title: Hepatic steatosis in living liver donor candidates: preoperative assessment by using breath-hold triple-echo MR imaging and 1H MR spectroscopy.
abstract: OBJECTIVE
  To evaluate the diagnostic performance of both breath-hold T2*-corrected triple-echo spoiled gradient-echo water-fat separation magnetic resonance (MR) imaging (triple-echo imaging) and high-speed T2-corrected multiecho hydrogen 1 ((1)H) MR spectroscopy in the assessment of macrovesicular hepatic steatosis in living liver donor candidates by using histologic assessment as a reference standard.
  
  
  METHODS
  The institutional review board approved this retrospective study with waiver of the need to obtain informed consent. One hundred eighty-two liver donor candidates who had undergone preoperative triple-echo imaging and single-voxel (3 × 3 × 3 cm) MR spectroscopy performed with a 3.0-T imaging unit and who had also undergone histologic evaluation of macrovesicular steatosis were included in this study. In part 1 of the study (n = 84), the Pearson correlation coefficient was calculated. Receiver operating characteristic (ROC) curve analysis was performed to detect substantial (≥10%) macrovesicular steatosis. In part 2 of the study, with a different patient group (n = 98), diagnostic performance was evaluated by using the diagnostic cutoff values determined in part 1 of the study.
  
  
  RESULTS
  The correlation coefficients of triple-echo MR imaging and MR spectroscopy with macrovesicular steatosis were 0.886 and 0.887, respectively. The areas under the ROC curve for detection of substantial macrovesicular steatosis were 0.959 and 0.988, with cutoff values of 4.93% and 5.79%, respectively, and without a significant difference (P = .328). In the part 2 study group, sensitivity and specificity were 90.9% (10 of 11) and 86.2% (75 of 87) for triple-echo MR imaging and 90.9% (10 of 11) and 86.2% (75 of 87) for MR spectroscopy, respectively.
  
  
  CONCLUSIONS
  Either breath-hold triple-echo MR imaging or MR spectroscopy can be used to detect substantial macrovesicular steatosis in living liver donor candidates. In the future, this may allow selective biopsy in candidates who are expected to have substantial macrovesicular steatosis on the basis of MR-based hepatic fat fraction.
authors.affiliation: From the Department of Radiology (I.H., J.M.L., J.H.Y., J.K.H., B.I.C.), Institute of Radiation Medicine (J.M.L., J.K.H., B.I.C.), and Department of Pathology (K.B.L.), Seoul National University Hospital, 28 Yeongon-dong, Jongno-gu, Seoul 110-744, Korea; and Siemens Healthcare, Erlangen, Germany (B.K.).
authors.forename: Inpyeong
authors.initials: I
authors.lastname: Hwang
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Kyoung Bun
authors.initials: KB
authors.lastname: Lee
authors.forename: Jeong Hee
authors.initials: JH
authors.lastname: Yoon
authors.forename: Berthold
authors.initials: B
authors.lastname: Kiefer
authors.forename: Joon Koo
authors.initials: JK
authors.lastname: Han
authors.forename: Byung Ihn
authors.initials: BI
authors.lastname: Choi
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D001706:Biopsy; D003287:Contrast Media; D005234:Fatty Liver / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA