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1. Bone marrow fat content is correlated with hepatic fat content in paediatric non-alcoholic fatty liver disease

Author

Yu, NY, Wolfson, T, Middleton, MS, Hamilton, G, Gamst, A, Angeles, JE, Schwimmer, JB, and Sirlin, CB

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Digestive Diseases, Clinical Research, Chronic Liver Disease and Cirrhosis, Pediatric, Liver Disease, Obesity, Biomedical Imaging, Musculoskeletal, Adipose Tissue, Adolescent, Adult, Bone Marrow, Child, Cross-Sectional Studies, Female, Humans, Image Interpretation, Computer-Assisted, Liver, Male, Non-alcoholic Fatty Liver Disease, Prospective Studies, Reproducibility of Results, Young Adult, Nuclear Medicine & Medical Imaging, Clinical sciences
Abstract

AimTo investigate the relationship between bone marrow fat content and hepatic fat content in children with known or suspected non-alcoholic fatty liver disease (NAFLD).Materials and methodsThis was an institutional review board-approved, Health Insurance Portability and Accountability Act (HIPAA)-compliant, cross-sectional, prospective analysis of data collected between October 2010 to March 2013 in 125 children with known or suspected NAFLD. Written informed consent was obtained for same-day research magnetic resonance imaging (MRI) of the lumbar spine, liver, and abdominal adiposity. Lumbar spine bone marrow proton density fat fraction (PDFF) and hepatic PDFF were estimated using complex-based MRI (C-MRI) techniques and magnitude-based MRI (M-MRI), respectively. Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SCAT) were quantified using high-resolution MRI. All images were acquired by two MRI technologists. Hepatic M-MRI images were analysed by an image analyst; all other images were analysed by a single investigator. The relationship between lumbar spine bone marrow PDFF and hepatic PDFF was assessed with and without adjusting for the presence of covariates using correlation and regression analysis.ResultsLumbar spine bone marrow PDFF was positively associated with hepatic PDFF in children with known or suspected NAFLD prior to adjusting for covariates (r=0.33, p=0.0002). Lumbar spine bone marrow PDFF was positively associated with hepatic PDFF in children with known or suspected NAFLD (r=0.24, p=0.0079) after adjusting for age, sex, body mass index z-score, VAT, and SCAT in a multivariable regression analysis.ConclusionBone marrow fat content is positively associated with hepatic fat content in children with known or suspected NAFLD. Further research is needed to confirm these results and understand their clinical and biological implications.

Published
2017

2. Liver histology and diffusion-weighted MRI in children with nonalcoholic fatty liver disease: A MAGNET study

Author

Manning, P, Murphy, P, Wang, K, Hooker, J, Wolfson, T, Middleton, MS, Newton, KP, Behling, C, Awai, HI, Durelle, J, Paiz, MN, Angeles, JE, De La Pena, D, McCutchan, JA, Schwimmer, JB, and Sirlin, CB

Subjects
Male, nonalcoholic fatty liver disease, Adolescent, Chronic Liver Disease and Cirrhosis, Clinical Trials and Supportive Activities, DWI, Medical and Health Sciences, Hepatitis, Rare Diseases, Engineering, children, Non-alcoholic Fatty Liver Disease, Clinical Research, NAFLD, Humans, Prospective Studies, Child, quantitative imaging biomarkers, intravoxel incoherent motion, QIBs, Liver Disease, Histological Techniques, Nuclear Medicine & Medical Imaging, Diffusion Magnetic Resonance Imaging, Cross-Sectional Studies, pediatric, Good Health and Well Being, Liver, ADC, Physical Sciences, Biomedical Imaging, Female, Digestive Diseases
Abstract

PurposeTo determine potential associations between histologic features of pediatric nonalcoholic fatty liver disease (NAFLD) and estimated quantitative magnetic resonance diffusion-weighted imaging (DWI) parameters.Materials and methodsThis prospective, cross-sectional study was performed as part of the Magnetic Resonance Assessment Guiding NAFLD Evaluation and Treatment (MAGNET) ancillary study to the Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN). Sixty-four children underwent a 3T DWI scan (b-values: 0, 100, and 500 s/mm2 ) within 180 days of a clinical liver biopsy of the right hepatic lobe. Three parameters were estimated in the right hepatic lobe: apparent diffusion coefficient (ADC), diffusivity (D), and perfusion fraction (F); the first assuming exponential decay and the latter two assuming biexponential intravoxel incoherent motion. Grading and staging of liver histology were done using the NASH CRN scoring system. Associations between histologic scores and DWI-estimated parameters were tested using multivariate linear regression.ResultsEstimated means ± standard deviations were: ADC: 1.3 (0.94-1.8) × 10-3 mm2 /s; D: 0.82 (0.56-1.0) × 10-3 mm2 /s; and F: 17 (6.0-28)%. Multivariate analyses showed ADC and D decreased with steatosis and F decreased with fibrosis (P < 0.05). Associations between DWI-estimated parameters and other histologic features were not significant: ADC: fibrosis (P = 0.12), lobular inflammation (P = 0.20), portal inflammation (P = 0.27), hepatocellular inflammation (P = 0.29), NASH (P = 0.30); D: fibrosis (P = 0.34), lobular inflammation (P = 0.84), portal inflammation (P = 0.76), hepatocellular inflammation (P = 0.38), NASH (P = 0.81); F: steatosis (P = 0.57), lobular inflammation (P = 0.22), portal inflammation (P = 0.42), hepatocellular inflammation (P = 0.59), NASH (P = 0.07).ConclusionIn children with NAFLD, steatosis and fibrosis have independent effects on DWI-estimated parameters ADC, D, and F. Further research is needed to determine the underlying mechanisms and clinical implications of these effects.Level of evidence1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1149-1158.

Published
2017
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