title: Hepatic steatosis assessment with 1H-spectroscopy and chemical shift imaging at 3.0 T before hepatic surgery: reliable enough for making clinical decisions?
abstract: OBJECTIVE
  To compare the accuracy of liver fat quantification using chemical shift imaging (CSI) and H1 MR-spectroscopy (MRS) at 3.0 T in patients undergoing liver resection.
  
  
  METHODS
  Totally 35 patients were included in this prospective IRB approved study. The histopathologically assessed liver fat was compared to the hepatic fat fractions calculated with CSI (with and without spleen correction) and MRS. Spearman's rank correlation and Fisher z-test were used for correlation analysis. Sensitivity and specificity regarding the detection of marked steatosis were calculated for the different modalities and compared using the McNemar test.
  
  
  RESULTS
  MRS (r=.85) and CSI with spleen correction (r=.85) showed a significantly better correlation (p=.03) with histology compared to CSI without spleen correction (r=.67). Sensitivity and specificity for the detection of marked steatosis was 100% (12/12) and 87% (20/23) for MRS and 92% (11/12) and 83% (19/23) for CSI with spleen correction (p>.12).
  
  
  CONCLUSIONS
  For the assessment of hepatic steatosis both CSI with spleen correction and MRS at 3.0 T, show a good correlation with histology. CSI without spleen correction should not be used. Sensitivity and specificity for the detection of marked steatosis are high with both modalities. However, results that are scattered around the cut-off values are not reliable enough for clinical decisions.
authors: Department of Radiology, Medical University of Vienna, Vienna, Austria. claus.koelblinger@meduniwien.ac.at
authors: Claus
authors: C
authors: Koelblinger
authors: Martin
authors: M
authors: Krššák
authors: Judith
authors: J
authors: Maresch
authors: Fritz
authors: F
authors: Wrba
authors: Klaus
authors: K
authors: Kaczirek
authors: Thomas
authors: T
authors: Gruenberger
authors: Dietmar
authors: D
authors: Tamandl
authors: Ahmed
authors: A
authors: Ba-Ssalamah
authors: Vanessa
authors: V
authors: Berger-Kulemann
authors: Michael
authors: M
authors: Weber
authors: Wolfgang
authors: W
authors: Schima
mesh_terms: D000273:Adipose Tissue; D005234:Fatty Liver / Q000175:diagnosis* / Q000378:metabolism* / Q000601:surgery; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D011522:Protons; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D011522:Protons