title: Predictive Value of Unenhanced Computerized Tomography for Detecting Hepatosteatosis in Living Liver Donors.
abstract: OBJECTIVE
  Macrovesicular hepatosteatosis is related to post-transplantation complications, so preoperative hepatosteatosis determination plays a critical role in donor selection. The aim of this study was to evaluate the efficacy of unenhanced computerized tomography (CT) in determining hepatosteatosis in liver donor candidates.
  
  
  METHODS
  Information about donor candidates was retrospectively reviewed. In this screening, 27 donor candidates who underwent liver biopsy because of suspected hepatosteatosis in routine abdominal CT examination before transplantation, were reviewed. Liver biopsies and CT images were reevaluated by an experienced pathologist and radiologist. Macrovesicular hepatosteatosis was graded according to percentage and divided into 3 groups. Three radiologic liver attenuation indices were used: 1) hepatic attenuation value (CT(L)); 2) the difference between hepatic attenuation and spleen attenuation (CT(L-S)); and 3) the ratio of hepatic attenuation to splenic attenuation (CT(L/S)).
  
  
  RESULTS
  CT(L), CT(L-S), and CT(L/S) values of donors with hepatosteatosis were significantly higher than the donors without hepatosteatosis. In receiver operating characteristic analysis, the optimal cutoff value of these indices for determining hepatosteatosis were; 42.5, -5, and 0.98, respectively. At these cutoff values, the sensitivity and specificity of these indices were calculated to be 80% and 75%, 93.3% and 83.3%, and 93.3% and 83.3%, respectively. There were no statistical differences between their diagnostic performances. When these 3 indices were used for detect significant hepatosteatosis (>20%) it was observed that hepatosteatosis of only one donor could not be determined whereas it was seen that specificity was decreased markedly.
  
  
  CONCLUSIONS
  Despite the high diagnostic yield of unenhanced CT, it is not suitable to use alone for assessment of hepatosteatosis in clinical practice.
authors: Department of Gastroenterology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey. Electronic address: ubarisk@gmail.com.
authors: U B
authors: UB
authors: Kuzu
authors: Department of Gastroenterology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors: H
authors: H
authors: Gökcan
authors: Department of Gastroenterology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors: N
authors: N
authors: Suna
authors: Department of Radiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors: M
authors: M
authors: Özdemir
authors: Department of Gastroenterology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors: H
authors: H
authors: Yıldız
authors: Department of Gastroenterology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors: S
authors: S
authors: Kaçar
authors: Department of Pathology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors: N
authors: N
authors: Turhan
authors: Department of Radiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors: S
authors: S
authors: Ökten
authors: Department of Gastroenterologic Surgery, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors: B
authors: B
authors: Bostancı
authors: Department of Gastroenterology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors: M
authors: M
authors: Akdoğan
mesh_terms: D000328:Adult; D046148:Donor Selection; D005234:Fatty Liver / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D057234:Preoperative Period; D012372:ROC Curve; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*