Magnetic Resonance Spectroscopy in Living-Donor Liver Transplantation

• One breath-hold stimulated echo acquisition mode 1H magnetic resonance spectroscopy (MRS) was performed to quantification of hepatic steatosis in living donors and compared with intraoperative liver biopsy.
• MRS has no radiation exposure, thus the examination can be repeated when necessary.
• MRS provided multiple voxel selection and obtained high diagnostic accuracy for liver fat quantification.

ObjectiveThe purpose of this study is to evaluate the accuracy rate of the one breath-hold single voxel hydrogen-1 magnetic resonance spectroscopy (MRS) in comparison with intraoperative biopsy for liver fat quantification in living-donor liver transplantation.Materials and MethodsA total of 80 living liver donors participated in this study. Each patient underwent both MRS and intraoperative biopsy for evaluation of liver fatty content. MRS was performed using 1.5-T magnetic resonance imaging and placed in segments 2–4, 5–8, and left lateral segment for each donor. Accuracy was assessed through receiver operating characteristic curve analysis. Sensitivity and specificity of MRS fat fractions were also calculated.ResultsEighty living-donor liver transplantation donors were enrolled in this study. There was no fatty liver in 59 subjects (73.8%), 5% to 10% fatty liver in 17 subjects, 11% to 15% fatty liver in 3 subjects, and >16% fatty liver in 1 subject. MRS fat fraction showed excellent parameters to predict between normal liver and fatty liver groups (1.85% ± 0.98, 8.13% ± 3.52, respectively; P < .0001). Linear regression between MRS fat fraction and pathology grading showed high correlation (R2 = 0.7092). Pearson correlation revealed high correlation between MRS and pathology results (r = 0.936), poor correlation between body mass index and pathology results (r = 0.390). The sensitivity and specificity for detection of liver steatosis in MRS fat fraction were 95.2% and 98.3%, respectively.Conclusion1H MRS fat fraction is a highly precise and accurate method in quantification of hepatic steatosis for the living donor and can be finished in a single breath-hold.