Multi-parametric magnetic resonance imaging as a diagnostic tool of hepatic steatosis for non-alcoholic fatty liver disease in Egyptian patients.

Abstract

Background and Aim: Non-invasive assessment of nonalcoholic fatty liver disease (NAFLD) is increasing in desirability due to the invasive nature and costs associated with the current form of assessment by liver biopsy. Quantitative multi-parametric magnetic resonance imaging (mpMRI) to measure liver fat (proton density fat fraction) is an emerging alternative which could be utilized as safe surrogate to liver biopsy. The aim of this study is to evaluate the diagnostic utility of multi-parametric MRI for hepatic steatosis in patients having NAFLD. Materials and Methods: Sixty patients with NAFLD were recruited into this cross-sectional study and were screened using non-invasive imaging technique; mpMRI. Patients were biopsied, and samples were scored by one expert hepato-pathologist. The diagnostic performance of mpMRI was assessed using area under receiver operating characteristic curve (AUC) with the median of the histology scores as the gold standard diagnoses. Results: AUROC for Magnetic resonance spectroscopy proton density fat fraction (MRS-PDFF ) was 1.000 (p =0.0001; 95% CI = 1.000-1.000), a cut-off value of 32.5 had the best sensitivity (97.5%) and specificity (100%).The AUROC for fat fraction (FF) index was 0.995 (p =0.0001; 95% CI = 1.000-0.985), a cut-off value of 22.5 had the best sensitivity (97.2%) and optimal specificity (84%). The AUROC for water fraction index (WF) was 0.998 (p =0.0001; 95% CI = 1.000-0.991), a cut-off value of 22.5 had the best sensitivity (97.2%) and optimal specificity (92%). Conclusions: Quantitative mpMRI is an effective alternative to liver biopsy for diagnosing non-alcoholic fatty liver, and thus may offer clinical utility in patient management.