{"title":"Evaluation of MRI proton density fat fraction in hepatic steatosis: a systematic review and meta-analysis","authors":"Narges Azizi, Hamed Naghibi, Madjid Shakiba, Mina Morsali, Diana Zarei, Hedayat Abbastabar, Hossein Ghanaati","doi":"10.1007/s00330-024-11001-1","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Amidst the global rise of metabolic dysfunction-associated steatotic liver disease (MASLD), driven by increasing obesity rates, there is a pressing need for precise, non-invasive diagnostic tools. Our research aims to validate MRI Proton Density Fat Fraction (MRI-PDFF) utility, compared to liver biopsy, in grading hepatic steatosis in MASLD.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A systematic search was conducted across Embase, PubMed/Medline, Scopus, and Web of Science until January 13, 2024, selecting studies that compare MRI-PDFF with liver biopsy for hepatic steatosis grading, defined as grades 0 (< 5% steatosis), 1 (5–33% steatosis), 2 (34–66% steatosis), and 3 (> 66% steatosis).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Twenty-two studies with 2844 patients were included. The analysis showed high accuracy of MRI-PDFF with AUCs of 0.97 (95% CI = 0.96–0.98) for grade 0 vs ≥ 1, 0.91 (95% CI = 0.88–0.93) for ≤ 1 vs ≥ 2, and 0.91 (95% CI = 0.88–0.93) for ≤ 2 vs 3, diagnostic odds ratio (DOR) from 98.74 (95% CI = 58.61–166.33) to 23.36 (95% CI = 13.76–39.68), sensitivity and specificity from 0.93 (95% CI = 0.88–0.96) to 0.76 (95% CI = 0.63–0.85) and 0.93 (95% CI = 0.88–0.96) to 0.89 (95% CI = 0.84–0.93), respectively. Likelihood ratio (LR) + ranged from 13.3 (95% CI = 7.4–24.0) to 7.2 (95% CI = 4.9–10.5), and LR − from 0.08 (95% CI = 0.05–0.13) to 0.27 (95% CI = 0.17–0.42). The proposed MRI-PDFF threshold of 5.7% for liver fat content emerges as a potential cut-off for the discrimination between grade 0 vs ≥ 1 (<i>p</i> = 0.075).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>MRI-PDFF is a precise non-invasive technique for diagnosing and grading hepatic steatosis, warranting further studies to establish its diagnostic thresholds.</p><h3 data-test=\"abstract-sub-heading\">Clinical relevance statement</h3><p>This study underscores the high diagnostic accuracy of MRI-PDFF for distinguishing between various grades of hepatic steatosis for early detection and management of MASLD, though further research is necessary for broader application.</p><h3 data-test=\"abstract-sub-heading\">Key Points</h3><ul>\n<li>\n<p><i>MRI-PDFF offers precision in diagnosing and monitoring hepatic steatosis</i>.</p>\n</li>\n<li>\n<p><i>The diagnostic accuracy of MRI-PDFF decreases as the grade of hepatic steatosis advances</i>.</p>\n</li>\n<li>\n<p><i>A 5.7% MRI-PDFF threshold differentiates steatotic from non-steatotic livers</i>.</p>\n</li>\n</ul><h3 data-test=\"abstract-sub-heading\">Graphical Abstract</h3>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":null,"pages":null},"PeriodicalIF":4.7000,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00330-024-11001-1","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Amidst the global rise of metabolic dysfunction-associated steatotic liver disease (MASLD), driven by increasing obesity rates, there is a pressing need for precise, non-invasive diagnostic tools. Our research aims to validate MRI Proton Density Fat Fraction (MRI-PDFF) utility, compared to liver biopsy, in grading hepatic steatosis in MASLD.
Methods
A systematic search was conducted across Embase, PubMed/Medline, Scopus, and Web of Science until January 13, 2024, selecting studies that compare MRI-PDFF with liver biopsy for hepatic steatosis grading, defined as grades 0 (< 5% steatosis), 1 (5–33% steatosis), 2 (34–66% steatosis), and 3 (> 66% steatosis).
Results
Twenty-two studies with 2844 patients were included. The analysis showed high accuracy of MRI-PDFF with AUCs of 0.97 (95% CI = 0.96–0.98) for grade 0 vs ≥ 1, 0.91 (95% CI = 0.88–0.93) for ≤ 1 vs ≥ 2, and 0.91 (95% CI = 0.88–0.93) for ≤ 2 vs 3, diagnostic odds ratio (DOR) from 98.74 (95% CI = 58.61–166.33) to 23.36 (95% CI = 13.76–39.68), sensitivity and specificity from 0.93 (95% CI = 0.88–0.96) to 0.76 (95% CI = 0.63–0.85) and 0.93 (95% CI = 0.88–0.96) to 0.89 (95% CI = 0.84–0.93), respectively. Likelihood ratio (LR) + ranged from 13.3 (95% CI = 7.4–24.0) to 7.2 (95% CI = 4.9–10.5), and LR − from 0.08 (95% CI = 0.05–0.13) to 0.27 (95% CI = 0.17–0.42). The proposed MRI-PDFF threshold of 5.7% for liver fat content emerges as a potential cut-off for the discrimination between grade 0 vs ≥ 1 (p = 0.075).
Conclusion
MRI-PDFF is a precise non-invasive technique for diagnosing and grading hepatic steatosis, warranting further studies to establish its diagnostic thresholds.
Clinical relevance statement
This study underscores the high diagnostic accuracy of MRI-PDFF for distinguishing between various grades of hepatic steatosis for early detection and management of MASLD, though further research is necessary for broader application.
Key Points
MRI-PDFF offers precision in diagnosing and monitoring hepatic steatosis.
The diagnostic accuracy of MRI-PDFF decreases as the grade of hepatic steatosis advances.
A 5.7% MRI-PDFF threshold differentiates steatotic from non-steatotic livers.
期刊介绍:
European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field.
This is the Journal of the European Society of Radiology, and the official journal of a number of societies.
From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.