Effect of Gadoxetic Acid on Quantification of Hepatic Steatosis Using Magnetic Resonance Spectroscopy: A Prospective Study

Purpose We prospectively evaluated whether gadoxetic acid (Gd-EOB-DTPA) administration for liver magnetic resonance (MR) imaging affects the quantification of hepatic steatosis using MR spectroscopy (MRS). Materials and Methods A total of 155 patients were included, who underwent gadoxetic acid-enhanced liver MR imaging and MRS during a 5-month period. Fast breath-hold high-speed T2-corrected multi-echo MRS was used before, and 20 min after, gadoxetic acid injection. The same location was maintained in the pre-contrast and post-contrast MRS. Changes in the fat fraction (FF) were compared between the pre- and post-contrast MRS using a paired t-test. The change in FF between cirrhotic and non-cirrhotic patients was compared using an independent t-test. In cirrhotic patients, the correlation between FF change and biochemical marker using Pearson's correlation test, was evaluated. Results The mean FF in the post-contrast MRS (5.05 ± 5.26%) was significantly higher than in the pre-contrast MRS (4.77 ± 0.57%) (p < 0.000). The FF change between pre-contrast and post-contrast MRS was significantly higher in non-cirrhotic patients (0.41 ± 0.77%) than in cirrhotic patients (0.14 ± 0.59) (p = 0.010). Albumin and alkaline phosphatase shows weak correlation with FF change (both p < 0.02). Conclusion Gadoxetic acid affects the quantification of hepatic steatosis by MRS. Hence, MRS should be performed before gadoxetic acid injection, particularly in non-cirrhotic patients.