Role of MR as Non-Invasive Procedure in Assessment of Fatty Liver Infiltration in Potential Liver Donor Versus Biopsy

Abstract

Background: Significant hepatic steatosis can impact surgical results in the donor. Liver biopsy is the gold standard for hepatic steatosis diagnosis and assessment. Liver biopsy is not useful for screening or monitoring hepatic steatosis in living liver donors. MR spectroscopy and the proton density fat fraction (FF) approach have shown encouraging results in assessing hepatic steatosis. Aim and Objectives: is to correlate between the MRI-PDFF techniques as a non-invasive technique in pre-operative assessment   of quantification of liver fat in comparison to the liver biopsy. Patients and Methods: This prospective control study was conducted at the National Hepatology and tropical medicine research institute including 42adult potential hepatic donors. The duration of the study ranged from 6-12 months. Results: regarding median fat percent for selected patients (n=42) We found that correlation between both reading was significant strong positive one (spearman correlation =0.960, p<0.001). despite the recorded liver fat percent through MRI PDFF was higher in males when compared to females, this was statistically insignificant. MRI PDFF true positive was 86.8% with false positive of 50% and true negative was 50% with false negative of 13.2%. Conclusion: Noninvasive MR hepatic PDFF technique with IDEAL sequence is a precise reliable technique for quantitative assessment of hepatic steatosis with high sensitivity, specificity and accuracy of It is recommended to be a part of preoperative liver evaluation in living donors and selectively performing liver biopsy in donor candidates diagnosed to have substantial steatosis based on MR PDFF findings.