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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2016; 26(01): 5-14
DOI: 10.4103/0971-3026.178281
Abdomen

Comparative accuracy of CT, dual-echo MRI and MR spectroscopy for preoperative liver fat quantification in living related liver donors

Ruchi Rastogi
Department of Radiology, Indraprastha Apollo Hospital, Delhi, India
,
Subhash Gupta
Department of Surgery, Indraprastha Apollo Hospital, Delhi, India
,
Bhavya Garg
Department of Radiology, Indraprastha Apollo Hospital, Delhi, India
,
Sandeep Vohra
Department of Radiology, Indraprastha Apollo Hospital, Delhi, India
,
Manav Wadhawan
Department of Gastroenerology, Indraprastha Apollo Hospital, Delhi, India
,
Harsh Rastogi
Department of Radiology, Indraprastha Apollo Hospital, Delhi, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Background: It is of significant importance to assess the extent of hepatic steatosis in living donor liver transplant (LDLT) surgery to ensure optimum graft regeneration as well as donor safety. Aim: To establish the accuracy of non-invasive imaging methods including computed tomography (CT), dual-echo in- and opposed-phase magnetic resonance imaging (MRI), and MR spectroscopy (MRS) for quantification of liver fat content (FC) in prospective LDLT donors with histopathology as reference standard. Settings and Design: This retrospective study was conducted at our institution on LDLT donors being assessed for biliary and vascular anatomy depiction by Magnetic Resonance Cholangiopancreatography (MRCP) and CT scan, respectively, between July 2013 and October 2014. Materials and Methods: Liver FC was measured in 73 donors by dual-echoT1 MRI and MRS. Of these, CT liver attenuation index (LAI) values were available in 62 patients. Statistical Analysis: CT and MRI FC were correlated with histopathological reference standard using Spearman correlation coefficient. Sensitivity, specificity, positive predictive value, negative predicative value, and positive and negative likelihood ratios with 95% confidence intervals were obtained. Results: CT LAI, dual-echo MRI, and MRS correlated well with the histopathology results (r = 0.713, 0.871, and 0.882, respectively). An accuracy of 95% and 96% was obtained for dual-echo MRI and MRS in FC estimation with their sensitivity being 97% and 94%, respectively. False-positive rate, positive predictive value (PPV), and negative predicative value (NPV) were 0.08, 0.92, and 0.97, respectively, for dual-echo MRI and 0.03, 0.97, and 0.95, respectively, for MRS. CT LAI method of fat estimation has a sensitivity, specificity, PPV, and NPV of 73%, 77.7%, 70.4%, and 80%, respectively. Conclusion: Dual-echo MRI, MRS, and CT LAI are accurate measures to quantify the degree of hepatic steatosis in LDLT donors, thus reducing the need for invasive liver biopsy and its associated complications. Dual-echo MRI and MRS results correlate better with histological results in the study, as compared to CT LAI method for fat quantification.

Keywords

Computed tomography liver attenuation index - dual-echo magnetic resonance imaging - hepatic steatosis - liver fat quantification - living donor liver transplantation - MR spectroscopy


Publication History

Article published online:
30 July 2021

© 2016. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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