Monitoring Fatty Liver Disease with MRI Following Bariatric Surgery: A 3rospective, Dual-Center Study

Purpose: To longitudinally monitor liver fat before and after bariatric surgery by using quantitative chemical shift-encoded (CSE) MRI and to compare with changes in body mass index (BMI), weight, and waist circumference (WC). Materials and Methods: For this prospective study, which was approved by the internal review board, a total of 126 participants with obesity who were undergoing evaluation for bariatric surgery with preoperative very low calorie diet (VLCD) were recruited from June 27, 2010, through May 5, 2015. Written informed consent was obtained from all participants. Participants underwent CSE MRI measuring liver proton density fat fraction (PDFF) before VLCD (23 weeks before surgery), after VLCD (13 days before surgery), and 1, 3, and 610 months following surgery. Linear regression was used to estimate rates of change of PDFF (?PDFF) and body anthropometrics. Initial PDFF (PDFF0), initial anthropometrics, and anthropometric rates of change were evaluated as predictors of ?PDFF. Mixed-effects regression was used to estimate time to normalization of PDFF. Results: Fifty participants (mean age, 51.0 years; age range, 2770 years), including 43 women (mean age, 50.8 years; age range, 2770 years) and seven men (mean age, 51.7 years; age range, 3662 years), with mean PDFF0 +/- standard deviation of 18.1% +/- 8.6 and mean BMI0 of 44.9 kg/m2 +/- 6.5 completed the study. By 610 months following surgery, mean PDFF decreased to 4.9% +/- 3.4 and mean BMI decreased to 34.5 kg/m2 +/- 5.4. Mean estimated time to PDFF normalization was 22.5 weeks +/- 11.5. PDFF0 was the only strong predictor for both ?PDFF and time to PDFF normalization. No body anthropometric correlated with either outcome. Conclusion: Average liver proton density fat fraction (PDFF) decreased to normal (< 5%) by 610 months following surgery, with mean time to normalization of approximately 5 months. Initial PDFF was a strong predictor of both rate of change of PDFF and time to normalization. Body anthropometrics did not predict either outcome. Online supplemental material is available for this article. (c) RSNA, 2018