Research Correspondence
Dynamic Positron Emission Tomography/Computed Tomography Imaging Correlate of Nonalcoholic Steatohepatitis

https://doi.org/10.1016/j.cgh.2020.10.029Get rights and content

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Methods

The study was approved by the institutional review board. Patients with nonalcoholic fatty liver disease, age ≥18 years, without risk factors of concomitant liver disease and who had undergone liver biopsy, were enrolled. The biopsy was scored according to established NASH-CRN (Clinical Research Network) criteria5 by expert pathologists. Liver biopsies were assessed according to nonalcoholic fatty liver disease activity score (NAS), the sum of steatosis (0–3), lobular inflammation (0–3), and

Results

Of 44 enrolled patients, 31 were female, age 55 ± 13 years, body mass index of 34.1 ± 5.8 kg/m2, 68% Whites, 23% Hispanics, and 14 with known diabetes. On liver biopsy, 82% of patients had clinical NASH with mean NAS of 5 ± 2 with 59% having NAS ≥5 and 52% with fibrotic NASH. As we showed previously, PET scan measurement of liver glucose (FDG) transport rate K1 correlated with the sum of lobular inflammation and ballooning degeneration.6 Steatosis scored on biopsy or by MRI proton density fat

Discussion

Using dynamic FDG-PET, we have derived a novel radiologic tool that demonstrates high sensitivity and specificity for identification of NASH. Although our previous study focused on understanding the linkage between FDG K1 kinetics and distribution in the context of liver inflammation, the current study brings forth novel PET/CT correlate of histologic NASH. The negative correlation of K1 with NASH may reflect decreased glucose transport with increased liver inflammation and injury in NASH

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Conflicts of interest This author discloses the following: Souvik Sarkar is on the Advisory Board for Genfit, LG Chem, and Eisai; and received a grant (to UC Davis) from Gilead Sciences. The other authors disclose no conflicts.

Funding Supported by University of California, Davis start-up funds to Souvik Sarkar and Guobao Wang, and Collaborative for Diagnostic Innovation grant to Souvik Sarkar and Guobao Wang. The University of California, Davis Institutional Review Board and Radiation Use Committee have reviewed and approved all study procedures.

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