Abdominal Imaging

, Volume 40, Issue 4, pp 795–802 | Cite as

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

  • Juan F. Gallegos-Orozco
  • Alvin C. Silva
  • Mashal J. Batheja
  • Yu-Hui Chang
  • Kathleen L. Hansen
  • Dora Lam-Himlin
  • Giovanni De Petris
  • Bashar A. Aqel
  • Thomas J. Byrne
  • Elizabeth J. Carey
  • David D. Douglas
  • David C. Mulligan
  • Annelise M. Silva
  • Jorge Rakela
  • Hugo E. Vargas
Article

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 χ2 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.

Keywords

Live liver donation Elastography Liver stiffness Liver steatosis Live donor liver transplantation 

Notes

Disclosures

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

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Juan F. Gallegos-Orozco
    • 1
  • Alvin C. Silva
    • 2
  • Mashal J. Batheja
    • 3
  • Yu-Hui Chang
    • 4
  • Kathleen L. Hansen
    • 5
  • Dora Lam-Himlin
    • 6
  • Giovanni De Petris
    • 6
  • Bashar A. Aqel
    • 5
  • Thomas J. Byrne
    • 5
  • Elizabeth J. Carey
    • 5
  • David D. Douglas
    • 5
  • David C. Mulligan
    • 7
  • Annelise M. Silva
    • 8
  • Jorge Rakela
    • 5
  • Hugo E. Vargas
    • 5
  1. 1.Division of Gastroenterology, Hepatology and NutritionUniversity of Utah School of MedicineSalt Lake CityUSA
  2. 2.Department of RadiologyMayo Clinic ArizonaPhoenixUSA
  3. 3.Division of Gastroenterology“Carl T. Hayden” VA Medical CenterPhoenixUSA
  4. 4.Department of BiostatisticsMayo Clinic ArizonaPhoenixUSA
  5. 5.Division of Gastroenterology and HepatologyMayo Clinic ArizonaPhoenixUSA
  6. 6.Department of Laboratory Medicine and PathologyMayo Clinic ArizonaPhoenixUSA
  7. 7.Department of SurgeryYale School of MedicineNew HavenUSA
  8. 8.Arizona State UniversityTempeUSA

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