Article Text

Download PDFPDF
Potential of Electron Beam Computed Tomography for Coronary Artery Calcium Screening to Evaluate Fatty Liver
  1. Susan Matulevicius, MD*†,
  2. Laura C. Huff, MD*†,
  3. Lidia S. Szczepaniak, PhD,
  4. Colby R. Ayers, MS,
  5. Matthew Budoff, MD§,
  6. Roderick McColl, PhD*∥,
  7. Amit Khera, MD, MSc*†,
  8. Ronald M. Peshock, MD*†∥
  1. From the *Department of Internal Medicine, Division of Cardiology, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX; †Donald W. Reynolds Cardiovascular Clinical Research Center, Dallas, TX;‡Cedars-Sinai Medical Center, The Heart Institute, Los Angeles, CA; §Department of Internal Medicine, Division of Cardiology, Los Angeles Biomedical Research Institute at Harbor - UCLA, Torrance, CA; and ∥Department of Radiology, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX.
  1. Received October 12, 2010, and in revised form January 28, 2011.
  2. Accepted for publication February 20, 2011.
  3. Reprints: Susan Matulevicius, MD, Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd, Dallas, TX 75390-9047. E-mail: Susan.Matulevicius{at}
  4. This study did not receive financial support.

Comparison With 1H Magnetic Resonance Spectroscopy in the Dallas Heart Study


Objectives Electron beam computed tomography (EBCT) for coronary artery calcification can potentially evaluate liver fat, another marker of cardiovascular risk. We compared quantitative estimates of hepatic steatosis measured by EBCT with those obtained by a well-validated, accurate-measure, magnetic resonance spectroscopy (1H MRS).

Methods EBCT and 1H MRS were performed in 2159 subjects from the Dallas Heart Study. Forty subjects were randomly selected from each of 5 subgroups of liver fat percent by 1H MRS (n = 200). EBCT average liver attenuation (HU) was determined in a 1- to 2-cm circular region of interest over the liver lobes. Pearson correlation coefficients were calculated. Using a previously defined 1H MRS hepatic steatosis cut point (>5.5%), an optimized EBCT liver attenuation cut point was determined by receiver operating characteristic analysis.

Results 1H MRS liver fat content and EBCT average right lobe liver attenuation were moderately negatively correlated (r = −0.64, P < 0.0001) in all subjects and in those with 1H MRS hepatic steatosis (r = −0.71, P < 0.0001). This correlation did not improve with attenuation correction of the EBCT data using a standard calcium phantom or statistical transformation. Using an optimized receiver operating characteristic EBCT cut point (64.5 HU), sensitivity was 78% and specificity was 72% for detecting 1H MRS hepatic steatosis, with a high false negative rate. Risk factors for hepatic steatosis (obesity, diabetes mellitus, insulin resistance, metabolic syndrome) were more strongly correlated with 1H MRS than EBCT liver fat measures.

Conclusions Liver attenuation on EBCT acquired for coronary artery calcification screening correlates modestly with 1H MRS measures of liver fat content, with a high false negative rate.

Key Words
  • electron beam computed tomography
  • magnetic resonance spectroscopy
  • hepatic steatosis

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.