Utility of magnetic resonance imaging versus histology for quantifying changes in liver fat in nonalcoholic fatty liver disease trials

• DOI: 10.1002/hep.26455
• Publication Date: 2013-05-20T19:45:14Z
• Authors: Mazen Noureddin; Jessica Lam; Michael R. Peterson; Michael Middleton; Gavin Hamilton; Thuy-Anh Le; Ricki Bettencourt; Chris Changchien; David A. Brenner; Claude Sirlin; Rohit Loomba
• Keywords: Adult; Male; 0301 basic medicine; Magnetic Resonance Spectroscopy; Biopsy; Clinical Sciences; Chronic Liver Disease and Cirrhosis; Clinical Trials and Supportive Activities; Immunology; 610; Clinical sciences; Medical Biochemistry and Metabolomics; Oral and gastrointestinal; Hepatitis; 03 medical and health sciences; Clinical Research; Non-alcoholic Fatty Liver Disease; 616; Humans; Longitudinal Studies; Biomedical and Clinical Sciences; Gastroenterology & Hepatology; Liver Disease; Body Weight; Middle Aged; Magnetic Resonance Imaging; 4.1 Discovery and preclinical testing of markers and technologies; 3. Good health; Fatty Liver; Liver; Biomedical Imaging; Female; Digestive Diseases; Biomarkers

The magnetic resonance imaging-estimated proton density fat fraction (MRI-PDFF) is a novel imaging-based biomarker that allows fat mapping of the entire liver, whereas the magnetic resonance spectroscopy-measured proton density fat fraction (MRS-PDFF) provides a biochemical measure of liver fat in small regions of interest. Cross-sectional studies have shown that MRI-PDFF correlates with MRS-PDFF. The aim of this study was to show the utility of MRI-PDFF in assessing quantitative changes in liver fat through a three-way comparison of MRI-PDFF and MRS-PDFF with the liver histology-determined steatosis grade at two time points in patients with nonalcoholic fatty liver disease (NAFLD). Fifty patients with biopsy-proven NAFLD who participated in a randomized trial underwent a paired evaluation with liver biopsy, MRI-PDFF, and MRS-PDFF at the baseline and 24 weeks. The mean age and body mass index were 47.8 ± 11.7 years and 30.7 ± 6.5 kg/m(2), respectively. MRI-PDFF showed a robust correlation with MRS-PDFF both at week 0 and at week 24 (r = 0.98, P < 0.0001 for both). Cross-sectionally, MRI-PDFF and MRS-PDFF increased with increases in the histology-determined steatosis grade both at week 0 and at week 24 (P < 0.05 for all). Longitudinally, patients who had a decrease (≥ 1%) or increase (≥ 1%) in MRI-PDFF (confirmed by MRS-PDFF) showed a parallel decrease or increase in their body weight and serum alanine aminotransferase and aspartate aminotransferase levels at week 24 (P < 0.05). This small increase or decrease in liver fat could not be quantified with histology.In this longitudinal study, MRI-PDFF correlated well with MRS-PDFF and was more sensitive than the histology-determined steatosis grade in quantifying increases or decreases in the liver fat content. Therefore, it could be used to quantify changes in liver fat in future clinical trials.