,

Crossey²,

Cox³

et al. 2016

WJG

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Chronic liver disease is a major cause of morbidity and mortality worldwide and usually develops over many years, as a result of chronic inflammation and scarring, resulting in end-stage liver disease and its complications. The progression of disease is characterised by ongoing inflammation and consequent fibrosis, although hepatic steatosis is increasingly being recognised as an important pathological feature of disease, rather than being simply an innocent bystander. However, the current gold standard method of quantifying and staging liver disease, histological analysis by liver biopsy, has several limitations and can have associated morbidity and even mortality. Therefore, there is a clear need for safe and non-invasive assessment modalities to determine hepatic steatosis, inflammation and fibrosis. This review covers key mechanisms and the importance of fibrosis and steatosis in the progression of liver disease. We address non-invasive imaging and blood biomarker assessments that can be used as an alternative to information gained on liver biopsy.

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Magnetic Resonance Fat Quantification in Living Donor Liver Transplantation

Cited by 31 publications

References 14 publications

Can negligible hepatic steatosis determined by magnetic resonance imaging–proton density fat fraction obviate the need for liver biopsy in potential liver donors?

Can negligible hepatic steatosis determined by magnetic resonance imaging–proton density fat fraction obviate the need for liver biopsy in potential liver donors?

Magnetic Resonance Spectroscopy in Living-Donor Liver Transplantation

Hepatic steatosis and fibrosis: Non-invasive assessment

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