Evaluation of hepatic steatosis before liver transplantation in ex vivo by volumetric quantitative PDFF-MRI

Gen Chen, Jipin Jiang, Xinqiang Wang, Min Yang, Yalong Xie, Hui Guo, Hao Tang, Lifen Zhou, Daoyu Hu, Ihab R. Kamel, Zhishui Chen, Zhen Li

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Over the last two decades, extended criteria have promoted an increased number of donor livers available for liver transplantation. But posttransplant graft loss is still a major concern. Macrovesicular hepatic steatosis (MHS) is recognized as the most significant prognostic histologic parameter in predicting posttransplant graft loss. We aimed to evaluate the utility of ex vivo volumetric quantitative MRI for quantifying MHS before liver transplantation using proton density fat-fraction (PDFF-MRI) histogram analysis. Methods: PDFF-MRI was performed at 3.0T in 40 livers. We obtained histogram parameters of whole-liver volume of interest, including the mean, median, 5th, 10th, 25th, 75th, 90th, and 95th percentile PDFF; skewness; kurtosis; entropy; and volume. Results: Livers from 40 cadaveric donors were included, and histologic ex vivo fat quantification was available for 33 livers. Ten livers had MHS and 23 had normal fat content. The MHS group had higher mean, median, 5th, 10th, 25th, 75th, 90th, and 95th percentile PDFF, and entropy than the group with normal fat content (P <.05). Median PDFF had greater area under the curve value than other parameters. Mean PDFF showed an excellent correlation with entropy and a moderate correlation with MHS quantification on histology. Conclusions: Ex vivo volumetric quantitative PDFF-MRI histogram analysis is a very useful and noninvasive method to detect MHS before liver transplantation. Median PDFF was the best predictor of the presence of MHS. Entropy is a very promising parameter.

Original languageEnglish (US)
Pages (from-to)2805-2814
Number of pages10
JournalMagnetic resonance in medicine
Volume85
Issue number5
DOIs
StateAccepted/In press - 2020

Keywords

  • histogram analysis
  • liver transplantation
  • magnetic resonance imaging
  • proton density fat fraction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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