Evaluation of Minimum‐to‐Severe Global and Macrovesicular Steatosis in Human Liver Specimens: A Portable Ambient Light‐Compatible Spectroscopic Probe

ABSTRACT Background and Aims Hepatic steatosis (HS), particularly macrovesicular steatosis (MaS), influences transplant outcomes. Accurate assessment of MaS is crucial for graft selection. While traditional assessment methods have limitations, non‐invasive spectroscopic techniques like Raman and reflectance spectroscopy offer promise. This study aimed to evaluate the efficacy of a portable ambient light‐compatible spectroscopic system in assessing global HS and MaS in human liver specimens. Methods A two‐stage approach was employed on thawed snap‐frozen human liver specimens under ambient room light: biochemical validation involving a comparison of fat content from Raman and reflectance intensities with triglyceride (TG) quantifications and histopathological validation, contrasting Raman‐derived fat content with evaluations by an expert pathologist and a “Positive Pixel Count” algorithm. Raman and reflectance intensities were combined to discern significant (≥ 10%) discrepancies in global HS and MaS. Results The initial set of 16 specimens showed a positive correlation between Raman and reflectance‐derived fat content and TG quantifications. The Raman system effectively differentiated minimum‐to‐severe global and macrovesicular steatosis in the subsequent 66 specimens. A dual‐variable prediction algorithm was developed, effectively classifying significant discrepancies (> 10%) between algorithm‐estimated global HS and pathologist‐estimated MaS. Conclusion Our study established the viability and reliability of a portable spectroscopic system for non‐invasive HS and MaS assessment in human liver specimens. The compatibility with ambient light conditions and the ability to address limitations of previous methods marks a significant advancement in this field. By offering promising differentiation between global HS and MaS, our system introduces an innovative approach to real‐time and quantitative donor HS assessments. The proposed method holds the promise of refining donor liver assessment during liver recovery and ultimately enhancing transplantation outcomes. This research explored a portable ambient light‐compatible spectroscopic probe to non‐invasively assess global and macrovesicular steatosis in human liver specimens. Our findings suggest that this method can be a reliable tool to aid surgeons' decision‐making on a liver's suitability for transplantation.