Magnetic Resonance Spectroscopy in Living-Donor Liver Transplantation. 
The purpose of this study is to evaluate the accuracy rate of the one breath-hold single voxel hydrogen-1 magnetic resonance spectroscopy (MRS) in comparison with intraoperative biopsy for liver fat quantification in living-donor liver transplantation.  A total of 80 living liver donors participated in this study.  Each patient underwent both MRS and intraoperative biopsy for evaluation of liver fatty content.  MRS was performed using 1.5-T magnetic resonance imaging and placed in segments 2-4, 5-8, and left lateral segment for each donor.  Accuracy was assessed through receiver operating characteristic curve analysis.  Sensitivity and specificity of MRS fat fractions were also calculated.  Eighty living-donor liver transplantation donors were enrolled in this study.  There was no fatty liver in 59 subjects (73.8%), 5% to 10% fatty liver in 17 subjects, 11% to 15% fatty liver in 3 subjects, and >16% fatty liver in 1 subject.  MRS fat fraction showed excellent parameters to predict between normal liver and fatty liver groups (1.85% ± 0.98, 8.13% ± 3.52, respectively; P < .0001).  Linear regression between MRS fat fraction and pathology grading showed high correlation (R(2) = 0.7092).  Pearson correlation revealed high correlation between MRS and pathology results (r = 0.936), poor correlation between body mass index and pathology results (r = 0.390).  The sensitivity and specificity for detection of liver steatosis in MRS fat fraction were 95.2% and 98.3%, respectively. ( 1)H MRS fat fraction is a highly precise and accurate method in quantification of hepatic steatosis for the living donor and can be finished in a single breath-hold.