Skip to main content
Top
Published in: Abdominal Radiology 2/2024

06-10-2023 | Magnetic Resonance Imaging | Hepatobiliary

Validity of an automated screening Dixon technique for quantifying hepatic steatosis in living liver donors

Authors: Sangkeun Song, Hokun Kim, Joon-Il Choi, Dong Hwan Kim, Bohyun Kim, Hyunsoo Lee, Jiwon Lee

Published in: Abdominal Radiology | Issue 2/2024

Login to get access

Abstract

Purpose

This retrospective study aimed to evaluate the validity of an automated screening Dixon (e-DIXON) technique for quantifying hepatic steatosis in living liver-donor patients by comparison with magnetic resonance spectroscopy (MRS) as a reference standard.

Methods

A total of 285 living liver-donor candidates were examined with the e-DIXON technique and single-voxel MRS to assess hepatic steatosis and iron deposition between January 2014 and February 2019. The sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of the e-DIXON technique for hepatic steatosis were calculated. The mean fat signal fractions obtained in MRS were compared between the donors diagnosed with hepatic steatosis and the normal group. The mean R2 values of donors with or without hepatic siderosis also were compared.

Results

The e-DIXON technique diagnosed normal in 133 (47%), fat in 124 (44%), iron in one (0.4%), and a combination of both fat and iron in 27 (10%) donors. The sensitivity, specificity, PPV, and NPV ​​for diagnosing hepatic steatosis were 94%, 70%, 64%, and 96%, respectively. There was a significant difference in the mean fat signal fraction obtained in MRS between the steatosis and normal groups (p < 0.001), but R2 values were not significantly different between siderosis and normal groups (p = 0.11). The e-DIXON technique showed a strong correlation with MRS in fat measurement (r2 = 0.92, p < 0.001).

Conclusion

The e-DIXON technique reliably screens for hepatic steatosis but may not accurate for detecting hepatic iron deposition.
Literature
1.
go back to reference Henninger B, Zoller H, Rauch S, Schocke M, Kannengiesser S, Zhong X, et al. Automated two-point dixon screening for the evaluation of hepatic steatosis and siderosis: comparison with R2-relaxometry and chemical shift-based sequences. Eur Radiol 2015;25:1356-1365CrossRefPubMed Henninger B, Zoller H, Rauch S, Schocke M, Kannengiesser S, Zhong X, et al. Automated two-point dixon screening for the evaluation of hepatic steatosis and siderosis: comparison with R2-relaxometry and chemical shift-based sequences. Eur Radiol 2015;25:1356-1365CrossRefPubMed
2.
go back to reference Szczepaniak LS, Nurenberg P, Leonard D, Browning JD, Reingold JS, Grundy S, et al. Magnetic resonance spectroscopy to measure hepatic triglyceride content: prevalence of hepatic steatosis in the general population. Am J Physiol Endocrinol Metab 2005;288:E462-468CrossRefPubMed Szczepaniak LS, Nurenberg P, Leonard D, Browning JD, Reingold JS, Grundy S, et al. Magnetic resonance spectroscopy to measure hepatic triglyceride content: prevalence of hepatic steatosis in the general population. Am J Physiol Endocrinol Metab 2005;288:E462-468CrossRefPubMed
3.
go back to reference Wu CH, Ho MC, Jeng YM, Hsu CY, Liang PC, Hu RH, et al. Quantification of hepatic steatosis: a comparison of the accuracy among multiple magnetic resonance techniques. J Gastroenterol Hepatol 2014;29:807-813CrossRefPubMed Wu CH, Ho MC, Jeng YM, Hsu CY, Liang PC, Hu RH, et al. Quantification of hepatic steatosis: a comparison of the accuracy among multiple magnetic resonance techniques. J Gastroenterol Hepatol 2014;29:807-813CrossRefPubMed
4.
go back to reference Idilman IS, Keskin O, Celik A, Savas B, Elhan AH, Idilman R, et al. A comparison of liver fat content as determined by magnetic resonance imaging-proton density fat fraction and MRS versus liver histology in non-alcoholic fatty liver disease. Acta Radiol 2016;57:271-278CrossRefPubMed Idilman IS, Keskin O, Celik A, Savas B, Elhan AH, Idilman R, et al. A comparison of liver fat content as determined by magnetic resonance imaging-proton density fat fraction and MRS versus liver histology in non-alcoholic fatty liver disease. Acta Radiol 2016;57:271-278CrossRefPubMed
5.
go back to reference Pais R, Charlotte F, Fedchuk L, Bedossa P, Lebray P, Poynard T, et al. A systematic review of follow-up biopsies reveals disease progression in patients with non-alcoholic fatty liver. J Hepatol 2013;59:550-556CrossRefPubMed Pais R, Charlotte F, Fedchuk L, Bedossa P, Lebray P, Poynard T, et al. A systematic review of follow-up biopsies reveals disease progression in patients with non-alcoholic fatty liver. J Hepatol 2013;59:550-556CrossRefPubMed
6.
go back to reference Younossi ZM, Otgonsuren M, Henry L, Venkatesan C, Mishra A, Erario M, et al. Association of nonalcoholic fatty liver disease (NAFLD) with hepatocellular carcinoma (HCC) in the United States from 2004 to 2009. Hepatology 2015;62:1723-1730CrossRefPubMed Younossi ZM, Otgonsuren M, Henry L, Venkatesan C, Mishra A, Erario M, et al. Association of nonalcoholic fatty liver disease (NAFLD) with hepatocellular carcinoma (HCC) in the United States from 2004 to 2009. Hepatology 2015;62:1723-1730CrossRefPubMed
7.
go back to reference Angulo P. Nonalcoholic fatty liver disease and liver transplantation. Liver Transpl 2006;12:523-534CrossRefPubMed Angulo P. Nonalcoholic fatty liver disease and liver transplantation. Liver Transpl 2006;12:523-534CrossRefPubMed
8.
go back to reference Bashir MR, Zhong X, Nickel MD, Fananapazir G, Kannengiesser SA, Kiefer B, et al. Quantification of hepatic steatosis with a multistep adaptive fitting MRI approach: prospective validation against MR spectroscopy. AJR Am J Roentgenol 2015;204:297-306CrossRefPubMed Bashir MR, Zhong X, Nickel MD, Fananapazir G, Kannengiesser SA, Kiefer B, et al. Quantification of hepatic steatosis with a multistep adaptive fitting MRI approach: prospective validation against MR spectroscopy. AJR Am J Roentgenol 2015;204:297-306CrossRefPubMed
9.
go back to reference Capitan V, Petit JM, Aho S, Lefevre PH, Favelier S, Loffroy R, et al. Macroscopic heterogeneity of liver fat: an MR-based study in type-2 diabetic patients. European Radiology 2012;22:2161-2168CrossRefPubMed Capitan V, Petit JM, Aho S, Lefevre PH, Favelier S, Loffroy R, et al. Macroscopic heterogeneity of liver fat: an MR-based study in type-2 diabetic patients. European Radiology 2012;22:2161-2168CrossRefPubMed
10.
go back to reference Cowin GJ, Jonsson JR, Bauer JD, Ash S, Ali A, Osland EJ, et al. Magnetic resonance imaging and spectroscopy for monitoring liver steatosis. Journal of Magnetic Resonance Imaging 2008;28:937-945CrossRefPubMed Cowin GJ, Jonsson JR, Bauer JD, Ash S, Ali A, Osland EJ, et al. Magnetic resonance imaging and spectroscopy for monitoring liver steatosis. Journal of Magnetic Resonance Imaging 2008;28:937-945CrossRefPubMed
11.
go back to reference Springer F, Machann J, Claussen CD, Schick F, Schwenzer NF. Liver fat content determined by magnetic resonance imaging and spectroscopy. World Journal of Gastroenterology 2010;16:1560-1566CrossRefPubMedPubMedCentral Springer F, Machann J, Claussen CD, Schick F, Schwenzer NF. Liver fat content determined by magnetic resonance imaging and spectroscopy. World Journal of Gastroenterology 2010;16:1560-1566CrossRefPubMedPubMedCentral
12.
go back to reference Caussy C, Reeder SB, Sirlin CB, Loomba R. Noninvasive, Quantitative Assessment of Liver Fat by MRI-PDFF as an Endpoint in NASH Trials. Hepatology 2018;68:763-772CrossRefPubMed Caussy C, Reeder SB, Sirlin CB, Loomba R. Noninvasive, Quantitative Assessment of Liver Fat by MRI-PDFF as an Endpoint in NASH Trials. Hepatology 2018;68:763-772CrossRefPubMed
13.
go back to reference Wei JL, Leung JC, Loong TC, Wong GL, Yeung DK, Chan RS, et al. Prevalence and Severity of Nonalcoholic Fatty Liver Disease in Non-Obese Patients: A Population Study Using Proton-Magnetic Resonance Spectroscopy. Am J Gastroenterol 2015;110:1306-1314; quiz 1315CrossRefPubMed Wei JL, Leung JC, Loong TC, Wong GL, Yeung DK, Chan RS, et al. Prevalence and Severity of Nonalcoholic Fatty Liver Disease in Non-Obese Patients: A Population Study Using Proton-Magnetic Resonance Spectroscopy. Am J Gastroenterol 2015;110:1306-1314; quiz 1315CrossRefPubMed
14.
go back to reference Satkunasingham J, Nik HH, Fischer S, Menezes R, Selzner N, Cattral M, et al. Can negligible hepatic steatosis determined by magnetic resonance imaging-proton density fat fraction obviate the need for liver biopsy in potential liver donors? Liver Transpl 2018;24:470-477CrossRefPubMed Satkunasingham J, Nik HH, Fischer S, Menezes R, Selzner N, Cattral M, et al. Can negligible hepatic steatosis determined by magnetic resonance imaging-proton density fat fraction obviate the need for liver biopsy in potential liver donors? Liver Transpl 2018;24:470-477CrossRefPubMed
15.
go back to reference Yokoo T, Serai SD, Pirasteh A, Bashir MR, Hamilton G, Hernando D, et al. Linearity, Bias, and Precision of Hepatic Proton Density Fat Fraction Measurements by Using MR Imaging: A Meta-Analysis. Radiology 2018;286:486-498CrossRefPubMed Yokoo T, Serai SD, Pirasteh A, Bashir MR, Hamilton G, Hernando D, et al. Linearity, Bias, and Precision of Hepatic Proton Density Fat Fraction Measurements by Using MR Imaging: A Meta-Analysis. Radiology 2018;286:486-498CrossRefPubMed
16.
go back to reference Bashir MR, Dale BM, Merkle EM, Boll DT. Automated liver sampling using a gradient dual-echo Dixon-based technique. Magnetic Resonance in Medicine 2012;67:1469-1477CrossRefPubMed Bashir MR, Dale BM, Merkle EM, Boll DT. Automated liver sampling using a gradient dual-echo Dixon-based technique. Magnetic Resonance in Medicine 2012;67:1469-1477CrossRefPubMed
17.
go back to reference Pineda N, Sharma P, Xu Q, Hu XP, Vos M, Martin DR. Measurement of Hepatic Lipid: High-Speed T2-Corrected Multiecho Acquisition at H-1 MR Spectroscopy-A Rapid and Accurate Technique. Radiology 2009;252:568-576CrossRefPubMed Pineda N, Sharma P, Xu Q, Hu XP, Vos M, Martin DR. Measurement of Hepatic Lipid: High-Speed T2-Corrected Multiecho Acquisition at H-1 MR Spectroscopy-A Rapid and Accurate Technique. Radiology 2009;252:568-576CrossRefPubMed
18.
go back to reference Bashir MR, Merkle EM, Smith AD, Boll DT. Hepatic MR imaging for in vivo differentiation of steatosis, iron deposition and combined storage disorder: Single-ratio in/opposed phase analysis vs. dual-ratio Dixon discrimination. European Journal of Radiology 2012;81:E101-E109CrossRefPubMed Bashir MR, Merkle EM, Smith AD, Boll DT. Hepatic MR imaging for in vivo differentiation of steatosis, iron deposition and combined storage disorder: Single-ratio in/opposed phase analysis vs. dual-ratio Dixon discrimination. European Journal of Radiology 2012;81:E101-E109CrossRefPubMed
19.
go back to reference Reeder SB, Cruite I, Hamilton G, Sirlin CB. Quantitative Assessment of Liver Fat with Magnetic Resonance Imaging and Spectroscopy. Journal of Magnetic Resonance Imaging 2011;34:729-749CrossRefPubMed Reeder SB, Cruite I, Hamilton G, Sirlin CB. Quantitative Assessment of Liver Fat with Magnetic Resonance Imaging and Spectroscopy. Journal of Magnetic Resonance Imaging 2011;34:729-749CrossRefPubMed
20.
go back to reference Runge JH, Smits LP, Verheij J, Depla A, Kuiken SD, Baak BC, et al. MR Spectroscopy-derived Proton Density Fat Fraction Is Superior to Controlled Attenuation Parameter for Detecting and Grading Hepatic Steatosis. Radiology 2018;286:547-556CrossRefPubMed Runge JH, Smits LP, Verheij J, Depla A, Kuiken SD, Baak BC, et al. MR Spectroscopy-derived Proton Density Fat Fraction Is Superior to Controlled Attenuation Parameter for Detecting and Grading Hepatic Steatosis. Radiology 2018;286:547-556CrossRefPubMed
21.
go back to reference Zhan C, Olsen S, Zhang HC, Kannengiesser S, Chandarana H, Shanbhogue KP. Detection of hepatic steatosis and iron content at 3 Tesla: comparison of two-point Dixon, quantitative multi-echo Dixon, and MR spectroscopy. Abdom Radiol (NY) 2019;44:3040-3048CrossRefPubMed Zhan C, Olsen S, Zhang HC, Kannengiesser S, Chandarana H, Shanbhogue KP. Detection of hepatic steatosis and iron content at 3 Tesla: comparison of two-point Dixon, quantitative multi-echo Dixon, and MR spectroscopy. Abdom Radiol (NY) 2019;44:3040-3048CrossRefPubMed
22.
go back to reference Hetterich H, Bayerl C, Peters A, Heier M, Linkohr B, Meisinger C, et al. Feasibility of a three-step magnetic resonance imaging approach for the assessment of hepatic steatosis in an asymptomatic study population. Eur Radiol 2016;26:1895-1904CrossRefPubMed Hetterich H, Bayerl C, Peters A, Heier M, Linkohr B, Meisinger C, et al. Feasibility of a three-step magnetic resonance imaging approach for the assessment of hepatic steatosis in an asymptomatic study population. Eur Radiol 2016;26:1895-1904CrossRefPubMed
23.
go back to reference Noureddin M, Lam J, Peterson MR, Middleton M, Hamilton G, Le TA, et al. Utility of magnetic resonance imaging versus histology for quantifying changes in liver fat in nonalcoholic fatty liver disease trials. Hepatology 2013;58:1930-1940CrossRefPubMed Noureddin M, Lam J, Peterson MR, Middleton M, Hamilton G, Le TA, et al. Utility of magnetic resonance imaging versus histology for quantifying changes in liver fat in nonalcoholic fatty liver disease trials. Hepatology 2013;58:1930-1940CrossRefPubMed
Metadata
Title
Validity of an automated screening Dixon technique for quantifying hepatic steatosis in living liver donors
Authors
Sangkeun Song
Hokun Kim
Joon-Il Choi
Dong Hwan Kim
Bohyun Kim
Hyunsoo Lee
Jiwon Lee
Publication date
06-10-2023
Publisher
Springer US
Published in
Abdominal Radiology / Issue 2/2024
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-023-04009-6

Other articles of this Issue 2/2024

Abdominal Radiology 2/2024 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.