Noninvasive estimation of hepatic steatosis using plain CT vs. Chemical‐shift MR imaging: Significance for living donors

Abstract

Purpose:To compare plain computed tomography (CT) and chemical-shift MR imaging (CSI) for establishing a noninvasive method to estimate the degree of steatosis. Materials and Methods:A total of 58 patients who had histological proof of liver tissue and underwent CT and/or CSI within two weeks, were studied. They consisted of 38 living donor candidates and 20 liver surgery patients without hepatitis or cirrhosis. The CT index (CTI) and MR index (MRI) were defined and correlated to histological grades of steatosis. Correlation was also performed exclusively for mild steatosis (grades 0 -2).Results: Both plain CT ( ϭ 0.74, P Ͻ 0.0001) and CSI ( ϭ 0.83, P Ͻ 0.0001) had good correlation with histological grades of steatosis, showing no significant difference between them. For mild steatosis, CSI ( ϭ 0.77, P Ͻ 0.0001) had better correlation than CT ( ϭ 0.49, P ϭ 0.001) (P ϭ 0.049). Accuracy in differentiation between grade 0 -1 vs. grade 2-4 steatosis was 85% using a CTI Ͼ6, and 91% using an MRI Ͻ0.03 as criteria. That between grade 0 -2 and grade 3-4 was 91% using a CTI Ͼ-8 and 88% using an MRI Ͻ0.25 as criteria. Conclusion:Both plain CT and CSI were useful in estimating the degree of steatosis but CSI was superior to CT in differentiating mild steatosis. These indices may at least partially replace percutaneous biopsy in evaluating grades of steatosis for living donors.

Specificity of unenhanced CT for non-invasive diagnosis of hepatic steatosis: implications for the investigation of the natural history of incidental steatosis

“…Many studies have subsequently evaluated the use of CT in the setting of NAFLD [26,[28][29][30][40][41][42][43][44]. In most investigations, the spleen has been used as an internal reference standard, either subtracting its attenuation value from that of the liver, or reporting the result as a liver/ spleen attenuation ratio.…”

Hepatic steatosis assessment with CT or MRI in patients with colorectal liver metastases after neoadjuvant chemotherapy

“…In contrast, our study evaluated two modalities in two different patient groups, albeit with highly similar demographic features (BMI, DM, age, sex distribution, steatosis degrees). Another study comparing MRI and CT for steatosis assessment in single patients, was performed by Yoshimitsu et al [28]. From a total of 58 patients, consisting of 38 living donor liver transplantation candidates, and 20 liver resection patients, 34 patients underwent both modalities.…”

MRI findings in nonalcoholic steatohepatitis: correlation with histopathology and clinical staging

“…Additionally, MRI has become an increasingly valuable imaging modality in the setting of diffuse liver diseases including NASH [2,3,6,[12][13][14][15][16][17][18][19][20][21]. In patients with chronic hepatitis, specific early and late enhancement patterns of the liver revealed on gadolinium-enhanced dynamic magnetic resonance (MR) images demonstrate a high degree of correlation with histopathologic findings [19][20][21].…”

“…NAFLD encompasses a spectrum of pathologic processes Imaging studies such as ultrasound and computerized tomography (CT) are useful in demonstrating and quantifying steatosis; however, distinction between simple fatty liver and NASH cannot be made by these imaging modalities [3,6,[8][9][10][11][12]. The evaluation of hepatic steatosis is often currently done by magnetic resonance imaging (MRI), as fat evaluation is more specific than with either ultrasound or CT, and the most commonly used MRI technique to quantify and to confirm the presence of fat in tissues is chemical-shift imaging [2,6,[12][13][14][15][16][17].…”