41. A Comparative Evaluation of MRI and Liver Biopsy for Liver Fat Estimation in Liver Transplant Donors

Abstract

Background and Aims: Donor hepatic steatosis is associated with a greater risk of complications after living donor liver transplantation (LDLT). MRI IDEAL IQ (Iterative Decomposition of water and fat with Echo Asymmetry and Least squares estimation) has recently been shown to be accurate for hepatic fat quantification in animal and human studies. In this study, we describe the use of MRI IDEAL IQ technique in quantification of hepatic steatosis in live liver donors and compared it with liver biopsy. Methods: Between November 2014 to February 2017 we prospectively evaluated 50 liver donors comparing the MRI IDEAL IQ technique with either preoperative or intraoperative liver biopsy. The accuracy of MRI was assessed by linear regression analysis between MRI liver fat fraction and biopsy fat estimation. Results: Less than 3% fat content was detected in 33 donors (84.6%), 3–6% fat content in 13 (26%), 6–9% fat content in 3 (6%) and more than 9% fat content in 1 donor (2%) on MRI. On linear regression analysis MRI IDEAL IQ fat evaluation correlated well with histopathological fat evaluation for detecting fat content in livers (R2 = 0.757). The accuracy of MRI IDEAL IQ was 88% with sensitivity and specificity rates of 100% and 84.6% respectively for detecting fat content in the liver (P < 0.0001). The average liver fat content evaluated by MRI correlated with BMI but not with age or sex. The groups were comparable in terms of demographic and clinical variables in donors, or development of early graft dysfunction and deranged kidney function in liver transplant recipients. Conclusions: The MRI IDEAL IQ technique is a highly reliable and accurate method, which can replace liver biopsy for the liver fat estimation in live liver donors and hence avoid potential complications of an invasive biopsy. The authors have none to declare.