Using a 3% Proton Density Fat Fraction as a Cut-Off Value Increases Sensitivity of Detection of Hepatic Steatosis, Based on Results From Histopathology Analysis

Nasr, Patrik; Forsgren, Mikael; Ignatova, Simone; Dahlström, Nils; Cedersund, Gunnar; Leinhard, Olof Dahlqvist; Norén, Bengt; Ekstedt, Mattias; Lundberg, Peter; Kechagias, Stergios

doi:10.1053/j.gastro.2017.03.005

Cited by 56 publications

(55 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results suggest that R2* increases by around 1 s ‐1 for every percentage point of PDFF at 1.5 T. Moreover, patients with severe steatosis can have a PDFF of up to 30%; R2* may thus be confounded by up to 30 s ‐1 . Since patients with severe iron overload can have a liver R2* of several hundred s ‐1 , considering the effect of PDFF may not be necessary in such patients.…”

Section: Discussionmentioning

confidence: 73%

“…The imaging used the following parameters: Liver PDFF was measured by MRS (PRESS sequence, TR = 1500 msec, TE = 35 msec, volume of interest [VOI] = 30 × 30 × 30 mm 3 , NSA = 8), as described previously. 24 The amplitudes of the water and fat resonances were quantified using jMRUI and the AMARES algorithm. 25 The amplitudes of the water and fat resonances were corrected for differences in T 1 and T 2 relaxation times.…”

Section: Mr Measurementsmentioning

confidence: 99%

See 1 more Smart Citation

Liver R2* is affected by both iron and fat: A dual biopsy‐validated study of chronic liver disease

Karlsson

Ekstedt

Dahlström

et al. 2019

Magnetic Resonance Imaging

Self Cite

View full text Add to dashboard Cite

Background Liver iron content (LIC) in chronic liver disease (CLD) is currently determined by performing an invasive liver biopsy. MRI using R2* relaxometry is a noninvasive alternative for estimating LIC. Fat accumulation in the liver, or proton density fat fraction (PDFF), may be a possible confounder of R2* measurements. Previous studies of the effect of PDFF on R2* have not used quantitative LIC measurement. Purpose To assess the associations between R2*, LIC, PDFF, and liver histology in patients with suspected CLD. Study Type Prospective. Population Eighty‐one patients with suspected CLD. Field Strength/Sequence 1.5 T. Multiecho turbo field echo to quantify R2*. PRESS MRS to quantify PDFF. Assessment Each patient underwent an MR examination, followed by two needle biopsies immediately following the MR examination. The first biopsy was used for conventional histological assessment of LIC, whereas the second biopsy was used to quantitatively measure LIC using mass spectrometry. R2* was correlated with both LIC and PDFF. A correction for the influence of fat on R2* was calculated. Statistical Tests Pearson correlation, linear regression, and area under the receiver operating curve. Results There was a positive linear correlation between R2* and PDFF (R = 0.69), after removing data from patients with elevated iron levels, as defined by LIC. R2*, corrected for PDFF, was the best method for identifying patients with elevated iron levels, with a correlation of R = 0.87 and a sensitivity and specificity of 87.5% and 98.6%, respectively. Data Conclusion PDFF increases R2*. Level of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:325–333.

show abstract

Section: Discussionmentioning

confidence: 73%

Section: Mr Measurementsmentioning

confidence: 99%

Liver R2* is affected by both iron and fat: A dual biopsy‐validated study of chronic liver disease

Karlsson

Ekstedt

Dahlström

et al. 2019

Magnetic Resonance Imaging

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, no study has investigated the association of quantitative liver fat measured by MRI‐PDFF and its effect on the development of T2DM. Although SPC and MR techniques are measuring fundamentally different properties of tissue, the correlation of hepatic fat content measured with SPC and 1 H‐MRS is excellent 20 . Thus, most likely non‐invasive measurement of HTGC with MR techniques in NAFLD patients can be used to assess the risk of development of T2DM in prospective cohort studies or pharmaceutical trials.…”

Section: Discussionmentioning

confidence: 99%

“…This method has been described elsewhere 20 . In short, a Nikon Eclipse E800 microscope with a Nikon DS‐Ri1 digital camera was used to capture all tissue images for histopathology analysis.…”

Section: Methodsmentioning

confidence: 99%

“…The clinical application of quantifying hepatic steatosis has increased in recent years, mainly because of the access to magnetic resonance (MR) techniques as non‐invasive alternatives for diagnosing NAFLD and monitoring changes in hepatic steatosis during clinical trials 17‐19 . SPC correlates excellently with hepatic triglyceride content (HTGC) measured with MR 20 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The amount of liver fat predicts mortality and development of type 2 diabetes in non‐alcoholic fatty liver disease

Nasr

Fredrikson

Ekstedt

et al. 2020

Liver International

Self Cite

View full text Add to dashboard Cite

Background & Aims: Non-alcoholic fatty liver disease (NAFLD) is a risk factor for development of type 2 diabetes mellitus (T2DM). We aimed to evaluate whether conventional histological grading of steatosis and accurate quantification of fat content in liver biopsies using stereological point counting (SPC) can predict mortality and future development of T2DM in NAFLD patients.Methods: 129 patients with biopsy proven NAFLD, enrolled between 1988 and 1992, were re-evaluated on two occasions, after 13.7 (±1.5) and 23.2 (±6.8) years. In patients accepting to undergo the procedure, repeat liver biopsies were performed on each follow-up and were evaluated with conventional histopathological methodology and SPC. Results: Of the 106 patients without T2DM at baseline, 66 (62%) developed T2DM during a mean follow-up of 23.2 (± 6.8) years. Steatosis grade and liver fat measured with SPC independently (adjusted for age, BMI, fibrosis stage) predicted development of T2DM with an aHR of 1.60 per grade and 1.03 for each SPC percentage increase respectively. Overall mortality and development of T2DM was more common in patients with grade 3 steatosis compared to lower grades of steatosis. Liver fat measured with SPC was significant for overall mortality (aHR 1.04). In patients that underwent repeat biopsy, reduction in liver fat measured with SPC was associated with decreased risk of developing T2DM (aHR 0.91 for each SPC percentage decrease). Conclusion: Steatosis grade and liver fat measured with SPC predict mortality and the risk of developing T2DM in NAFLD. Reduction in liver fat decreases the risk of developing T2DM.

show abstract

Differential fat accumulation in early adulthood according to adolescent‐BMI and heavy metal exposure

Betanzos-Robledo

Téllez‐Rojo

Lamadrid‐Figueroa³

et al. 2022

New Drctns Chld & Adlscnt

View full text Add to dashboard Cite

Introduction: Heavy metals such as Lead (Pb) and Mercury (Hg) can affect adipose tissue mass and function. Considering the high prevalence of exposure to heavy metals and obesity in Mexico, we aim to examine if exposure to Pb and Hg in adolescence can modify how fat is accumulated in early adulthood. Methods: This study included 100 participants from the ELEMENT cohort in Mexico. Adolescent Pb and Hg blood levels were determined at 14-16 years. Age-and sex-specific adolescent BMI Z-scores were calculated. At early adulthood (21-22 years), fat accumulation measurements were performedThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

show abstract

Using a 3% Proton Density Fat Fraction as a Cut-Off Value Increases Sensitivity of Detection of Hepatic Steatosis, Based on Results From Histopathology Analysis

Cited by 56 publications

References 23 publications

Liver R2* is affected by both iron and fat: A dual biopsy‐validated study of chronic liver disease

Liver R2* is affected by both iron and fat: A dual biopsy‐validated study of chronic liver disease

The amount of liver fat predicts mortality and development of type 2 diabetes in non‐alcoholic fatty liver disease

Differential fat accumulation in early adulthood according to adolescent‐BMI and heavy metal exposure

Contact Info

Product

Resources

About