Quantification of steatosis in alcoholic and nonalcoholic fatty liver disease: Evaluation of four MR techniques versus biopsy

• Published in: European journal of radiology Vol. 118; pp. 169 - 174
• Main Authors: Boudinaud, Claire, Abergel, Armand, Joubert-Zakeyh, Juliette, Fontarensky, Mikael, Pereira, Bruno, Chauveau, Benoit, Garcier, Jean Marc, Chabrot, Pascal, Boyer, Louis, Magnin, Benoît
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.09.2019
• Subjects: Adult; Aged; Aged, 80 and over; Biopsy; Fatty liver; Fatty Liver - diagnostic imaging; Fatty Liver - pathology; Female; Histological techniques; Humans; Liver - diagnostic imaging; Liver - pathology; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Magnetic Resonance Spectroscopy - methods; Male; Middle Aged; Non-alcoholic Fatty Liver Disease - diagnostic imaging; Non-alcoholic Fatty Liver Disease - pathology; Reproducibility of Results; Spectrum analysis; ALAT; ALP; Histological techniques; HCC; ROI; 18F-FDG PET/CT; HDL; PDFF; Fatty liver; Magnetic resonance imaging; GGT; LDL; Spectrum analysis; ASAT
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2019.07.025

•MR allows a non invasive and reliable quantification of hepatic steatosis, avoiding biopsy.•All four MR techniques tested in our study are applicable in daily practice.•Reliability of the different MR techniques isn’t affected by underlying liver diseases. Given the growing prevalence of obesity and metabolic syndrome, the management of hepatic steatosis, especially its quantification, is a major issue. We assessed the quantification of liver steatosis using four different MR methods, in order to determine the one that is best correlated with the reference method which consists of histological measurement by liver biopsy. Seventy-one successive patients requiring liver biopsy for acute or chronic liver disease were enrolled prospectively between March 2017 and March 2018, 11 were excluded and 60 were reported. Liver MR (1.5 T) was organised in order to be performed the same day, using four different steatosis quantification techniques (3-echo MRI, 6-echo MRI, 11-echo MRI and MR Spectroscopy). Quantitative histological and imaging data were compared. In a secondary analysis, we studied the possible influence of alcohol drinking, hepatic iron overload, and the presence of liver fibrosis. All four MR techniques were found to have excellent correlations with the histological measurements: 3-echo MRI (r = 0.852, p < 0.001), 6-echo MRI (r = 0.819, p < 0.001), 11-echo MRI (r = 0.818, p < 0.001) and MR Spectroscopy (r = 0,812, p < 0,001). Interestingly, we also found that the presence of alcohol consumption, iron overload and fibrosis did not interfere with measurements, whichever technique was used. In the evaluation of hepatic steatosis, our study showed very good correlations of all four MR techniques with the histological standard. There was no confounding factor in a representative group of patients with associated liver conditions such as alcohol consumption, fibrosis and iron overload, for each technique. All four MR techniques may be used in daily practice.