Magnetic resonance for quantitative assessment of liver steatosis: a new potential tool to monitor antiretroviral-drug-related toxicities

• Published in: Antiviral therapy 2012-01, Vol.17 (6), p.965-971
• Main Authors: GUARALDI, Giovanni, BESUTTI, Giulia, STENTARELLI, Chiara, ZONA, Stefano, NOCETTI, Luca, LORIA, Paola, BALLESTRI, Stefano, LOSI, Luisa, TORRICELLI, Pietro, LIGABUE, Guido
• Format: Article
• Language: English
• Subjects: Adult; Anti-Retroviral Agents - adverse effects; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Biological and medical sciences; Biopsy - methods; Contraindications; Drug-Related Side Effects and Adverse Reactions - pathology; Fatty Liver - chemically induced; Fatty Liver - diagnosis; Female; Gastroenterology. Liver. Pancreas. Abdomen; HIV Infections - drug therapy; HIV Infections - pathology; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Linear Models; Liver - drug effects; Liver - pathology; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Magnetic Resonance Imaging - methods; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Pharmacology. Drug treatments; Pilot Projects; Reference Standards; ROC Curve; Sensitivity and Specificity; Tertiary Care Centers; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids
• ISSN: 1359-6535; 2040-2058
• DOI: 10.3851/imp2228

There is an increasing need for new diagnostic tools to monitor antiretroviral drug-related toxicities. Magnetic resonance (MR) imaging and MR spectroscopy are non-invasive diagnostic methods used in the detection and quantification of liver fat. The aim of this study was to compare sensitivity and specificity of different MR techniques in the quantitative assessment of liver steatosis, using liver biopsy as the reference standard, in patients with and without HIV infection. Sequentially evaluated patients with suspected steatosis who were referred for liver biopsy at our tertiary care site were eligible. MR liver fat content (LFC) was estimated by T2-weighted and fat-suppressed T2-weighted spin-echo, dual-phase T1-weighted gradient-echo, multiecho gradient-echo and (1)H spectroscopy. Association between LFC and histological steatosis percentage was calculated by using univariate linear regressions and Pearson's coefficient. Respective receiver operating characteristic (ROC) curves were used to compare specificity and sensitivity of MR methods in diagnosis (cutoff 5%) and in quantitative evaluation (cutoff 33%) of steatosis. A total of 28 patients were identified: 12 refused or had contraindications for liver biopsy and 16 had biopsies plus MR. LFC and histological steatosis percentage were strongly associated (fat-suppressed r=0.86 [P