S1347 Comparison of Quantification of Hepatic Steatosis Between Liver MRI and Biopsy in Obese Patients in Pre-Transplant Setting

Abstract

Introduction: Liver biopsy is a gold standard for assessing steatosis in non-alcoholic fatty liver disease (NAFLD). However, it carries risks including bleeding, discomfort, sampling error bias, inter-, and intra-observer variability. Magnetic resonance imaging with proton density fat-fraction (MRI-PDFF) has been explored to quantify steatosis to characterize NAFLD with accuracy and reproducibility. Our study assesses if MRI quantification of hepatic steatosis is consistent with that performed by liver biopsy for obese patients. Methods: In this study, a bivariate correlation was performed to calculate a Pearson’s correlation coefficient for patients with BMI≥30 who underwent screening with liver biopsy and liver MRI to quantify steatosis prior to living donation hepatectomy at Cleveland Clinic between 2019 and 2022. We excluded non-obese patients as well as patients who had contraindications to MRI, high alcohol use, pre-existing liver disease, or bleeding disorders. Results: We included 28 patients (median [standard deviation]) aged 41.0 [9.89] with BMI 32.3 [2.99] (Table). Patients were predominantly female (n=16, 57.1%), Caucasians (n=24, 85.7%), and with Class 1 Obesity (n=23, 23.2%). Mean MRI steatosis was 3.48 [2.53] while mean biopsy steatosis was 1.79 [3.45]. Bivariate correlation analysis showed that liver MRI and biopsy steatosis quantification to be positively correlated with moderate strength, R = 0.60, p < 0.001 for patients with BMI≥30. Conclusion: Our data highlight that liver MRI quantification of hepatic steatosis is consistent with biopsy for obese patients. These findings indicate that a liver MRI could be an accurate alternative for potential living liver donors. Further work is needed to evaluate if a liver MRI is a suitable alternative for individuals across different classes of obesity (Figure).Figure 1.: Correlation between liver biopsy steatosis and MRI steatosis Table 1. - Baseline characteristics of potential liver donors with obesity prior to hepatectomy Baseline characteristics n % Sex Female 16 57.1 Male 12 42.9 Race/Ethnicity Caucasian 24 85.7 African American 2 7.14 Hispanic 1 3.57 Other 2 7.14 Obesity classification Class I (30-34.9) 23 23.2 Class II (35-39.9) 3 3.03 Class III (>40) 2 2.02