Satoshi Goshima MD, PhD, Abstract Co-Author: Nothing to Disclose

Haruo Watanabe MD, Abstract Co-Author: Nothing to Disclose

Hiroshi Kondo MD, Abstract Co-Author: Nothing to Disclose

Hiroshi Kawada MD, Presenter: Nothing to Disclose

Masayuki Kanematsu MD, Abstract Co-Author: Nothing to Disclose

Kyongtae Tyler Bae MD, PhD, Abstract Co-Author: Patent agreement, Covidien AG Patent agreement, Bayer AG Expert Advisory Committee, Bracco Group

To evaluate the feasibility of proton MR spectroscopy (MRS) for the assessment of necroinflammatory activity and fibrosis of the liver in patients with chronic liver damage.

This prospective study received institutional review board approval and written informed consent was obtained. Proton MRS at 3T MR was performed in 62 consecutive patients with chronic liver damage (43 men, 19 women; age range, 52–91 years). Necroinflammatory activity grades and hepatic fibrosis stages were histopathologically- proven through liver biopsy specimens obtained in all of the patients. MRS was acquired using a 256 acquisition time series of PRESS single voxels (30x30x40 mm3, TR/TE= 1500/38). Unsuppressed water spectra with 8 acquisitions were also acquired at each location. Each spectrum was processed with operations including Fourier transformation, baseline subtraction, and phase and frequency corrections. Multiple regression analysis was performed to associate (albumin, total bilirubin, prothrombin time, aspartate amino transferase, alanine amino transferase, choline esterase, ammonia level, amplitude of choline, water, and choline/water ratio) with hepatic necroinflammatory activity grades and hepatic fibrosis stages.

Proton MRS was successfully performed in 51 patients (82%). Choline/water ratio most strongly correlated with necroinflammatory activity grade (r = 0.55, P < .001) among the MRS, hematological and clinical parameters. Multiple regression analysis showed that the choline/water ratio significantly correlated (r2 = 0.30, P < .001) with necroinflammatory activity grades, but not with fibrosis stages.

Proton MR spectroscopy may help as a non-invasive method for the evaluation of necroinflammatory activity of the liver in patients with chronic liver damage.

Proton MR spectroscopy may provide useful imaging biomarker information for the staging of hepatic necroinflammatory activity in patients with chronic liver damage.

Goshima, S, Watanabe, H, Kondo, H, Kawada, H, Kanematsu, M, Bae, K, Assessing Necroinflammatory Activity and Fibrosis of the Liver Using Proton MR Spectroscopy in Patients with Chronic Liver Damage.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11003517.html