Mark G. Swanson PhD, Presenter: Nothing to Disclose

Michelle Nystrom, Abstract Co-Author: Nothing to Disclose

Raphael Merriman MD, Abstract Co-Author: Nothing to Disclose

Alireza Ghotb, Abstract Co-Author: Nothing to Disclose

Antonio C. Westphalen MD, Abstract Co-Author: Nothing to Disclose

Aliya Qayyum MD, Abstract Co-Author: Spouse, Employee, Koninklijke Philips Electronics NV

To evaluate the glycerol to choline ratio as a metabolic indicator of disease severity in nonalcoholic fatty liver disease (NAFLD) with HR-MAS in human liver tissue.

Committee on Human Research approval was obtained, and the study was in compliance with the Health Insurance Portability and Accountability Act. Twenty liver biopsy samples were obtained from healthy controls (n=5) or nonalcoholic fatty liver disease patients (n=15) demonstrating simple steatosis (n=8), or nonalcoholic steatohepatitis (NASH) (n=7) according to criteria established by the Nonalcoholic Steatohepatitis Clinical Research Network. Tissues were analyzed ex vivo using high resolution magic angle spinning (HR-MAS) MR spectroscopy for correlation with histopathologic variables. One dimensional water-presaturated spectra were acquired at 11.7 T, 10C, and a 2,250 Hz spin rate using a Varian INOVA spectrometer (Palo Alto, CA). Data were analyzed off line using ACD/Labs 1D NMR Processor (ACD/Labs, Toronto) and compared between groups using a Student’s T-test.

The glycerol to choline ratio increased significantly with progression from normal liver (mean = 0.79 + 0.08) to simple steatosis (mean = 2.44 + 1.49, p = 0.017) to NASH (4.11 + 2.45, p = 0.032). The glycerol to noise ratio increased consistently from normal liver to simple steatosis (101%) and from steatosis to NASH (81%), whereas the choline to noise ratio was nearly equal between normal liver and steatosis (2%) but decreased between steatosis and NASH (28%). However, because of the small number of samples neither glycerol nor choline to noise ratios alone were significantly different between normal, steatosis, and NASH.

Our preliminary data suggests increased glycerol and decreased choline observed at high magnetic field strengths may indicate histopathologic disease progression in nonalcoholic fatty liver disease from simple steatosis to steatohepatitis.

Ex vivo HR-MAS liver data suggests increased glycerol and decreased choline may indicate histopathologic disease progression in nonalcoholic fatty liver disease from steatosis to steatohepatitis.

Swanson, M, Nystrom, M, Merriman, R, Ghotb, A, Westphalen, A, Qayyum, A, Ex vivo MR Spectroscopy of Human Liver Tissues in Non-alcoholic Fatty Liver Disease: Glycerol to Choline Ratio as a Biometric Indicator of Disease Severity.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6015104.html