Journal of Gastroenterology and Hepatology

Volume 29, Issue 4 pp. 807-813

Hepatology

Quantification of hepatic steatosis: A comparison of the accuracy among multiple magnetic resonance techniques

Chih-Horng Wu,

Chih-Horng Wu

Department of Medical Imaging, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan

Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan

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Ming-Chih Ho,

Corresponding Author

Ming-Chih Ho

Department of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

Correspondence

Prof Tiffany Ting-Fang Shih, Department of Radiology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan. Email: [email protected]

Dr Ming-Chih Ho, Department of Surgery, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan. Email: [email protected]

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Yung-Ming Jeng,

Yung-Ming Jeng

Department of Pathology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

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Chao-Yu Hsu,

Chao-Yu Hsu

Department of Medical Imaging, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan

Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan

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Po-Chin Liang,

Po-Chin Liang

Department of Medical Imaging, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

Department of Radiology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

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Rey-Heng Hu,

Rey-Heng Hu

Department of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

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Hong-Shiee Lai,

Hong-Shiee Lai

Department of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

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Tiffany Ting-Fang Shih,

Corresponding Author

Tiffany Ting-Fang Shih

Department of Medical Imaging, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

Department of Radiology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

Correspondence

Prof Tiffany Ting-Fang Shih, Department of Radiology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan. Email: [email protected]

Dr Ming-Chih Ho, Department of Surgery, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan. Email: [email protected]

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Chih-Horng Wu,

Chih-Horng Wu

Department of Medical Imaging, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan

Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan

Search for more papers by this author

Ming-Chih Ho,

Corresponding Author

Ming-Chih Ho

Department of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

Correspondence

Prof Tiffany Ting-Fang Shih, Department of Radiology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan. Email: [email protected]

Dr Ming-Chih Ho, Department of Surgery, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan. Email: [email protected]

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Yung-Ming Jeng,

Yung-Ming Jeng

Department of Pathology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

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Chao-Yu Hsu,

Chao-Yu Hsu

Department of Medical Imaging, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan

Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan

Search for more papers by this author

Po-Chin Liang,

Po-Chin Liang

Department of Medical Imaging, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

Department of Radiology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

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Rey-Heng Hu,

Rey-Heng Hu

Department of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

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Hong-Shiee Lai,

Hong-Shiee Lai

Department of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

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Tiffany Ting-Fang Shih,

Corresponding Author

Tiffany Ting-Fang Shih

Department of Medical Imaging, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

Department of Radiology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

Correspondence

Prof Tiffany Ting-Fang Shih, Department of Radiology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan. Email: [email protected]

Dr Ming-Chih Ho, Department of Surgery, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan. Email: [email protected]

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First published: 13 November 2013

https://doi.org/10.1111/jgh.12451

Citations: 34

Declaration of conflict of interest: The authors declare that there is no conflict of interest.

Financial support: National Taiwan University Hospital under Grant No. NTUH. 102-N2255.

Tiffany Ting-Fang Shih and Ming-Chih Ho share equal contribution.

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Abstract

Background and Aim

Magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) are important diagnostic tools for the non-invasive assessment of hepatic steatosis (HS). This study was conducted to compare different magnetic resonance (MR) techniques and correlate the MR findings with histological and intracellular lipid density findings.

Methods

In this institutional review board-approved, Health Insurance Portability and Accountability Act-compliant prospective study, 60 patients scheduled for liver resection were included in this study. Fat fraction in the non-tumorous liver parenchyma was estimated using double-echo MRI, triple-echo MRI (TE-MRI), and MRS. HS was defined by the histologic steatosis percentage (HSP), and intrahepatocellular triglyceride density (IHTGD) of the surgical specimen used as the reference standard. Imaging quantification results were evaluated using Pearson's correlation. Lin's concordance coefficient and Bland–Altman 95% limits of agreement were used to evaluate the concordance of IHTGDs estimated by the three MR techniques. The diagnostic performance was compared using receiver operating characteristic curve analysis.

Results

HS assessed by TE-MRI and MRS had a stronger relationship with HS assessed by HSP and IHTGD. The TE-MRI method had the highest concordance correlation coefficients (ρ = 0.881) and percentage (95%, 57/60) within the Bland–Altman 95% limits of agreement. Receiver operating characteristic curve analysis for diagnosing > 5% HSP showed significantly larger area under the curve (0.9783) for TE-MRI than for double-echo MRI (0.8773, P = 0.0121).

Conclusions

Among the three MR techniques, TE-MRI and MRS may be the preferred techniques for non-invasive assessment of HS.

References

1 Browning JD, Szczepaniak LS, Dobbins R et al. Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatology 2004; 40: 1387–1395.
10.1002/hep.20466
PubMed Web of Science® Google Scholar
2 Szczepaniak LS, Nurenberg P, Leonard D et al. Magnetic resonance spectroscopy to measure hepatic triglyceride content: prevalence of hepatic steatosis in the general population. Am. J. Physiol. Endocrinol. Metab. 2005; 288: E462–468.
10.1152/ajpendo.00064.2004
CAS PubMed Web of Science® Google Scholar
3 Lai S-W, Tan C-K, Ng K-C. Epidemiology of fatty liver in a hospital-based study in Taiwan. South. Med. J. 2002; 95: 1288–1292.
10.1097/00007611-200295110-00012
PubMed Web of Science® Google Scholar
4 Selzner M, Clavien PA. Fatty liver in liver transplantation and surgery. Semin. Liver Dis. 2001; 21: 105–114.
10.1055/s-2001-12933
CAS PubMed Web of Science® Google Scholar
5 Kim HJ, Kim HJ, Lee KE et al. Metabolic significance of nonalcoholic fatty liver disease in nonobese, nondiabetic adults. Arch. Intern. Med. 2004; 164: 2169–2175.
10.1001/archinte.164.19.2169
PubMed Web of Science® Google Scholar
6 Farrell GC, Larter CZ. Nonalcoholic fatty liver disease: from steatosis to cirrhosis. Hepatology 2006; 43 (2 Suppl. 1): S99–S112.
10.1002/hep.20973
CAS PubMed Web of Science® Google Scholar
7 Adams LA, Sanderson S, Lindor KD, Angulo P. The histological course of nonalcoholic fatty liver disease: a longitudinal study of 103 patients with sequential liver biopsies. J. Hepatol. 2005; 42: 132–138.
10.1016/j.jhep.2004.09.012
PubMed Web of Science® Google Scholar
8 Zamboni F, Franchello A, David E et al. Effect of macrovescicular steatosis and other donor and recipient characteristics on the outcome of liver transplantation. Clin. Transplant. 2001; 15: 53–57.
10.1034/j.1399-0012.2001.150109.x
CAS PubMed Web of Science® Google Scholar
9 Fan ST, Lo CM, Liu CL, Yong BH, Chan JKF, Ng IOL. Safety of donors in live donor liver transplantation using right lobe grafts. Arch. Surg. 2000; 135: 336–340.
10.1001/archsurg.135.3.336
CAS PubMed Google Scholar
10 Bravo AA, Sheth SG, Chopra S. Liver biopsy. N. Engl. J. Med. 2001; 344: 495–500.
10.1056/NEJM200102153440706
CAS PubMed Web of Science® Google Scholar
11 Ratziu V, Charlotte F, Heurtier A et al. Sampling variability of liver biopsy in nonalcoholic fatty liver disease. Gastroenterology 2005; 128: 1898–1906.
10.1053/j.gastro.2005.03.084
PubMed Web of Science® Google Scholar
12 Lee SS, Park SH, Kim HJ et al. Non-invasive assessment of hepatic steatosis: prospective comparison of the accuracy of imaging examinations. J. Hepatol. 2010; 52: 579–585.
10.1016/j.jhep.2010.01.008
CAS PubMed Web of Science® Google Scholar
13 Mehta SR, Thomas EL, Bell JD, Johnston DG, Taylor-Robinson SD. Non-invasive means of measuring hepatic fat content. World J. Gastroenterol. 2008; 14: 3476–3483.
10.3748/wjg.14.3476
PubMed Web of Science® Google Scholar
14 Van Werven JR, Marsman HA, Nederveen AJ et al. Assessment of hepatic steatosis in patients undergoing liver resection: comparison of US, CT, T1-weighted dual-echo MR imaging, and point-resolved 1H MR spectroscopy1. Radiology 2010; 256: 159–168.
10.1148/radiol.10091790
PubMed Web of Science® Google Scholar
15 Borra RJH, Salo S, Dean K et al. Nonalcoholic fatty liver disease: rapid evaluation of liver fat content with in-phase and out-of-phase MR imaging1. Radiology 2008; 250: 130–136.
10.1148/radiol.2501071934
PubMed Web of Science® Google Scholar
16 Raptis DA, Fischer MA, Graf R et al. MRI: the new reference standard in quantifying hepatic steatosis? Gut 2011; 61: 117–127.
10.1136/gutjnl-2011-300155
PubMed Web of Science® Google Scholar
17 Szczepaniak LS, Babcock EE, Schick F et al. Measurement of intracellular triglyceride stores by H spectroscopy: validation in vivo. Am. J. Physiol. Endocrinol. Metab. 1999; 276: E977–989.
10.1152/ajpendo.1999.276.5.E977
CAS PubMed Web of Science® Google Scholar
18 Westphalen ACA, Qayyum A, Yeh BM et al. Liver fat: effect of hepatic iron deposition on evaluation with opposed-phase MR imaging. Radiology 2007; 242: 450–455.
10.1148/radiol.2422052024
PubMed Web of Science® Google Scholar
19 Guiu B, Loffroy R, Petit J-M et al. Mapping of liver fat with triple-echo gradient echo imaging: validation against 3.0-T proton MR spectroscopy. Eur. Radiol. 2009; 19: 1786–1793.
10.1007/s00330-009-1330-9
PubMed Web of Science® Google Scholar
20 Guiu B, Petit JM, Loffroy R et al. Quantification of liver fat content: comparison of triple-echo chemical shift gradient-echo imaging and in vivo proton MR Spectroscopy. Radiology 2009; 250: 95–102.
10.1148/radiol.2493080217
PubMed Web of Science® Google Scholar
21 Kang B-K, Yu ES, Lee SS et al. Hepatic fat quantification: a prospective comparison of magnetic resonance spectroscopy and analysis methods for chemical-shift gradient echo magnetic resonance imaging with histologic assessment as the reference standard. Invest. Radiol. 2012; 47: 368–375.
10.1097/RLI.0b013e31824baff3
CAS PubMed Web of Science® Google Scholar
22 Guiu B, Petit J-M, Loffroy R et al. Liver methylene fraction by dual- and triple-echo gradient-echo imaging at 3.0T: correlation with proton MR spectroscopy and estimation of robustness after SPIO administration. J. Magn. Reson. Imaging 2011; 33: 119–127.
10.1002/jmri.22390
PubMed Web of Science® Google Scholar
23 Cassidy FH, Yokoo T, Aganovic L et al. Fatty liver disease: MR imaging techniques for the detection and quantification of liver steatosis1. Radiographics 2009; 29: 231–260.
10.1148/rg.291075123
PubMed Web of Science® Google Scholar
24 Trotter JF. Selection of donors for living donor liver transplantation. Liver Transpl. 2003; 9 (10C): S2–S7.
10.1053/jlts.2003.50221
PubMed Web of Science® Google Scholar
25 Qayyum A, Goh JS, Kakar S, Yeh BM, Merriman RB, Coakley FV. Accuracy of liver fat quantification at mr imaging: comparison of out-of-phase gradient-echo and fat-saturated fast spin-echo techniques—initial experience1. Radiology 2005; 237: 507–511.
10.1148/radiol.2372040539
PubMed Web of Science® Google Scholar
26 Yokoo T, Bydder M, Hamilton G et al. Nonalcoholic fatty liver disease: diagnostic and fat-grading accuracy of low-flip-angle multiecho gradient-recalled-echo MR imaging at 1.5 T1. Radiology 2009; 251: 67–76.
10.1148/radiol.2511080666
PubMed Web of Science® Google Scholar
27 Pineda N, Sharma P, Xu Q, Hu X, Vos M, Martin DR. Measurement of hepatic lipid: high-speed T2-corrected multiecho acquisition at 1H MR spectroscopy—a rapid and accurate technique1. Radiology 2009; 252: 568–576.
10.1148/radiol.2523082084
PubMed Web of Science® Google Scholar
28 Lee SS, Lee Y, Kim N et al. Hepatic fat quantification using chemical shift MR imaging and MR spectroscopy in the presence of hepatic iron deposition: validation in phantoms and in patients with chronic liver disease. J. Magn. Reson. Imaging 2011; 33: 1390–1398.
10.1002/jmri.22583
PubMed Web of Science® Google Scholar

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Volume29, Issue4

April 2014

Pages 807-813

Quantification of hepatic steatosis: A comparison of the accuracy among multiple magnetic resonance techniques

Abstract

Background and Aim

Methods

Results

Conclusions

References

Citing Literature

References

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Quantification of hepatic steatosis: A comparison of the accuracy among multiple magnetic resonance techniques

Abstract

Background and Aim

Methods

Results

Conclusions

References

Citing Literature

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