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ASSESSING HEPATIC STEATOSIS BY MAGNETIC RESONANCE IN POTENTIAL LIVING LIVER DONORS
DDEM KURU Z, ZEYNEP ELLK, AYEGL GRSOY ORUH, MEHMET ADIGZEL, MESUT GMSOY, SABA KREMTC, ELVAN ONUR KIRIMKER, HALE GKCAN, ATLLA HALL ELHAN, DENZ BALCI, BERNA SAVA, AYE ERDEN, RAMAZAN DLMAN
Diagnostic and Interventional Radiology - 2024;30(6):351-356
Ankara University Faculty of Medicine, Department of Radiology, Ankara, Trkiye

PURPOSE To determine the accuracy of magnetic resonance imaging-proton density fat fraction (MRI-PDFF) measurements for detecting liver fat content in potential living liver donors and to compare these results using liver biopsy findings. METHODS A total of 139 living liver donors (men/women: 83/56) who underwent MRI between January 2017 and September 2021 were included in this analysis retrospectively. The PDFFs were measured using both MR spectroscopy (MRS) and chemical shift-based MRI (CS-MRI) for each donor in a blinded manner. RESULTS Significant positive correlations were found between liver biopsy and MRS-PDFF and CS-MRI PDFF in terms of hepatic steatosis detection [r = 0.701, 95% confidence interval (CI): 0.6040.798, r = 0.654, 95% CI: 0.5440.765, P < 0.001, respectively). A weak level correlation was observed between liver biopsy, MRI methods, and vibration-controlled transient elastography attenuation parameters in 42 available donors. Based on receiver operating characteristic (ROC) analysis, MRS-PDFF and CSMRI PDFF significantly distinguished >5% of histopathologically detected hepatic steatosis with an area under the ROC curve (AUC) of 0.837 0.036 (P < 0.001, 95% CI: 0.7660.907) and 0.810 0.036 (P < 0.001, 95% CI: 0.7390.881), respectively. The negative predictive values (NPVs) of MRS-PDFF and CS-MRI PDFF were 88.3% and 81.3%, respectively. In terms of distinguishing between clinically significant hepatic steatosis (≥10% on histopathology), the AUC of MRS-PDFF and CS-MRI were 0.871 0.034 (P < 0.001 95% CI: 0.8040.937) and 0.855 0.036 (P < 0.001, 95% CI: 0.7840.925), respectively. The NPVs of MRS-PDFF and CS-MRI were 99% and 92%, respectively. CONCLUSION The methods of MRS-PDFF and CS-MRI PDFF provide a non-invasive and accurate approach for assessing hepatic steatosis in potential living liver donor candidates. These MRI PDFF techniques present a promising clinical advantage in the preoperative evaluation of living liver donors by eliminating the requirement for invasive procedures like liver biopsy.

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