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Chang YC, Yen KC, Liang PC, Ho MC, Ho CM, Hsiao CY, Hsiao CH, Lu CH, Wu CH. Automated liver volumetry and hepatic steatosis quantification with magnetic resonance imaging proton density fat fraction. J Formos Med Assoc 2024:S0929-6646(24)00212-2. [PMID: 38643056 DOI: 10.1016/j.jfma.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 04/04/2024] [Accepted: 04/16/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Preoperative imaging evaluation of liver volume and hepatic steatosis for the donor affects transplantation outcomes. However, computed tomography (CT) for liver volumetry and magnetic resonance spectroscopy (MRS) for hepatic steatosis are time consuming. Therefore, we investigated the correlation of automated 3D-multi-echo-Dixon sequence magnetic resonance imaging (ME-Dixon MRI) and its derived proton density fat fraction (MRI-PDFF) with CT liver volumetry and MRS hepatic steatosis measurements in living liver donors. METHODS This retrospective cross-sectional study was conducted from December 2017 to November 2022. We enrolled donors who received a dynamic CT scan and an MRI exam within 2 days. First, the CT volumetry was processed semiautomatically using commercial software, and ME-Dixon MRI volumetry was automatically measured using an embedded sequence. Next, the signal intensity of MRI-PDFF volumetric data was correlated with MRS as the gold standard. RESULTS We included the 165 living donors. The total liver volume of ME-Dixon MRI was significantly correlated with CT (r = 0.913, p < 0.001). The fat percentage measured using MRI-PDFF revealed a strong correlation between automatic segmental volume and MRS (r = 0.705, p < 0.001). Furthermore, the hepatic steatosis group (MRS ≥5%) had a strong correlation than the non-hepatic steatosis group (MRS <5%) in both volumetric (r = 0.906 vs. r = 0.887) and fat fraction analysis (r = 0.779 vs. r = 0.338). CONCLUSION Automated ME-Dixon MRI liver volumetry and MRI-PDFF were strongly correlated with CT liver volumetry and MRS hepatic steatosis measurements, especially in donors with hepatic steatosis.
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Affiliation(s)
- Yuan-Chen Chang
- Department of Medical Imaging and Radiology, National Taiwan University Hospital and College of Medicine, Taiwan
| | - Kuang-Chen Yen
- Department of Medical Imaging and Radiology, National Taiwan University Hospital and College of Medicine, Taiwan
| | - Po-Chin Liang
- Department of Medical Imaging and Radiology, National Taiwan University Hospital and College of Medicine, Taiwan
| | - Ming-Chih Ho
- Departments of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan; Center for Functional Image and Interventional Image, National Taiwan University, Taipei, Taiwan; Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - Cheng-Maw Ho
- Departments of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chih-Yang Hsiao
- Departments of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chiu-Han Hsiao
- Research Center for Information Technology Innovation, Academia Sinica, Taiwan
| | - Chia-Hsun Lu
- Department of Radiology, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chih-Horng Wu
- Department of Medical Imaging and Radiology, National Taiwan University Hospital and College of Medicine, Taiwan; Hepatits Research Center, National Taiwan University Hospital, Taipei, Taiwan; Center of Minimal-Invasive Interventional Radiology, National Taiwan University Hospital, Taipei, Taiwan.
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Cullen JM, Conzen KD, Pomfret EA. Living Donor Liver Transplantation: Left Lobe or Right Lobe. Surg Clin North Am 2024; 104:89-102. [PMID: 37953043 DOI: 10.1016/j.suc.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Living Donor Liver Transplantation (LDLT) has seen great advancements since its inception in 1988. Herein, the nuances of LDLT are discussed spanning from donor evaluation to the recipient operation. Special attention is given to donor anatomy and graft optimization techniques in the recipient.
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Affiliation(s)
- J Michael Cullen
- Colorado Center for Transplantation Care, Research and Education (CCTCARE), University of Colorado Anschutz, University of Colorado Anschutz Medical Campus, 1635 Aurora Ct, AOP 7th Fl, C-318, Aurora, CO 80045, USA
| | - Kendra D Conzen
- Colorado Center for Transplantation Care, Research and Education (CCTCARE), University of Colorado Anschutz, University of Colorado Anschutz Medical Campus, 1635 Aurora Ct, AOP 7th Fl, C-318, Aurora, CO 80045, USA.
| | - Elizabeth A Pomfret
- Division of Transplant Surgery, Igal Kam, MD Endowed Chair in Transplantation Surgery, Colorado Center for Transplantation Care, Research and Education (CCTCARE), University of Colorado Anschutz Medical Campus, 1635 Aurora Ct, AOP 7th Fl, C-318, Aurora, CO 80045, USA
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Vernuccio F, Mercante I, Tong XX, Crimì F, Cillo U, Quaia E. Biliary complications after liver transplantation: A computed tomography and magnetic resonance imaging pictorial review. World J Gastroenterol 2023; 29:3257-3268. [PMID: 37377585 PMCID: PMC10292145 DOI: 10.3748/wjg.v29.i21.3257] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/23/2023] [Accepted: 04/27/2023] [Indexed: 06/01/2023] Open
Abstract
Biliary complications are the most common complications after liver transplantation. Computed tomography (CT) and magnetic resonance imaging (MRI) are cornerstones for timely diagnosis of biliary complications after liver transplantation. The diagnosis of these complications by CT and MRI requires expertise, mainly with respect to identifying subtle early signs to avoid missed or incorrect diagnoses. For example, biliary strictures may be misdiagnosed on MRI due to size mismatch of the common ducts of the donor and recipient, postoperative edema, pneumobilia, or susceptibility artifacts caused by surgical clips. Proper and prompt diagnosis of biliary complications after transplantation allows the timely initiation of appropriate management. The aim of this pictorial review is to illustrate various CT and MRI findings related to biliary complications after liver transplantation, based on time of presentation after surgery and frequency of occurrence.
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Affiliation(s)
- Federica Vernuccio
- Department of Radiology, University Hospital of Padova, Padova 35128, Italy
| | - Irene Mercante
- Department of Radiology-DIMED, University of Padova, Padova 35128, Italy
| | - Xiao-Xiao Tong
- Department of Radiology-DIMED, University of Padova, Padova 35128, Italy
| | - Filippo Crimì
- Department of Radiology-DIMED, University of Padova, Padova 35128, Italy
| | - Umberto Cillo
- Department of Surgery, Hepatobiliary Surgery and Liver Transplant Center, Oncology and Gastroenterology (DISCOG), University of Padova, Padova 35128, Italy
| | - Emilio Quaia
- Department of Radiology-DIMED, University of Padova, Padova 35128, Italy
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Pomohaci MD, Grasu MC, Dumitru RL, Toma M, Lupescu IG. Liver Transplant in Patients with Hepatocarcinoma: Imaging Guidelines and Future Perspectives Using Artificial Intelligence. Diagnostics (Basel) 2023; 13:diagnostics13091663. [PMID: 37175054 PMCID: PMC10178485 DOI: 10.3390/diagnostics13091663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/26/2023] [Accepted: 05/05/2023] [Indexed: 05/15/2023] Open
Abstract
Hepatocellular carcinoma is the most common primary malignant hepatic tumor and occurs most often in the setting of chronic liver disease. Liver transplantation is a curative treatment option and is an ideal solution because it solves the chronic underlying liver disorder while removing the malignant lesion. However, due to organ shortages, this treatment can only be applied to carefully selected patients according to clinical guidelines. Artificial intelligence is an emerging technology with multiple applications in medicine with a predilection for domains that work with medical imaging, like radiology. With the help of these technologies, laborious tasks can be automated, and new lesion imaging criteria can be developed based on pixel-level analysis. Our objectives are to review the developing AI applications that could be implemented to better stratify liver transplant candidates. The papers analysed applied AI for liver segmentation, evaluation of steatosis, sarcopenia assessment, lesion detection, segmentation, and characterization. A liver transplant is an optimal treatment for patients with hepatocellular carcinoma in the setting of chronic liver disease. Furthermore, AI could provide solutions for improving the management of liver transplant candidates to improve survival.
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Affiliation(s)
- Mihai Dan Pomohaci
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania
- Department of Radiology, The University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
| | - Mugur Cristian Grasu
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania
- Department of Radiology, The University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
| | - Radu Lucian Dumitru
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania
- Department of Radiology, The University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
| | - Mihai Toma
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania
- Department of Radiology, The University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
| | - Ioana Gabriela Lupescu
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania
- Department of Radiology, The University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
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High-resolution MR imaging with gadoxetate disodium for the comprehensive evaluation of potential living liver donors. Liver Transpl 2023; 29:497-507. [PMID: 36738083 DOI: 10.1097/lvt.0000000000000099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 12/21/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Several major transplantation centers have used composite multimodality evaluation for the preoperative evaluation of potential living liver donors. This approach can be time-consuming and, although rare, can cause complications. We aimed to demonstrate the clinical feasibility of our comprehensive preoperative MR protocol for the preoperative assessment of living liver donor candidates instead of composite multimodality evaluation. MATERIALS AND METHODS Thirty-five consecutive living liver donor candidates underwent multiphasic liver CT and comprehensive donor protocol MR examinations for preoperative evaluation in a single large-volume liver transplantation (LT) center. Three blinded abdominal radiologists reviewed the CT and MR images for vascular and biliary variations. The strength of agreement between CT and MR angiography was assessed using the kappa index. The detection rate of biliary anatomical variations was calculated. The sensitivity and specificity for detecting significant steatosis (>5%) were calculated. The estimated total volume and right lobe volumes measured by MR volumetry were compared with the corresponding CT volumetry measurements using the intraclass correlation coefficient (ICC). RESULTS Among the 35 patients, 26 underwent LT. The measurement of agreement showed a moderate to substantial agreement between CT and MR angiography interpretations (kappa values, 0.47-0.79; p < 0.001). Combining T2-weighted and T1-weighted MR cholangiography techniques detected all biliary anatomical variations in 9 of the 26 patients. MR-proton density fat fraction showed a sensitivity of 100% (3/3) and a specificity of 91.3% (21/23) for detecting pathologically determined steatosis (>5%). MR volumetry reached an excellent agreement with CT volumetry (reviewers 1 and 2: ICC, 0.92; 95% CI, 0.84-0.96). CONCLUSION Our one-stop comprehensive liver donor MR imaging protocol can provide complete information regarding hepatic vascular and biliary anatomies, hepatic parenchymal quality, and liver volume for living liver donor candidates and can replace composite multimodality evaluation.
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Kim SM, Ageel AH, Hwang S, Jung DH, Ha TY, Song GW, Park GC, Ahn CS, Moon DB. Preoperative estimation of hemi-liver volume using standard liver volume and portal vein diameter ratio in living donor liver transplantation. Ann Hepatobiliary Pancreat Surg 2022; 26:308-312. [PMID: 35999792 PMCID: PMC9721257 DOI: 10.14701/ahbps.22-030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/16/2022] [Accepted: 06/24/2022] [Indexed: 12/15/2022] Open
Abstract
Backgrounds/Aims Although body surface area (BSA)-based standard liver volume (SLV) formulae have been used for living donor liver transplantation and hepatic resection, hemi-liver volume (HLV) is needed more frequently. HLV can be assessed using right or left portal vein diameter (RPVD or LPVD). The aim of this study was to validate the reliability of using portal vein diameter ratio (PVDR) for assessing HLV in living liver donors. Methods This study included 92 living liver donors (59 males and 33 females) who underwent surgery between January 2020 and December 2020. Computed tomography (CT) images were used for measurements. Results Mean age of donors was 35.5 ± 7.2 years. CT volumetry-measured total liver volume (TLV), right HLV, left HLV, and percentage of right HLV in TLV were 1,442.9 ± 314.2 mL, 931.5 ± 206.4 mL, 551.4 ± 126.5 mL, and 64.6% ± 3.6%, respectively. RPVD, LPVD, and main portal vein diameter were 12.2 ± 1.5 mm, 10.0 ± 1.3 mm, and 15.3 ± 1.7 mm, respectively (corresponding square values: 149.9 ± 36.9 mm2, 101.5 ± 25.2 mm2, and 237.2 ± 52.2 mm2, respectively). The sum of RPVD2 and LPVD2 was 251.1 ± 56.9 mm2. BSA-based SLV was 1,279.5 ± 188.7 mL (error rate: 9.1% ± 14.4%). SLV formula- and PVDR-based right HLV was 760.0 ± 130.7 mL (error rate: 16.2% ± 13.3%). Conclusions Combining BSA-based SLV and PVDR appears to be a simple method to predict right or left HLV in living donors or split liver transplantation.
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Affiliation(s)
- Sung-Min Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Amro Hasan Ageel
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea,Department of Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Shin Hwang
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea,Corresponding author: Shin Hwang, MD, PhD Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3930, Fax: +82-2-3010-6701, E-mail: ORCID: https://orcid.org/0000-0002-9045-2531
| | - Dong-Hwan Jung
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae-Yong Ha
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gi-Won Song
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gil-Chun Park
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chul-Soo Ahn
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Deok-Bog Moon
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kaya H, Karatay E, Tuney D. The volumetric measurement of developing liver atrophy in patients with Chilaiditi's sign. SURGICAL AND RADIOLOGIC ANATOMY : SRA 2022; 44:1239-1246. [PMID: 36053336 DOI: 10.1007/s00276-022-03013-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/24/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The Chilaiditi's sign is a hepatodiaphragmatic interposition of the colon and is a rare diagnosed condition. This condition may cause a problem in liver transplantation applications which are progressively increasing in number. Although not reported in the literature, we observed that liver atrophy developed in the intestinal interposition region in patients with Chilaiditi's sign in computed tomography (CT) images. This study aimed to determine the amount of liver atrophy caused by the interposed colon, the factors that change the rate of atrophy, and the effects of this situation on the liver parenchyma. MATERIALS AND METHODS A total of 30,000 patients who presented to radiology department with any reason between March 2012 and March 2013 and who underwent thoracoabdominal or abdominal CT imaging were retrospectively analyzed. The volumes of the liver right lobe and lateral/medial segments of the left lobe were estimated in cm3 using Volume Viewer application in 75 cases (20 females, 55 males) in which Chilaiditi's sign was observed in CT images. RESULTS 17-27% of the lobes affected from the colon interposition were seen to develop atrophy. The ratio of right lobe volume to total liver volume was found to be higher in patients with left lobe atrophy (74%) than right lobe atrophy (55%) (p < 0.001). Similarly, the rate of the volume of the left lobe to the total liver volume was found to be higher in cases with right lobe atrophy (45%) compared to left lobe atrophy (26%) (p < 0.001). CONCLUSION Hepatodiaphragmatic interposition of the colon can cause liver atrophy. This condition should especially be considered in the liver transplantation applications. Compensatory hypertrophy may develop in the unaffected liver lobe and CT is very useful for diagnostic imaging.
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Affiliation(s)
- Hatice Kaya
- Department of Radiology, Marmara University Pendik Training and Research Hospital, Fevzi Çakmak, MuhsinYazıcıoğlu Cd No:10 Pendik, 34899, Istanbul, Turkey
| | - Emrah Karatay
- Department of Radiology, Marmara University Pendik Training and Research Hospital, Fevzi Çakmak, MuhsinYazıcıoğlu Cd No:10 Pendik, 34899, Istanbul, Turkey.
| | - Davut Tuney
- Department of Radiology, Faculty of Medicine, Marmara University, Istanbul, Turkey
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Chotkan KA, Mensink JW, Pol RA, Van Der Kaaij NP, Beenen LFM, Nijboer WN, Schaefer B, Alwayn IPJ, Braat AE. Radiological Screening Methods in Deceased Organ Donation: An Overview of Guidelines Worldwide. Transpl Int 2022; 35:10289. [PMID: 35664428 PMCID: PMC9161442 DOI: 10.3389/ti.2022.10289] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
Organ transplantation is performed worldwide, but policies regarding donor imaging are not uniform. An overview of the policies in different regions is missing. This study aims to investigate the various protocols worldwide on imaging in deceased organ donation. An online survey was created to determine the current policies. Competent authorities were approached to fill out the survey based on their current protocols. In total 32 of the 48 countries approached filled out the questionnaire (response rate 67%). In 16% of the countries no abdominal imaging is required prior to procurement. In 50%, abdominal ultrasound (US) is performed to screen the abdomen and in 19% an enhanced abdominal Computed Tomography (CT). In 15% of the countries both an unenhanced abdominal CT scan and abdominal US are performed. In 38% of the countries a chest radiographic (CXR) is performed to screen the thorax, in 28% only a chest CT, and in 34% both are performed. Policies regarding radiologic screening in deceased organ donors show a great variation between different countries. Consensus on which imaging method should be applied is missing. A uniform approach will contribute to quality and safety, justifying (inter)national exchange of organs.
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Affiliation(s)
- K. A. Chotkan
- Department of Surgery, Division of Transplantation, Leiden University Medical Center, Leiden, Netherlands
- Department of Organ and Tissue Donation, Dutch Transplant Foundation, Leiden, Netherlands
| | - J. W. Mensink
- Department of Surgery, Division of Transplantation, Leiden University Medical Center, Leiden, Netherlands
- Department of Organ and Tissue Donation, Dutch Transplant Foundation, Leiden, Netherlands
| | - R. A. Pol
- Department of Surgery, Division of Transplantation, University Medical Center Groningen, Groningen, Netherlands
| | - N. P. Van Der Kaaij
- Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - L. F. M. Beenen
- Department of Radiology, Amsterdam UMC, Amsterdam, Netherlands
| | - W. N. Nijboer
- Department of Surgery, Division of Transplantation, Leiden University Medical Center, Leiden, Netherlands
- Transplant Center, Leiden University Medical Center, Leiden, Netherlands
| | - B. Schaefer
- Department of Organ and Tissue Donation, Dutch Transplant Foundation, Leiden, Netherlands
| | - I. P. J. Alwayn
- Department of Surgery, Division of Transplantation, Leiden University Medical Center, Leiden, Netherlands
- Transplant Center, Leiden University Medical Center, Leiden, Netherlands
| | - A. E. Braat
- Department of Surgery, Division of Transplantation, Leiden University Medical Center, Leiden, Netherlands
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9
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Diagnostic Modalities of Non-Alcoholic Fatty Liver Disease: From Biochemical Biomarkers to Multi-Omics Non-Invasive Approaches. Diagnostics (Basel) 2022; 12:diagnostics12020407. [PMID: 35204498 PMCID: PMC8871470 DOI: 10.3390/diagnostics12020407] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 02/05/2023] Open
Abstract
Non-Alcoholic Fatty Liver Disease (NAFLD) is currently the most common cause of chronic liver disease worldwide, and its prevalence is increasing globally. NAFLD is a multifaceted disorder, and its spectrum includes steatosis to steatohepatitis, which may evolve to advanced fibrosis and cirrhosis. In addition, the presence of NAFLD is independently associated with a higher cardiometabolic risk and increased mortality rates. Considering that the vast majority of individuals with NAFLD are mainly asymptomatic, early diagnosis of non-alcoholic steatohepatitis (NASH) and accurate staging of fibrosis risk is crucial for better stratification, monitoring and targeted management of patients at risk. To date, liver biopsy remains the gold standard procedure for the diagnosis of NASH and staging of NAFLD. However, due to its invasive nature, research on non-invasive tests is rapidly increasing with significant advances having been achieved during the last decades in the diagnostic field. New promising non-invasive biomarkers and techniques have been developed, evaluated and assessed, including biochemical markers, imaging modalities and the most recent multi-omics approaches. Our article provides a comprehensive review of the currently available and emerging non-invasive diagnostic tools used in assessing NAFLD, also highlighting the importance of accurate and validated diagnostic tools.
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Salum GM, el Meguid MA, Abelhafez TH, Medhat E, Abdel Aziz AO, Dawood R. Evaluation of seven gene signature for predicting HCV recurrence post-liver transplantation. J Genet Eng Biotechnol 2021; 19:174. [PMID: 34757522 PMCID: PMC8581076 DOI: 10.1186/s43141-021-00266-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 10/05/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Orthotropic liver transplantation (OLT) offers a therapeutic choice for hepatocellular carcinoma (HCC) patients. The poor outcome of liver transplantation is HCV recurrence. Several genome-wide associated studies (GWAS) have reported many genetic variants to be associated with HCV recurrence. Seven gene polymorphisms formed a cirrhosis risk score (CRS) signature that could be used to distinguish chronic HCV patients at high risk from those at low risk for cirrhosis in non-transplant patients. This study aims to examine the association of CRS score and other clinical parameters with the probability for HCC emergence and/or the rate of HCV recurrence following liver transplantation. RESULTS Seven gene polymorphisms, forming the CRS, were genotyped by real-time PCR using allelic discrimination protocol in 199 end-stage liver disease patients (79 child A, 43 child B, and 77child C), comprising 106 patients who encountered liver transplantation. Recipient CRS scores were correlated with HCV recurrence (HCV-Rec) at the end of the third year after OLT. Around 81% (39) recipients with low steatosis (LS; < 3.5%) donor percentage revealed no HCV recurrence (non-Rec) (p<0.001). CRS score could distinguish between child A, child B, and child C only at the low-risk group. Among the HCV Rec group 27% (8/30), 40% (12/30), and 33% (10/30) fell into the high, moderate, and low CRS risk groups, respectively. Stepwise logistic regression evinced two features more likely to be seen in HCV-Rec patients: abnormal ALT [OR, 1.1; 95% CI, 1.02-1.2] and donor steatosis >3.5% [OR, 46.07; 95% CI, 1.5-1407.8]. CONCLUSIONS Accordingly, the CRS score seems to be less useful to predict HCV recurrence after OLT. ALT and donor steatosis (exceed 3.5%) can significantly promote the HCV recurrence post-OLT. Moreover, the combination of MMF and CNI positively heightens HCV recurrence.
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Affiliation(s)
- Ghada M. Salum
- Department of Microbial Biotechnology, Genetic Engineering Division, National Research Centre, Dokki, P.O. 12622, Giza, Egypt
| | - Mai Abd el Meguid
- Department of Microbial Biotechnology, Genetic Engineering Division, National Research Centre, Dokki, P.O. 12622, Giza, Egypt
| | - Tawfeek H. Abelhafez
- Department of Microbial Biotechnology, Genetic Engineering Division, National Research Centre, Dokki, P.O. 12622, Giza, Egypt
| | - Eman Medhat
- Department of Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ashraf O. Abdel Aziz
- Department of Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Reham Dawood
- Department of Microbial Biotechnology, Genetic Engineering Division, National Research Centre, Dokki, P.O. 12622, Giza, Egypt
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