Quantitative Imaging Biomarkers of NAFLD

Kinner, Sonja; Reeder, Scott B.; Yokoo, Takeshi

doi:10.1007/s10620-016-4037-1

Cited by 83 publications

(67 citation statements)

References 98 publications

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“…Conventional ultrasound (US) is the most common method for the qualitative assessment of hepatic steatosis (HS) because of its ready availability and low cost. On US, a steatotic liver appears brighter than surrounding structures because of the increased sound‐wave scatter and attenuation from lipid‐laden vesicles . In a meta‐analysis of 28 studies using US to evaluate HS, the mean sensitivity of ultrasonography (USG) for the identification of HS compared with liver biopsy ranged from 73% to 91% .…”

Section: Ultrasoundmentioning

confidence: 99%

“…On US, a steatotic liver appears brighter than surrounding structures because of the increased soundwave scatter and attenuation from lipid-laden vesicles. (15) In a meta-analysis of 28 studies using US to evaluate HS, the mean sensitivity of ultrasonography (USG) for the identification of HS compared with liver biopsy ranged from 73% to 91%. (16) For mild steatosis (0%-10%) on liver biopsy, however, sensitivity dropped to 62.2%-81.2%.…”

Section: Ultrasoundmentioning

confidence: 99%

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Noninvasive imaging methods to determine severity of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis

Hannah

Harrison

2016

Hepatology

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Nonalcoholic fatty liver disease (NAFLD) is now the most common form of liver disease in developed countries, with an estimated prevalence of 20%-30% and increasing to as high as 90% in diabetics. As the rates of NAFLD continue to rise in parallel with those of the obesity pandemic, it is increasingly important to differentiate those patients with the highest risk of progression to fibrosis and cirrhosis. In fact, those patients with nonalcoholic steatohepatitis (NASH) and fibrosis are at the greatest risk of progression to advanced disease, cirrhosis, and hepatocellular cancer and are more likely to develop liver-related mortality. Thus, it is critically important to distinguish between NASH and non-NASH NAFLD. Whereas liver biopsy remains the gold standard for staging of disease, complications of this procedure and other well-recognized limitations make it impractical for widespread use given the overall NAFLD disease burden. Noninvasive imaging modalities are increasingly being utilized to evaluate and stage NAFLD in patients with such a wide spectrum of disease. In this article, the role of these new and promising noninvasive imaging modalities to assess disease severity in NAFLD are reviewed. (Hepatology 2016;64:2234-2243).

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Section: Ultrasoundmentioning

confidence: 99%

Section: Ultrasoundmentioning

confidence: 99%

Noninvasive imaging methods to determine severity of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis

Hannah

Harrison

2016

Hepatology

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“…Dual echo chemical shift MRI originally described by Dixon has also been studied extensively but is susceptible to

{normalT}_{2}^{*}

effects which can lead to underestimation of hepatic fat . More recently, multiecho modified Dixon techniques with estimation of proton density fat fraction (PDFF) have been developed to allow for correction of

{normalT}_{2}^{*}

decay and other confounding factors . MRI has already been used in donor assessment for examining hepatic vascular and biliary anatomy .…”

mentioning

confidence: 99%

“…(17,23) More recently, multiecho modified Dixon techniques with estimation of proton density fat fraction (PDFF) have been developed to allow for correction of T Ã 2 decay and other confounding factors. (24)(25)(26) MRI has already been used in donor assessment for examining hepatic vascular and biliary anatomy. (27) A few studies have examined the role of MRI-based fat quantification in potential liver donors with a view to adopt a more selective role for liver biopsy.…”

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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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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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“…Compared with liver biopsy as the gold standard, liver imaging examination is more commonly used in clinical work. Ultrasound, CT and MRI have high sensitivity and specificity in the diagnosis of liver steatosis (26,27). According to the Chinese guidelines for the prevention and treatment of NAFLD (2018 updated edition) (28), the diagnosis of NAFLD should meet the following requirements: (1) liver biopsy indicates significant hepatic steatosis and/or imaging examination, such as ultrasound, CT and MRI results consistent with the manifestations of fatty liver, which liver fat content is more than 5%, (2) no history of alcohol consumption more than 30 g for men and 20 g for women per day, and (3) rule out other factors or diseases that contribute to hepatic steatosis.…”

Section: Imaging Evaluation Of the Liver Metastasis Assessmentmentioning

confidence: 99%

Effect of Non-alcoholic Fatty Liver Disease on the Risk of Synchronous Liver Metastasis: Analysis of 451 Consecutive Patients of Newly Diagnosed Colorectal Cancer

Zhang

2020

Front. Oncol.

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Background: The purpose of this study was to investigate the effect of non-alcoholic fatty liver disease (NAFLD) on the risk of synchronous colorectal liver metastasis (synCRLM).Methods: A retrospective analysis was performed on 451 consecutive patients with newly diagnosed colorectal cancer (CRC) from January 2014 to January 2019. According to the presence of NAFLD, the CRC patients were divided into two groups, NAFLD group (60 cases) and the control group (391 cases). The clinicopathological features and the prevalence of synCRLM between the two groups were compared. Logistic regression analysis was used to analyze the risk factors of synCRLM. Different non-invasive liver fibrosis scoring models were used to evaluate the effect of advanced fibrosis and cirrhosis stage in NAFLD on the prevalence of synCRLM.Results: The prevalence of synCRLM was significantly higher in patients with NAFLD than that in patients without NAFLD (18.33 vs. 7.42%; χ 2 = 7.669, P = 0.006). A logistic regression analysis indicated that NAFLD, CEA, CA19-9, and lymph node status were risk factors for synCRLM, and NAFLD showed the highest hazard ratio (3.930 [95% confidence interval: 1.616 ∼ 9.560]). In NAFLD patients, both fibrosis-4 index (FIB-4) and NAFLD fibrosis score (NFS) were significantly lower in those with synCRLM compared to those without synCRLM [FIB-4: 1.246 (0.833 ∼ 1.276) vs. 1.436 (1.016 ∼ 2.699), Z = −2.130, P = 0.033; NFS: −1.282 (−2.407 ∼ −0.262) vs. −0.255 (−1.582 ∼ 0.755), Z = −2.302, P = 0.021; Mann-Whitney test].Conclusion: NAFLD may be associated with increased liver metastasis, and for NAFLD-related advanced liver fibrosis and cirrhosis may be associated with reduced synchronous liver metastasis in CRC patients. However, the correlation between simple steatosis and steatohepatitis remains to be further determined. Certain factors such as NAFLD, lymph node metastasis, elevated levels of preoperative CEA and CA19-9 are suggesting a high risk of synCRLM.

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Quantitative Imaging Biomarkers of NAFLD

Cited by 83 publications

References 98 publications

Noninvasive imaging methods to determine severity of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis

Noninvasive imaging methods to determine severity of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis

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

Effect of Non-alcoholic Fatty Liver Disease on the Risk of Synchronous Liver Metastasis: Analysis of 451 Consecutive Patients of Newly Diagnosed Colorectal Cancer

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