Accuracy of common proton density fat fraction thresholds for magnitude- and complex-based chemical shift-encoded MRI fo
- PDF / 1,368,078 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 85 Downloads / 139 Views
HEPATOBILIARY
Accuracy of common proton density fat fraction thresholds for magnitude‑ and complex‑based chemical shift‑encoded MRI for assessing hepatic steatosis in patients with obesity Guilherme Moura Cunha1,11 · Tydus T. Thai1 · Gavin Hamilton1 · Yesenia Covarrubias1 · Alexandra Schlein1 · Michael S. Middleton1 · Curtis N. Wiens2 · Alan McMillan2 · Rashmi Agni3 · Luke M. Funk4 · Guilherme M. Campos5 · Santiago Horgan6 · Garth Jacobson6 · Tanya Wolfson7 · Anthony Gamst7 · Jeffrey B. Schwimmer8 · Scott B. Reeder2,9,10 · Claude B. Sirlin1
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Purpose MRI proton density fat fraction (PDFF) can be calculated using magnitude (MRI-M) or complex (MRI-C) MRI data. The purpose of this study was to identify, assess, and compare the accuracy of common PDFF thresholds for MRI-M and MRI-C for assessing hepatic steatosis in patients with obesity, using histology as reference. Methods This two-center prospective study included patients undergoing MRI-C- and MRI-M-PDFF estimations within 3 days before weight loss surgery. Liver biopsy was performed, and histology-determined steatosis grades were used as reference standard. Using receiver operating characteristics (ROC) analysis on data pooled from both methods, single common thresholds for diagnosing and differentiating none or mild (0–1) from moderate to severe steatosis (2–3) were selected as the ones achieving the highest sensitivity while providing at least 90% specificity. Selection methods were cross-validated. Performances were compared using McNemar’s tests. Results Of 81 included patients, 54 (67%) had steatosis. The common PDFF threshold for diagnosing steatosis was 5.4%, which provided a cross-validated 0.88 (95% CI 0.77–0.95) sensitivity and 0.92 (0.75–0.99) specificity for MRI-M and 0.87 sensitivity (0.75–0.94) with 0.81 (0.61–0.93) specificity for MRI-C. The common PDFF threshold to differentiate steatosis grades 0–1 from 2 to 3 was 14.7%, which provided cross-validated 0.86 (95% CI 0.59–0.98) sensitivity and 0.95 (0.87–0.99) specificity for MRI-M and 0.93 sensitivity (0.68–0.99) with 0.97(0.89–0.99) specificity for MRI-C. Conclusion If independently validated, diagnostic thresholds of 5.4% and 14.7% could be adopted for both techniques for detecting and differentiating none to mild from moderate to severe steatosis, respectively, with high diagnostic accuracy. Keywords Liver · Magnetic resonance imaging · Non-alcoholic fat liver disease · Obesity Abbreviations CSE-MRI Chemical shift-encoded-MRI MRI-M Magnitude-based data MRI MRI-C Complex-based data MRI PDFF Proton density fat fraction WLS Weight loss surgery NAFLD Non-alcoholic fatty liver disease
* Guilherme Moura Cunha [email protected] Extended author information available on the last page of the article
Introduction The increasing prevalence of obesity has caused non-alcoholic fatty liver disease (NAFLD) to become the most common cause of chronic liver disease worldwide [1]. MRI is an accurate, reproducible, and non-in
Data Loading...
