Up to 90% of neuroendocrine tumor patients have metastatic disease in the liver at diagnosis. These patients are treated with somatostatin analog therapy and monitored with CT or MRI. We demonstrate in a retrospective study that somatostatin therapy is associated with the development of elevated liver fat fraction on MRI. Furthermore, preliminary results suggest that hepatic steatosis decreases lesion detectability on CT compared to MRI. Studies are ongoing to determine the severity of steatosis and relationship to cumulative somatostatin dose, variation in fat fraction over time and the response to change in medication, and effect on liver function.