TY - JOUR
T1 - Prospective comparison of longitudinal change in hepatic proton density fat fraction (PDFF) estimated by magnitude-based MRI (MRI-M) and complex-based MRI (MRI-C)
AU - Mamidipalli, Adrija
AU - Fowler, Kathryn J.
AU - Hamilton, Gavin
AU - Wolfson, Tanya
AU - Covarrubias, Yesenia
AU - Tran, Calvin
AU - Fazeli, Soudabeh
AU - Wiens, Curtis N.
AU - McMillan, Alan
AU - Artz, Nathan S.
AU - Funk, Luke M.
AU - Campos, Guilherme M.
AU - Greenberg, Jacob A.
AU - Gamst, Anthony
AU - Middleton, Michael S.
AU - Schwimmer, Jeffrey B.
AU - Reeder, Scott B.
AU - Sirlin, Claude B.
N1 - Funding Information:
This study has received funding by R01 DK088925.
Funding Information:
Dr. Schwimmer consults for Novo Nordisk, and has received grant support from Galmed and Intercept.
Publisher Copyright:
© 2020, European Society of Radiology.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Purpose: To compare longitudinal hepatic proton density fat fraction (PDFF) changes estimated by magnitude- vs. complex-based chemical-shift-encoded MRI during a weight loss surgery (WLS) program in severely obese adults with biopsy-proven nonalcoholic fatty liver disease (NAFLD). Methods: This was a secondary analysis of a prospective dual-center longitudinal study of 54 adults (44 women; mean age 52 years; range 27–70 years) with obesity, biopsy-proven NAFLD, and baseline PDFF ≥ 5%, enrolled in a WLS program. PDFF was estimated by confounder-corrected chemical-shift-encoded MRI using magnitude (MRI-M)- and complex (MRI-C)-based techniques at baseline (visit 1), after a 2- to 4-week very low–calorie diet (visit 2), and at 1, 3, and 6 months (visits 3 to 5) after surgery. At each visit, PDFF values estimated by MRI-M and MRI-C were compared by a paired t test. Rates of PDFF change estimated by MRI-M and MRI-C for visits 1 to 3, and for visits 3 to 5 were assessed by Bland-Altman analysis and intraclass correlation coefficients (ICCs). Results: MRI-M PDFF estimates were lower by 0.5–0.7% compared with those of MRI-C at all visits (p < 0.001). There was high agreement and no difference between PDFF change rates estimated by MRI-M vs. MRI-C for visits 1 to 3 (ICC 0.983, 95% CI 0.971, 0.99; bias = − 0.13%, p = 0.22), or visits 3 to 5 (ICC 0.956, 95% CI 0.919–0.977%; bias = 0.03%, p = 0.36). Conclusion: Although MRI-M underestimates PDFF compared with MRI-C cross-sectionally, this bias is consistent and MRI-M and MRI-C agree in estimating the rate of hepatic PDFF change longitudinally. Key Points: • MRI-M demonstrates a significant but small and consistent bias (0.5–0.7%; p < 0.001) towards underestimation of PDFF compared with MRI-C at 3 T. • Rates of PDFF change estimated by MRI-M and MRI-C agree closely (ICC 0.96–0.98) in adults with severe obesity and biopsy- proven NAFLD enrolled in a weight loss surgery program. • Our findings support the use of either MRI technique (MRI-M or MRI-C) for clinical care or by individual sites or for multi-center trials that include PDFF change as an endpoint. However, since there is a bias in their measurements, the same technique should be used in any given patient for longitudinal follow-up.
AB - Purpose: To compare longitudinal hepatic proton density fat fraction (PDFF) changes estimated by magnitude- vs. complex-based chemical-shift-encoded MRI during a weight loss surgery (WLS) program in severely obese adults with biopsy-proven nonalcoholic fatty liver disease (NAFLD). Methods: This was a secondary analysis of a prospective dual-center longitudinal study of 54 adults (44 women; mean age 52 years; range 27–70 years) with obesity, biopsy-proven NAFLD, and baseline PDFF ≥ 5%, enrolled in a WLS program. PDFF was estimated by confounder-corrected chemical-shift-encoded MRI using magnitude (MRI-M)- and complex (MRI-C)-based techniques at baseline (visit 1), after a 2- to 4-week very low–calorie diet (visit 2), and at 1, 3, and 6 months (visits 3 to 5) after surgery. At each visit, PDFF values estimated by MRI-M and MRI-C were compared by a paired t test. Rates of PDFF change estimated by MRI-M and MRI-C for visits 1 to 3, and for visits 3 to 5 were assessed by Bland-Altman analysis and intraclass correlation coefficients (ICCs). Results: MRI-M PDFF estimates were lower by 0.5–0.7% compared with those of MRI-C at all visits (p < 0.001). There was high agreement and no difference between PDFF change rates estimated by MRI-M vs. MRI-C for visits 1 to 3 (ICC 0.983, 95% CI 0.971, 0.99; bias = − 0.13%, p = 0.22), or visits 3 to 5 (ICC 0.956, 95% CI 0.919–0.977%; bias = 0.03%, p = 0.36). Conclusion: Although MRI-M underestimates PDFF compared with MRI-C cross-sectionally, this bias is consistent and MRI-M and MRI-C agree in estimating the rate of hepatic PDFF change longitudinally. Key Points: • MRI-M demonstrates a significant but small and consistent bias (0.5–0.7%; p < 0.001) towards underestimation of PDFF compared with MRI-C at 3 T. • Rates of PDFF change estimated by MRI-M and MRI-C agree closely (ICC 0.96–0.98) in adults with severe obesity and biopsy- proven NAFLD enrolled in a weight loss surgery program. • Our findings support the use of either MRI technique (MRI-M or MRI-C) for clinical care or by individual sites or for multi-center trials that include PDFF change as an endpoint. However, since there is a bias in their measurements, the same technique should be used in any given patient for longitudinal follow-up.
KW - Longitudinal study
KW - Magnetic resonance imaging
KW - Nonalcoholic fatty liver disease
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U2 - 10.1007/s00330-020-06858-x
DO - 10.1007/s00330-020-06858-x
M3 - Article
C2 - 32318847
AN - SCOPUS:85084048042
SN - 0938-7994
VL - 30
SP - 5120
EP - 5129
JO - European Radiology
JF - European Radiology
IS - 9
ER -