Comparison of Liver Fibrosis and Function Indices with Extracellular Volume Using Dual-energy CT: A Retrospective Study

Abstract

Background: Dual-energy computed tomography (DECT) enables the direct measurement of iodine accumulation in the extracellular space. Objective: To compare measures of liver fibrosis and function with extracellular volume (ECV) from iodine/water images using DECT. Methods: Data was obtained from 119 consecutive patients who underwent abdominal DECT. A region of interest was set in the right lobe of the liver, pancreas, spleen, and aorta on iodine density images. ECV was calculated using the following formula: ECV = (1  hematocrit) × [iodine concentration in the liver (or pancreas, spleen) / iodine concentration in the aorta]. The severity of liver fibrosis was estimated using the aminotransferase/platelet ratio index (APRI) and the Fibrosis-4 (FIB-4) index. Liver function was assessed by the Child-Pugh classification and albumin-bilirubin (ALBI) grade. Data were analyzed by Spearman rank correlation coefficient, one-way analysis of variance, and post hoc analysis. Results: The correlation between ECV and fibrosis indices (APRI and FIB-4) was only significant and with a weak magnitude for the liver ECV quantification at the equilibrium phase (r=0.25 and r=0.20, respectively). The correlations between liver function index and ECV quantification were more robust than with fibrosis index. The highest correlations (r=0.50) were found between ALBI grade and liver ECV at the equilibrium phase. Liver ECV value at the equilibrium phase were significant difference between ALBI grade 1 vs. 2 and grade 1 vs. 3. Conclusion: Liver ECV quantification by DECT is more suitable for evaluating liver function than liver fibrosis severity.

Dual-energy CT quantification of extracellular liver volume predicts short-term disease progression in patients with hepatitis B liver cirrhosis-acute decompensation

“…ECV is a marker used to quantify the status of the extracellular matrix, which is an important component of the cellular microenvironment, and the development of disease is usually accompanied by changes in the cellular microenvironment. Therefore, ECV can reflect the extent of tissue inflammation, liver function, and the degree of fibrosis [ 21 , 28 , 29 ]. In the dynamic progression of cirrhosis, the gradual deposition of collagen in the liver leads to gradual expansion of the extracellular gap.…”