Accuracy of computed tomography for detecting hepatic steatosis in donors for liver transplantation: A meta‐analysis

Zheng, Danping; Tian, Wei; Zheng, Zhouying; Gu, Jincui; Guo, Zhiyong; He, Xiaoshun

doi:10.1111/ctr.13013

Cited by 19 publications

(15 citation statements)

References 54 publications

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“…Based on the above research results, we investigated the relationship between hepatic and pancreatic steatosis parameters measured by non-enhanced CT 15 . CT is also known to be correlated with liver biopsy for the detection of HS in many studies 16 . Since CT is one of the most highly correlated methods with liver and pancreas biopsies, CT was chosen as the reference radiological method in our study.…”

Section: Discussionmentioning

confidence: 99%

“…The efficacy of CT in measuring hepatosteatosis (HS) is more pronounced. CT has become an alternative method for liver biopsy in many transplantation centres due to its strength in the determination of HS in liver transplant donor candidates 16 . Despite the power of CT and many other radiological methods in the diagnosis of HS, liver biopsy is still considered the gold standard method in diagnosing NAFLD 17 .…”

Section: Introductionmentioning

confidence: 99%

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The comparison of pancreatic and hepatic steatosis in healthy liver donor candidates

Sökmen

Sahin

Oral

et al. 2021

Sci Rep

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The aim of this study was to investigate the relationship between nonalcoholic fatty liver disease (NAFLD) and pancreatic steatosis (PS) in patients with biopsy-proven NAFLD. 228 patients with biopsy-proven NAFLD patients who admitted to the Faculty of Medicine of Demiroglu Bilim University between 2004 and 2019 were included in the study. Demographic, laboratory, histological and radiological findings of the patients were recorded retrospectively. Hepatosteatosis (HS) levels were measured by both CT and biopsy, while PS levels were measured by 3 different CT-based techniques. 89 (39%) of the patients were female and 139 (61%) were male. The mean body mass index (BMI) was 27.2 ± 4.0. Biochemical parameters were within normal limits. Liver biopsy showed a significant correlation with HS grade on CT scan (p < 0.001). When CT findings were compared, a significant correlation was found between PS and HS (p < 0.05), but there was no correlation between the HS level in biopsy and the pancreatic adiposity on CT (p > 0.05). Our study was the first to compare biopsy-proven NAFLD and PS, and no correlation was found between biopsy-proven NAFLD and PS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The comparison of pancreatic and hepatic steatosis in healthy liver donor candidates

Sökmen

Sahin

Oral

et al. 2021

Sci Rep

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“…Other studies evaluating the accuracy of CT yielded similar results. A meta-analysis comparing CT with liver biopsies in liver donors showed that CT had a sensitivity and specificity of 0.81 and 0.94, respectively, and that the accuracy of CT increased when fat infiltration was higher [30]. Similarly, CT had a lower concordance with liver biopsies than ultrasound [31].…”

Section: Main Findingsmentioning

confidence: 99%

Accuracy of a Semi-Quantitative Ultrasound Method to Determine Liver Fat Infiltration in Early Adulthood

et al. 2020

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An inexpensive and simple method to determine non-alcoholic fatty liver disease (NAFLD) is the abdominal ultrasound, but there are still doubts about its accuracy. We assessed the precision of a semi-quantitative ultrasound method to determine liver fat infiltration, using magnetic resonance spectroscopy (MRS) as the reference. The study was conducted in youths from an ongoing cohort study. Clinical validation was performed, using receiver operating characteristic analysis, in n = 60 participants (22.6y; 50% males). Abdominal ultrasound was carried out with liver brightness (score 0–3), diaphragm attenuation (0–2) and liver vessel blurring (0–1) scored by two observers. Liver fat was estimated using MRS. Then, analytical validation was conducted in the remaining participants (n = 555; 22.7y; 51% males) using effects size estimates. An ultrasound score ≥4.0 had the highest sensitivity (78%) and specificity (85%) for NAFLD diagnosis. An area under the curve of 86% denotes a good diagnostic performance of the test, whereas a Kappa of 0.63 suggests substantial agreement of ultrasound vs. MRS. The analytical validation showed that participants having NAFLD according to ultrasound had an unhealthier cardiometabolic profile than participants without the condition. Abdominal ultrasound, combined with a semi-quantitative score system, is a reliable method to determine liver fat infiltration in young adults and should be encouraged whenever MRS is unavailable.

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“…Computed tomography (CT) is more widely available, easier to perform, and facilitates quantitative HS assessment based on the measurement of liver attenuation. ( 11‐13 )…”

mentioning

confidence: 99%

“…Computed tomography (CT) is more widely available, easier to perform, and facilitates quantitative HS assessment based on the measurement of liver attenuation. (11)(12)(13) Previous studies show that the distribution of fat within the liver is not uniform and that greater spatial heterogeneity exists in those with more severe HS. (14)(15)(16)(17) This nonuniform spatial distribution of fat may cause errors in quantification and classification of HS via liver biopsy, in which only a small piece of hepatic tissue is obtained.…”

mentioning

confidence: 99%

Lifestyle Modification Leads to Spatially Variable Reduction in Hepatic Steatosis in Potential Living Liver Donors

Park¹,

Kim²,

Kwon

et al. 2020

Liver Transpl

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The spatial variability of hepatic fat reduction in potential living liver donors with hepatic steatosis (HS) who undergo lifestyle modification has not been investigated. Here, we aimed to examine the intrasegmental and intersegmental variability of changes in liver attenuation on computed tomography (CT) in potential living liver donors with HS after diet modification and exercise. A total of 87 living liver donor candidates (30.5 ± 7.0 years; 74 males) with biopsy‐proven macrovesicular fat (MaF) ≥10% were included. All underwent diet modification and exercise to improve HS, baseline and follow‐up unenhanced CT scans, and liver biopsies. Attenuation and its variability (mean and standard deviation, respectively, in Hounsfield units) in segmental, lobar, superficial, deep, and whole areas of the liver were measured across 32 different regions of interest on both baseline and follow‐up CT. At baseline, the right lobe and superficial areas of liver showed significantly lower and more variable attenuation than left lobe and deep areas. Greater variability was noted in patients with more severe HS. Mean interval changes in liver attenuation and variability before and after diet modification and exercise were 13.7 (range, −10.6 to 46.2) and 4.7 (1.6‐10.6), respectively. The mean interval change in liver attenuation was significantly higher in the right lobe than in the left (14.7 versus 12.7; P < 0.001), and in superficial areas than in deep areas (14.0 versus 13.4; P = 0.02). Greater variability and larger interval changes in liver attenuation were noted in those who responded (≥20% decrease in MaF) to diet modification and exercise than in those who did not. In conclusion, potential living liver donors with HS show significant intrasegmental and intersegmental variability in hepatic fat reduction on CT before and after diet modification and exercise.

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Accuracy of computed tomography for detecting hepatic steatosis in donors for liver transplantation: A meta‐analysis

Abstract: Computed tomography shows high accuracy in detecting significant HS while poor accuracy in detecting the presence of HS in liver donors. Donors estimated to have significant HS by CT may avoid unnecessary liver biopsy.

Cited by 19 publications

References 54 publications

The comparison of pancreatic and hepatic steatosis in healthy liver donor candidates

The comparison of pancreatic and hepatic steatosis in healthy liver donor candidates

Accuracy of a Semi-Quantitative Ultrasound Method to Determine Liver Fat Infiltration in Early Adulthood

Lifestyle Modification Leads to Spatially Variable Reduction in Hepatic Steatosis in Potential Living Liver Donors

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