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Magnetic resonance elastography can discriminate normal vs. abnormal liver biopsy in candidates for live liver donation

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Abstract

Purpose

The aim of this study was to define liver shear stiffness by magnetic resonance elastography (MRE) that distinguishes normal from abnormal liver biopsy, especially when steatosis ≥20%, among potential live liver donors.

Methods

Baseline clinical, laboratory, imaging, MRE, and liver biopsy results were recorded. Using MRE, hepatic shear stiffness in kilopascals (kPa) was measured and compared to liver biopsy. Comparison between groups was done using χ 2 or Fisher’s exact test for categorical variables and Wilcoxon test for continuous variables. Receiver operating characteristic (ROC) curve was calculated to assess diagnostic accuracy. Statistical significance was set at p < 0.05.

Results

38 healthy adults were included. Liver biopsy was normal in 27 and abnormal in 11. ROC curve for MRE defined optimal cutoff at 2.6 kPa (sensitivity 0.72, specificity 0.85, AUC 0.81) to distinguish these 2 groups. Hepatic steatosis ≥20% on biopsy is a contraindication for liver donation in our center. We evaluated the ability of MRE to distinguish this degree of steatosis: 8 persons had steatosis ≥20% and were excluded from donation. ROC curve for MRE defined optimal cutoff at 2.82 kPa (sensitivity 0.88, specificity 1, AUC 0.98) to identify this group.

Conclusions

Liver stiffness measured by MRE, even in the absence of liver fibrosis, can be useful in differentiating normal from abnormal liver histology, and most importantly in patients under evaluation for live liver donation, can very accurately distinguish those with complicated hepatic steatosis ≥20%, our cutoff for donation. In the future, MRE might provide supplementary information to make liver biopsy unnecessary in the donor evaluation process.

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Disclosures

The authors have no conflict of interest or financial involvement with this manuscript.

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Authors and Affiliations

  1. Division of Gastroenterology, Hepatology and Nutrition, University of Utah School of Medicine, 30 North 1900 East, SOM 4R118, Salt Lake City, UT, 84132, USA

    Juan F. Gallegos-Orozco

  2. Department of Radiology, Mayo Clinic Arizona, Phoenix, AZ, USA

    Alvin C. Silva

  3. Division of Gastroenterology, “Carl T. Hayden” VA Medical Center, Phoenix, AZ, USA

    Mashal J. Batheja

  4. Department of Biostatistics, Mayo Clinic Arizona, Phoenix, AZ, USA

    Yu-Hui Chang

  5. Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, Phoenix, AZ, USA

    Kathleen L. Hansen, Bashar A. Aqel, Thomas J. Byrne, Elizabeth J. Carey, David D. Douglas, Jorge Rakela & Hugo E. Vargas

  6. Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix, AZ, USA

    Dora Lam-Himlin & Giovanni De Petris

  7. Department of Surgery, Yale School of Medicine, New Haven, CT, USA

    David C. Mulligan

  8. Arizona State University, Tempe, AZ, USA

    Annelise M. Silva

Authors
  1. Juan F. Gallegos-Orozco
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  2. Alvin C. Silva
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  13. Annelise M. Silva
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Corresponding author

Correspondence to Juan F. Gallegos-Orozco.

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Gallegos-Orozco, J.F., Silva, A.C., Batheja, M.J. et al. Magnetic resonance elastography can discriminate normal vs. abnormal liver biopsy in candidates for live liver donation. Abdom Imaging 40, 795–802 (2015). https://doi.org/10.1007/s00261-014-0310-y

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  • DOI: https://doi.org/10.1007/s00261-014-0310-y

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