UW Radiology’s Scott Reeder, Fred T. Lee, Jr., and Diego Hernando discussed the innovative approach UW is taking towards imaging the liver, including viewing liver fat, iron, and liver biopsy during presentations at RSNA 2013.
Scott Reeder, M.D., Ph.D., discussed non-invasive ways to view the liver in his presentation, “Hot Topic Session: MR Quantification Techniques in the Liver: Fat.” He reviewed the accuracy of both CT and MR imaging when it comes to steatosis, or the abnormal retention of fat within the liver cells. This fatty liver disease is associated with a number of conditions, and Dr. Reeder showed examples from a number of cases, including those with etiologies in long-term alcohol abuse and hepatitis.
Diego Hernando, Ph.D., discussed imaging fundamentals of liver iron in his presentation, “” Hot Topic Session: MR Quantification Techniques in the Liver: Iron.” Although a certain level of iron in the liver is necessary on a daily basis, an overload of iron in the liver, or hemochromatosis, can cause serious problems such as carcinoma or cirrhosis. The main treatment for hemochromatosis is blood-letting, and Dr. Hernando pointed out that non-invasive imaging is a useful way to monitor its success.
Dr. Fred T. Lee, Jr., M.D., presented a session entitled ” Controversy Session: The Evolving Role of Image-guided Hepatic Biopsy.” Lee strove to illuminate ongoing imaging and biochemical studies used to diagnose hepatocellular carcinoma and lessen the need for biopsies.
Lee noted, “In liver biopsy, there is a huge sample error issue because you’re only taking one to two cores from any given area.” He further went on to note that in a test of the efficacy and reliability of liver sampling procedure, colleague Dr. Reeder performed 45 biopsies on one liver.
Approximately half of the samples Dr. Reeder took showed the liver to be in the acceptable range for fat content to perform a transplant. However, the other half of the samples showed the liver to be in an unacceptable range for liver fat to successfully perform a transplant. Lee advocated the use of ultrasound as a guide for liver biopsy, where it is effective as a first step except in extreme cases like morbid obesity.