Detection of liver fibrosis using qualitative and quantitative MR elastography compared to liver surface nodularity measurement, gadoxetic acid uptake, and serum markers

Besa, Cecilia; Wagner, Mathilde; Lo, Grace C.; Gordic, Sonja; Chatterji, Manjil; Kennedy, Paul; Stueck, Ashley; Thung, Swan N.; Babb, James S.; Smith, Andrew D.; Taouli, Bachir

doi:10.1002/jmri.25911

Cited by 39 publications

(21 citation statements)

References 41 publications

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“…Alternatively, MR elastography was used as the reference for fibrosis staging. MR elastography provided the strongest correlation with fibrosis compared with other methods (14,36), with a histologic agreement below 60% (26). Therefore, our results should be interpreted in terms of agreement between the two methods, MR elastography and DW MRI, rather than genuine pathologic fibrosis.…”

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confidence: 55%

Diffusion-weighted MRI-based Virtual Elastography for the Assessment of Liver Fibrosis

Kromrey¹,

Bihan²,

Ichikawa³

2020

Radiology

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C hronic liver diseases can progress to severe fibrosis and cirrhosis. Fibrosis stage is associated with several complications, such as portal hypertension, variceal bleeding, hepatic encephalopathy, and liver failure (1,2). Liver cirrhosis is also a risk factor of hepatocellular carcinoma (3). Because studies have revealed that liver fibrosis can be reversible (4-6), its detection at an early stage and correct staging are essential for improving prognosis.Liver biopsy is the reference standard for diagnosing parenchymal liver diseases (7). Besides procedural risks (eg, bleeding and infection) and patient discomfort, sampling error from biopsy may occur because of small sample size, an inhomogeneous distribution of disease, and observer variability (8). Several imaging techniques, especially MRI performed with liver-specific contrast agents or functional methods such as MR elastography and diffusion-weighted (DW) imaging, have been reported as markers of liver fibrosis (9-11). MR elastography helps to provide liver fibrosis staging with sensitivity and specificity values up to 90%-99% (12-16) by measuring tissue elasticity by using mechanical waves. However, MR elastography may not be available in many institutions because of the need for complex mechanical setup, dedicated MRI sequence, and lengthy image acquisition.DW imaging helps to measure the diffusion-driven displacement of water protons, which are more hindered in fibrotic tissue. The standard method based on an apparent diffusion coefficient (ADC) has been evaluated in

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mentioning

confidence: 55%

Diffusion-weighted MRI-based Virtual Elastography for the Assessment of Liver Fibrosis

Kromrey¹,

Bihan²,

Ichikawa³

2020

Radiology

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“…Moreover, recently published studies have already shown positive correlations between hepatic T1, T2, and ECV with liver fibrosis in both animal and human models [15,[18][19][20]36]. There are also studies showing positive correlations between T1, T2 mapping parameters and MRE with liver fibrosis, however, without focusing on AIH patients [21,37]. One of the most studied tools for non-invasive assessment of liver fibrosis in patients with AIH is liver stiffness measurement derived by TE (FibroScan) [38,39].…”

Section: Discussionmentioning

confidence: 99%

Non-invasive assessment of liver fibrosis in autoimmune hepatitis: Diagnostic value of liver magnetic resonance parametric mapping including extracellular volume fraction

et al. 2020

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Purpose Autoimmune hepatitis (AIH) is an immune-mediated chronic liver disease that leads to severe fibrosis and cirrhosis. The aim of this study was to determine the diagnostic value of T1 and T2 mapping as well as extracellular volume fraction (ECV) for non-invasive assessment of liver fibrosis in AIH patients. Methods In this prospective study, 27 patients (age range: 19–77 years) with AIH underwent liver MRI. T1 and T2 relaxation times as well as ECV were quantified by mapping techniques. The presence of significant fibrosis (≥ F2) was defined as magnetic resonance elastography (MRE)-based liver stiffness ≥ 3.66 kPa. MRE was used as reference standard, against which the diagnostic performance of MRI-derived mapping parameters was tested. Diagnostic performance was compared by utilizing receiver-operating characteristic (ROC) analysis. Results MRE-based liver stiffness correlated with both, hepatic native T1 (r = 0.69; P < 0.001) as well as ECV (r = 0.80; P < 0.001). For the assessment of significant fibrosis, ECV yielded a sensitivity of 85.7% (95% confidence interval (CI): 60.1–96.0%) and a specificity of 84.6% (CI 60.1–96.0%); hepatic native T1 yielded a sensitivity of 85.7% (CI 60.1–96.0%); and a specificity of 76.9% (CI 49.7–91.8%). Diagnostic performance of hepatic ECV (area under the curve (AUC): 0.885), native hepatic T1 (AUC: 0.846) for assessment of significant fibrosis was similar compared to clinical fibrosis scores (APRI (AUC: 0.852), FIB-4 (AUC: 0.758), and AAR (0.654) (P > 0.05 for each comparison)). Conclusion Quantitative mapping parameters such as T1 and ECV can identify significant fibrosis in AIH patients. Future studies are needed to explore the value of parametric mapping for the evaluation of different disease stages.

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“…In contrast, advanced radiologic imaging techniques, such as magnetic resonance elastography (MRE), may provide a more global view of the liver with capability to diagnosis fibrosis non- invasively. In humans, MRE has been shown to provide valuable qualitative and quantitative assessment of liver fibrosis (27–29). From a preclinical standpoint, Huang et al were able to demonstrate a positive correlation between liver stiffness and histologic fibrosis in an 8-pig pilot study investigating the utility of MRE in swine (11); a similar analysis using the Oncopig platform has been initiated.…”

Section: Discussionmentioning

confidence: 99%

Characterization of an Inducible Alcoholic Liver Fibrosis Model for Hepatocellular Carcinoma Investigation in a Transgenic Porcine Tumorigenic Platform

Gaba

Mendoza-Elias

Regan

et al. 2018

Journal of Vascular and Interventional Radiology

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Detection of liver fibrosis using qualitative and quantitative MR elastography compared to liver surface nodularity measurement, gadoxetic acid uptake, and serum markers

Abstract: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1552-1561.

Cited by 39 publications

References 41 publications

Diffusion-weighted MRI-based Virtual Elastography for the Assessment of Liver Fibrosis

Diffusion-weighted MRI-based Virtual Elastography for the Assessment of Liver Fibrosis

Non-invasive assessment of liver fibrosis in autoimmune hepatitis: Diagnostic value of liver magnetic resonance parametric mapping including extracellular volume fraction

Characterization of an Inducible Alcoholic Liver Fibrosis Model for Hepatocellular Carcinoma Investigation in a Transgenic Porcine Tumorigenic Platform

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