"The results showed a rapid early phase of improvements in liver fat, followed by a phase of continued improvements at a slower pace," Dr. Pooler said. "The changes began with the initiation of the low-calorie diet and occurred in advance of the overall improvements in BMI among the patients."

The results suggest several potential roles for CSE-MRI in the management of obese patients with fatty livers. PDFF measurements could help in the selection of patients for bariatric surgery because of the strong correlation between liver fat reductions and pre-treatment liver fat content. In addition, since decreases in liver fat content were only weakly correlated with starting weight and overall weight loss, monitoring liver fat with MRI following bariatric surgery, independent of monitoring weight loss, would be useful. The greatest potential benefit could be for patients with fatty livers regardless of their starting weight or weight loss.


"There is this assumption that when you lose weight you also reduce liver fat, but the relationship was very hard to measure prior to having a good tool like MRI," Dr. Pooler said. "This study shows that the MRI technique is very clinically feasible for monitoring liver fat over time."

Dr. Pooler said the CSE-MRI technique could have applications beyond monitoring the effects of bariatric surgery.

"We looked at bariatric surgery patients in our study, but there's no reason this clinical tool can't be used to monitor all sorts of weight loss patients," he said. "We want patients and physicians to know that this is an option for them. We've done the validation and the next step is to make people more aware of this option."

"Monitoring Fatty Liver Disease with MRI Following Bariatric Surgery: A Prospective, Dual-Center Study." Collaborating with Dr. Pooler were Curtis N. Wiens, Ph.D., Alan McMillan, Ph.D., Nathan S. Artz, Ph.D., Alexandra Schlein, B.S., Yesenia Covarrubias, B.S., Jonathan Hooker, B.S., Jeffrey B. Schwimmer, M.D., Luke M. Funk, M.D., M.P.H., Guilherme M. Campos, M.D., Jacob A. Greenberg, M.D., Ed.M., Garth Jacobsen, M.D., Santiago Horgan, M.D., Tanya Wolfson, M.A., Anthony C. Gamst, Ph.D., Claude B. Sirlin, M.D., and Scott B. Reeder, M.D., Ph.D.

Radiology is edited by David A. Bluemke, M.D., Ph.D., University of Wisconsin School of Medicine and Public Health, Madison, Wis., and owned and published by the Radiological Society of North America, Inc.

RSNA is an association of over 54,000 radiologists, radiation oncologists, medical physicists and related scientists, promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)

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