Quantitative magnetic resonance imaging of hepatic steatosis: Validation in ex vivo human livers

被引:140
作者
Bannas, Peter [1 ,2 ]
Kramer, Harald [1 ,3 ]
Hernando, Diego [1 ]
Agni, Rashmi [4 ]
Cunningham, Ashley M. [4 ]
Mandal, Rakesh [4 ]
Motosugi, Utaroh [1 ]
Sharma, Samir D. [1 ]
del Rio, Alejandro Munoz [1 ]
Fernandez, Luis [5 ]
Reeder, Scott B. [1 ,6 ,7 ,8 ,9 ]
机构
[1] Univ Wisconsin, Dept Radiol, Madison, WI 53792 USA
[2] Univ Hosp Hamburg Eppendorf, Dept Radiol, Hamburg, Germany
[3] Ludwig Maximilians Univ Hosp, Dept Radiol, Munich, Germany
[4] Univ Wisconsin, Dept Pathol, Madison, WI 53792 USA
[5] Univ Wisconsin, Dept Surg, Madison, WI 53792 USA
[6] Univ Wisconsin, Dept Med Phys, Madison, WI 53792 USA
[7] Univ Wisconsin, Dept Biomed Engn, Madison, WI 53792 USA
[8] Univ Wisconsin, Dept Med, Madison, WI 53792 USA
[9] Univ Wisconsin, Dept Emergency Med, Madison, WI 53792 USA
基金
美国国家卫生研究院;
关键词
DENSITY FAT-FRACTION; NONALCOHOLIC STEATOHEPATITIS; SAMPLING VARIABILITY; UNITED-STATES; DISEASE; QUANTIFICATION; SEPARATION; MRI; ACCURATE; BIOPSY;
D O I
10.1002/hep.28012
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Emerging magnetic resonance imaging (MRI) biomarkers of hepatic steatosis have demonstrated tremendous promise for accurate quantification of hepatic triglyceride concentration. These methods quantify the proton density fat-fraction (PDFF), which reflects the concentration of triglycerides in tissue. Previous in vivo studies have compared MRI-PDFF with histologic steatosis grading for assessment of hepatic steatosis. However, the correlation of MRI-PDFF with the underlying hepatic triglyceride content remained unknown. The aim of this ex vivo study was to validate the accuracy of MRI-PDFF as an imaging biomarker of hepatic steatosis. Using ex vivo human livers, we compared MRI-PDFF with magnetic resonance spectroscopy-PDFF (MRS-PDFF), biochemical triglyceride extraction, and histology as three independent reference standards. A secondary aim was to compare the precision of MRI-PDFF relative to biopsy for the quantification of hepatic steatosis. MRI-PDFF was prospectively performed at 1.5 Tesla in 13 explanted human livers. We performed colocalized paired evaluation of liver fat content in all nine Couinaud segments using single-voxel MRS-PDFF (n=117) and tissue wedges for biochemical triglyceride extraction (n=117), and five core biopsies performed in each segment for histologic grading (n=585). Accuracy of MRI-PDFF was assessed through linear regression with MRS-PDFF, triglyceride extraction, and histology. Intraobserver agreement, interobserver agreement, and repeatability of MRI-PDFF and histologic grading were assessed through Bland-Altman analyses. MRI-PDFF showed an excellent correlation with MRS-PDFF (r = 0.984, confidence interval 0.978-0.989) and strong correlation with histology (r = 0.850, confidence interval 0.791-0.894) and triglyceride extraction (r = 0.871, confidence interval 0.818-0.909). Intraobserver agreement, interobserver agreement, and repeatability showed a significantly smaller variance for MRI-PDFF than for histologic steatosis grading (all P<0.001). Conclusion: MRI-PDFF is an accurate, precise, and reader-independent noninvasive imaging biomarker of liver triglyceride content, capable of steatosis quantification over the entire liver. (Hepatology 2015;62:1444-1455)
引用
收藏
页码:1444 / 1455
页数:12
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