Comparing Different Methods for the Diagnosis of Liver Steatosis: What Are the Best Diagnostic Tools?

Overview

Journal Diagnostics (Basel)

Specialty Radiology

Date 2024 Oct 25

PMID 39451615

Authors

Sophie Chopinet

Olivier Lopez

Sophie Brustlein

Antoine Uzel

Anais Moyon

Isabelle Varlet

Laure Balasse

Frank Kober

Mickael Bobot

Monique Bernard

Aurelie Haffner

Michael Sdika

Bruno Montcel

Benjamin Guillet

Vincent Vidal

Emilie Gregoire

Jean Hardwigsen

Pauline Brige

Affiliations

Soon will be listed here.

Abstract

Background: Due to the ongoing organ shortage, marginal grafts with steatosis are more frequently used in liver transplantation, leading to higher occurrences of graft dysfunction. A histological analysis is the gold standard for the quantification of liver steatosis (LS), but has its drawbacks: it is an invasive method that varies from one pathologist to another and is not available in every hospital at the time of organ procurement. This study aimed to compare non-invasive diagnostic tools to a histological analysis for the quantification of liver steatosis.

Methods: Male C57BL6J mice were fed with a methioninecholine-deficient (MCD) diet for 14 days or 28 days to induce LS, and were compared to a control group of animals fed with a normal diet. The following non-invasive techniques were performed and compared to the histological quantification of liver steatosis: magnetic resonance spectroscopy (MRS), CARS microscopy, Tc MIBI SPECT imaging, and a new near-infrared spectrometer (NIR-SG1).

Results: After 28 days on the MCD diet, an evaluation of LS showed ≥30% macrovesicular steatosis. High correlations were found between the NIR-SG1 and the blinded pathologist analysis (R = 0.945) ( = 0.001), and between the CARS microscopy (R = 0.801 ( < 0.001); MRS, R = 0.898 ( < 0.001)) and the blinded pathologist analysis. The ROC curve analysis showed that the area under the curve (AUC) was 1 for both the NIR-SG1 and MRS ( = 0.021 and < 0.001, respectively), while the AUC = 0.910 for the Oil Red O stain ( < 0.001) and the AUC = 0.865 for the CARS microscopy ( < 0.001). The AUC for the Tc MIBI SPECT was 0.640 ( = 0.013), and this was a less discriminating technique for LS quantification.

Conclusions: The best-performing non-invasive methods for LS quantification are MRS, CARS microscopy, and the NIR-SG1. The NIR-SG1 is particularly appropriate for clinical practice and needs to be validated by clinical studies on liver grafts.

References

Qayyum A, Chen D, Breiman R, Westphalen A, Yeh B, Jones K . Evaluation of diffuse liver steatosis by ultrasound, computed tomography, and magnetic resonance imaging: which modality is best?. Clin Imaging. 2009; 33(2):110-5. PMC: 2743961. DOI: 10.1016/j.clinimag.2008.06.036. View

Nahon P, Soubrane O . Fa(s)t assessment of the liver graft: Is it relevant?. J Hepatol. 2019; 70(3):346-347. DOI: 10.1016/j.jhep.2018.12.017. View

Pais R, Barritt 4th A, Calmus Y, Scatton O, Runge T, Lebray P . NAFLD and liver transplantation: Current burden and expected challenges. J Hepatol. 2016; 65(6):1245-1257. PMC: 5326676. DOI: 10.1016/j.jhep.2016.07.033. View

Yin Z, Murphy M, Li J, Glaser K, Mauer A, Mounajjed T . Prediction of nonalcoholic fatty liver disease (NAFLD) activity score (NAS) with multiparametric hepatic magnetic resonance imaging and elastography. Eur Radiol. 2019; 29(11):5823-5831. PMC: 6751038. DOI: 10.1007/s00330-019-06076-0. View

Eslam M, Newsome P, Sarin S, Anstee Q, Targher G, Romero-Gomez M . A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol. 2020; 73(1):202-209. DOI: 10.1016/j.jhep.2020.03.039. View

Reistad N, Nilsson J, Bergenfeldt M, Rissler P, Sturesson C . Intraoperative liver steatosis characterization using diffuse reflectance spectroscopy. HPB (Oxford). 2018; 21(2):175-180. DOI: 10.1016/j.hpb.2018.06.1809. View

McCormack L, Petrowsky H, Jochum W, Mullhaupt B, Weber M, Clavien P . Use of severely steatotic grafts in liver transplantation: a matched case-control study. Ann Surg. 2007; 246(6):940-6. DOI: 10.1097/SLA.0b013e31815c2a3f. View

Lombardini A, Mytskaniuk V, Sivankutty S, Andresen E, Chen X, Wenger J . High-resolution multimodal flexible coherent Raman endoscope. Light Sci Appl. 2019; 7:10. PMC: 6107025. DOI: 10.1038/s41377-018-0003-3. View

Farrell G, Larter C . Nonalcoholic fatty liver disease: from steatosis to cirrhosis. Hepatology. 2006; 43(2 Suppl 1):S99-S112. DOI: 10.1002/hep.20973. View

10.

Chiang H, Lin L, Li C, Lin C, Chiang H, Huang T . Magnetic resonance fat quantification in living donor liver transplantation. Transplant Proc. 2014; 46(3):666-8. DOI: 10.1016/j.transproceed.2013.11.050. View

11.

Kleiner D, Brunt E, Van Natta M, Behling C, Contos M, Cummings O . Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005; 41(6):1313-21. DOI: 10.1002/hep.20701. View

12.

Evers D, Westerkamp A, Spliethoff J, Pully V, Hompes D, Hendriks B . Diffuse reflectance spectroscopy: toward real-time quantification of steatosis in liver. Transpl Int. 2015; 28(4):465-74. DOI: 10.1111/tri.12517. View

13.

Sasso M, Miette V, Sandrin L, Beaugrand M . The controlled attenuation parameter (CAP): a novel tool for the non-invasive evaluation of steatosis using Fibroscan. Clin Res Hepatol Gastroenterol. 2011; 36(1):13-20. DOI: 10.1016/j.clinre.2011.08.001. View

14.

Elbanna K, Mansoori B, Mileto A, Rogalla P, Guimaraes L . Dual-energy CT in diffuse liver disease: is there a role?. Abdom Radiol (NY). 2020; 45(11):3413-3424. DOI: 10.1007/s00261-020-02702-4. View

15.

Crane P, LALIBERTE R, Heminway S, Thoolen M, Orlandi C . Effect of mitochondrial viability and metabolism on technetium-99m-sestamibi myocardial retention. Eur J Nucl Med. 1993; 20(1):20-5. DOI: 10.1007/BF02261241. View

16.

Le T, Ziemba A, Urasaki Y, Brotman S, Pizzorno G . Label-free evaluation of hepatic microvesicular steatosis with multimodal coherent anti-Stokes Raman scattering microscopy. PLoS One. 2012; 7(11):e51092. PMC: 3511365. DOI: 10.1371/journal.pone.0051092. View

17.

Zhang Q, Zhang Q, Zhang D . The Impact of Steatosis on the Outcome of Liver Transplantation: A Meta-Analysis. Biomed Res Int. 2019; 2019:3962785. PMC: 6536983. DOI: 10.1155/2019/3962785. View

18.

Wu Y, Chen H, Chang W, Jhan J, Lin H, Liau I . Quantitative assessment of hepatic fat of intact liver tissues with coherent anti-stokes Raman scattering microscopy. Anal Chem. 2009; 81(4):1496-504. DOI: 10.1021/ac8026838. View

19.

Boudinaud C, Abergel A, Joubert-Zakeyh J, Fontarensky M, Pereira B, Chauveau B . Quantification of steatosis in alcoholic and nonalcoholic fatty liver disease: Evaluation of four MR techniques versus biopsy. Eur J Radiol. 2019; 118:169-174. DOI: 10.1016/j.ejrad.2019.07.025. View

20.

Cesaretti M, Izzo A, Pellegrino R . Letter to the Editor: Assessment of liver graft steatosis: a new panorama. Liver Transpl. 2023; 29(5):E6-E7. DOI: 10.1097/LVT.0000000000000072. View