Abstract

Non-alcoholic fatty liver disease is a highly prevalent condition worldwide that increases the risk to develop liver fibrosis, cirrhosis, and hepatocellular carcinoma. Thus, it is imperative to develop novel diagnostic tools that together with liver biopsy help to differentiate mild and advanced degrees of steatosis. Ex-vivo liver samples were collected from mice fed a methionine-choline deficient diet for two or eight weeks, and from a control group. The degree of hepatic steatosis was histologically evaluated, and fat content was assessed by Oil-Red O staining. On the other hand, fluorescence spectroscopy was used for the assessment of the steatosis progression. Fluorescence spectra were recorded at excitation wavelengths of 330, 365, 385, 405, and 415 nm by establishing surface contact of the fiber optic probe with the liver specimens. A multi-variate statistical approach based on principal component analysis followed by quadratic discriminant analysis was applied to spectral data to obtain classifiers able to distinguish mild and moderate stages of steatosis at the different excitation wavelengths. Receiver Operating Characteristic (ROC) curves were computed to compare classifier’s performances for each one of the five excitation wavelengths and steatosis stages. Optimal sensitivity and specificity were calculated from the corresponding ROC curves using the Youden index. Intensity in the endogenous fluorescence spectra at the given wavelengths progressively increased according to the time of exposure to diet. The area under the curve of the spectra was able to discriminate control liver samples from those with steatosis and differentiate among the time of exposure to the diet for most of the used excitation wavelengths. High specificities and sensitivities were obtained for every case; however, fluorescence spectra obtained by exciting with 405 nm yielded the best results distinguishing between the mentioned classes with a total classification error of 1.5% and optimal sensitivities and specificities better than 98.6% and 99.3%, respectively.

Highlights

  • The anomalous accumulation of lipids in the liver of patients with negligible alcohol consumption and seronegative to hepatitis C virus infection (HCV) is called non-alcoholic fatty liver disease (NAFLD)and is characterized by a broad spectrum of hepatic histopathological changes [1]

  • The central purpose of this work was to examine whether the liver tissue has specific endogenous fluorescence patterns depending on the degree of steatosis, and assessing the feasibility of grading liver steatosis by means of Endogenous fluorescence spectroscopy (EFS) as a complementary tool to liver biopsy using an animal model of NAFLD

  • We developed several tests to evaluate the capability of EFS as an assessment tool the measured fluorescence spectra shown in Figure 1d, where the intensity differences between the group mean spectra, in the interval above 600 nm, are larger than the respective group standard deviations

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Summary

Introduction

The anomalous accumulation of lipids in the liver of patients with negligible alcohol consumption and seronegative to hepatitis C virus infection (HCV) is called non-alcoholic fatty liver disease (NAFLD)and is characterized by a broad spectrum of hepatic histopathological changes [1]. Numerous studies have consistently reported significant intra- and inter-observer variability in the assessment of intrahepatic lipid accumulation, especially in mild-to-moderate and moderate-to-advanced steatosis degrees by means of a liver biopsy [3,4,5,6,7,8,9,10]. Such a marked variability may result in an underestimation of the degree of steatosis and an inadequate diagnosis of the disease, which could lead to poor medical treatment and follow-up for patients [6,11]. It is imperative to establish techniques complementary to liver biopsy in order to more precisely grade hepatic steatosis in patients at risk of developing chronic liver disease

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