Quantification of Liver Fat Content: Comparison of Triple-Echo Chemical Shift Gradient-Echo Imaging and in Vivo Proton MR Spectroscopy

Guiu, Boris; Petit, Jean‐Michel; Loffroy, Romaric; Salem, Douraı̈ed Ben; Aho, Serge; Masson, David; Hillon, Patrick; Krausé, D.; Cercueil, Jean-Pierre

doi:10.1148/radiol.2493080217

Cited by 172 publications

(194 citation statements)

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“…It produces separate fat and water images covering a large fi eld of view and is suitable for the assessment of fat content in whole organs such as the pancreas. Th e measurements are reproducible and accurate, and have been validated against histology in animal models ( 22,23 ). In this study, we performed MRI on a large general population cohort to measure pancreatic and liver fat.…”

Section: Introductionmentioning

confidence: 99%

Fatty Pancreas, Insulin Resistance, and β-Cell Function: A Population Study Using Fat-Water Magnetic Resonance Imaging

Wong

Yeung

et al. 2014

American Journal of Gastroenterology

221

181

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OBJECTIVES:Nonalcoholic fatty liver disease is the most common chronic liver disease. Fatty pancreas has also been described but is diffi cult to assess. It is now possible to measure pancreatic and liver fat accurately with magnetic resonance imaging (MRI). We aimed to defi ne the normal range of pancreatic fat and identify factors associated with fatty pancreas. In addition, the effect of fatty liver and fatty pancreas on insulin resistance (IR) and pancreatic ␤ -cell function was studied. METHODS:Fat-water MRI and proton-magnetic resonance spectroscopy were performed on 685 healthy volunteers from the general population to measure pancreatic and liver fat, respectively. On the basis of fasting plasma glucose and insulin levels, the IR and ␤ -cell function were assessed using the homeostasis model assessment (HOMA). RESULTS:Among subjects without signifi cant alcohol consumption or any component of metabolic syndrome, 90 % had pancreatic fat between 1.8 and 10.4 % . Using the upper limit of normal of 10.4 % , 110 (16.1 % ; 95 % confi dence interval 13.3 -18.8 % ) subjects had fatty pancreas. On multivariable analysis, high serum ferritin, central obesity, and hypertriglyceridemia were independent factors associated with fatty pancreas. Subjects with both fatty pancreas and fatty liver had higher HOMA-IR than did those with either condition alone. Fatty pancreas was not associated with HOMA-β after adjusting for liver fat and body mass index.CONCLUSIONS: In all, 16.1 % of this community cohort of adult Hong Kong Chinese volunteers had a fatty pancreas by our defi nition. Central obesity, hypertriglyceridemia, and hyperferritinemia are associated with fatty pancreas. Individuals with fatty pancreas have increased IR.

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Section: Introductionmentioning

confidence: 99%

Fatty Pancreas, Insulin Resistance, and β-Cell Function: A Population Study Using Fat-Water Magnetic Resonance Imaging

Wong

Yeung

et al. 2014

American Journal of Gastroenterology

221

181

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“…1 H MRS provides a measurement of TAG and water in a region of interest, which are influenced by the tissue assessed and the sequences used. Multi-echo MRI techniques also measure fat content comparing the signal phase and relaxation time from each component (fat and water) to calculate the relative abundance (14) . This approach has the benefit of enabling fat distribution to be visualised and reduce the need for post-processing.…”

Section: Case Definitionmentioning

confidence: 99%

The importance of fatty liver disease in clinical practice

2010

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The worldwide obesity epidemic over the last 20 years has led to a dramatic increase in the prevalence of non-alcoholic fatty liver disease, the hepatic manifestation of the metabolic syndrome. Estimates of prevalence vary depending on the population studied and the methods used to assess hepatic fat content, but are commonly quoted as between 10 and 30% of the adults in the Western hemisphere. Fatty liver develops when fatty acid uptake and synthesis in the liver exceeds fatty acid oxidation and export as TAG. Studies of pathogenesis point to insulin resistance, lipotoxicity, oxidative stress and chronic inflammation being central to the development and progression of the disease. A proportion of individuals with fatty liver develop progressive disease, though large prospective longitudinal studies are lacking. Nevertheless, fatty liver is associated with increased all-cause and liver-related mortality compared with the general population. Management of fatty liver centres around lifestyle and dietary measures to induce controlled and sustained weight loss. Management of cardiovascular risk factors aims to reduce mortality, while certain dietary interventions have been shown to reduce steatosis and inflammation. Specific pharmacological treatments also show promise, but their use is not widespread. A multi-system and multi-disciplinary approach to the management of this disorder is proposed.

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“…T2 weighted imaging showed the fat lesions as a diffuse hyper-signal in CDAA liver, compared to controls. The increased signal in the CDAA group is due to the longer T2 relaxation time of fat compared to water [186,225,226]. Nodular lesions were easily distinguishable from the surrounding liver tissue at 24 weeks, appearing as hypo-intense signal on T2 images and hyper-intense signal on both IP and OP images.…”

Section: Discussionmentioning

confidence: 92%

“…Accurate determination of liver fat and characterisation of clinical markers as a risk factor for HCC would be extremely valuable. The current standard of fat quantitation by magnetic resonance imaging (MRI) is by in / out-phase (IPOP) Dixon imaging, multiple-point Dixon, or localized spectroscopy [186,187]. Clinically, the IPOP technique is often used for fat fraction determination due to it being widely available and relatively rapid acquisition times.…”

Section: Introductionmentioning

confidence: 99%

“…When T2 * decay is significant, the three echo Dixon method can be used to estimate hepatic fat fraction with the added advantage of yielding a rough estimate of T2 * and thus iron load but may be affected by T1 longitudinal relaxation [188,189]. MR spectroscopy can provide accurate quantitative measurements of liver fat, but it is limited to single or coarse multiple voxels and in the liver can be of low sensitivity and spectral resolution [190][191][192].…”

Section: Introductionmentioning

confidence: 99%

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Magnetic resonance characterisation of developing hepatocellular carcinoma in a diet induced model of liver cancer in the rat

Alghamdi¹

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Non-alcoholic fatty liver disease (NAFLD), a disorder associated with abnormal lipid accumulation within hepatocytes, is considered benign disorder in nature. However, in some cases it may progress to inflammation, nonalcoholic steatohepatitis (NASH), then cirrhosis, precancerous nodules and finally to hepatocellular carcinoma (HCC). NAFLD and NASH are both reversible with appropriate clinical intervention and lifestyle changes. In developed countries, the non-alcoholic fatty liver disease (NAFLD) is becoming one of the most common causes of precancerous and HCC lesions [1]. Unfortunately, most nodular lesions are detected too late with a poor prognosis. The discovery of markers that can predict which livers may progress to HCC would allow early intervention and potentially halting progress to HCC. This would be of great benefit at any stage up to precancerous lesions, however the earlier the better.Development of end stage liver malignancy would be decreased, resulting in decreased mortality from this disease.Histology is considered the reference standard for the assessment of fatty disease and nodular lesion in liver. However, there are significant drawbacks including invasiveness, small sample size and observer-dependence which limits its usefulness in evaluating liver disease.Magnetic resonance imaging is a non-invasive modality that can provide information on anatomical and physiological changes in the liver (e.g. fatty liver disease and HCC). MRI images are primarily assessed visually by expert radiologists looking for anatomical and contrast changes in the images compared to normal tissue. This qualitative method requires inspection of all datasets for abnormalities. Visual interpretation is subjective, labour intensive, and depends on the experience of the radiologist. This can introduce inter-observer variation and is suitable only when the pathology leads to sufficient contrast changes in the images acquired.MRI also allows the calculation of quantitative parameters like T1, T2 and diffusion values. These parameters are dependent on physical, chemical and microstructural properties of the tissue. When standard protocols are used, the calculation of these parameters should be independent of the observer. This has the potential for more precise characterization of changes that occur over time. Clinically, here has been limited utilization of these methods, as they generally require longer acquisition times and significant post processing of the images. Declaration by authorThis thesis is composed of my original work, and contains no material previously published or written by another person except where due reference has been made in the text.

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Quantification of Liver Fat Content: Comparison of Triple-Echo Chemical Shift Gradient-Echo Imaging and in Vivo Proton MR Spectroscopy

Cited by 172 publications

References 53 publications

Fatty Pancreas, Insulin Resistance, and β-Cell Function: A Population Study Using Fat-Water Magnetic Resonance Imaging

Fatty Pancreas, Insulin Resistance, and β-Cell Function: A Population Study Using Fat-Water Magnetic Resonance Imaging

The importance of fatty liver disease in clinical practice

Magnetic resonance characterisation of developing hepatocellular carcinoma in a diet induced model of liver cancer in the rat

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