Diagnosis of Cirrhosis by Spiral Computed Tomography

Westphalen, Antonio C.; Qayyum, Aliya; Aslam, Rizwan; Rybkin, Alexander V.; Chen, Mei-Hsiu; Coakley, Fergus V.

doi:10.1097/rct.0b013e31815ea857

Cited by 17 publications

(4 citation statements)

References 18 publications

(18 reference statements)

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“…The use of subjective LSN to stage liver fibrosis has been also applied to computed tomography (CT) [10], [11] and magnetic resonance imaging (MRI) [6] with varying levels of reported diagnostic accuracy.…”

Section: Introductionmentioning

confidence: 99%

“…The use of liver morphology, specifically by subjectively evaluating liver surface nodularity (LSN), to stage liver fibrosis has been well studied in ultrasound imaging, with varying levels of diagnostic accuracy for predicting liver fibrosis stage reported in the literature [7] , [8] , [9] . The use of subjective LSN to stage liver fibrosis has been also applied to computed tomography (CT) [10] , [11] and magnetic resonance imaging (MRI) [6] with varying levels of reported diagnostic accuracy.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility and reproducibility of liver surface nodularity quantification for the assessment of liver cirrhosis using CT and MRI

Besa

King

et al. 2017

European Journal of Radiology Open

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PurposeTo assess intra-observer, inter-observer and inter-modality (CT vs. MRI) reproducibility of liver surface nodularity (LSN) scores measured with software used for detection of liver fibrosis.MethodsThis IRB-approved retrospective study included patients with both abdominal CT and MRI within 6 months of histopathologic sampling. Two independent observers used post-processing software to quantify LSN scores on axial non-contrast CT (NCT), axial contrast-enhanced CT (CECT), axial T2-weighted (T2W) HASTE, and axial and coronal post-gadoxetic acid T1-weighted (T1W) images obtained during the hepatobiliary phase (HBP). Ten slices were used to acquire the LSN scores. Intra-observer, inter-observer, and inter-modality (CT vs. MRI) reproducibility were assessed with intraclass correlation coefficient (ICC) and coefficients of variability (CV). Accuracy for detection of cirrhosis was evaluated for each technique.Results26 patients (M/F 19/7, mean age 57 years), including 7 with cirrhosis (26.9%), were assessed. Technical failure occurred with NCT (1/23, 4.3%) and T2 HASTE (8/28, 28.6%). Intra-observer reproducibility was excellent for NCT, CECT, axial and coronal T1W HBP [ICC ≥ 0.92, CV ≤ 8%]. Inter-observer reproducibility was also excellent for NCT and CECT (ICC ≥ 0.95, CV ≤ 7.3%) and for coronal T1W HBP (ICC = 0.84, CV = 5.6%). There was fair to moderate agreement between CT and MRI (ICC 0.20–0.44). There were significant differences in mean LSN scores between non-cirrhotic and cirrhotic patients with NCT (2.6 vs. 4.2, p = 0.04) and T1W HBP (3.7 vs. 4.6; p = 0.01) images, with AUCs of 0.81 and 0.82, respectively.ConclusionsLSN measurement is highly reproducible with NCT and post-contrast T1W HBP on MRI, with different results obtained between CT and MRI.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Feasibility and reproducibility of liver surface nodularity quantification for the assessment of liver cirrhosis using CT and MRI

Besa

King

et al. 2017

European Journal of Radiology Open

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“…[ 1 ] Current modalities including elastography, laboratory biomarkers, and subjective LSN stage system are not qualified to replace the reference standard of invasive liver biopsy, as a result of limited accuracy, dedicated equipment requirement, and interobserver variability. [ 18 ] Recent studies have developed and validated a new semiautomated software equipped with quantitative tool for deriving objective scores of LSN on multidetector computed tomography (MDCT) and MRI for predicting early cirrhosis, [ 12 , 13 , 19 ] obviating the invasive liver biopsy and the drawbacks of previous methods with varied diagnostic performance. To our knowledge, there has been no previous meta-analysis evaluating the diagnostic performance of quantitative LSN score for predicting early cirrhosis based on imaging procedures, additionally, no consensus has been reached about the diagnostic accuracy of LSN with varied cut-off values.…”

Section: Discussionmentioning

confidence: 99%

“…There is growing evidence that the morphologic change of liver surface nodularity (LSN) based on imaging modalities is associated with the severity of CLD, which has been applied in US, [ 9 – 11 ] computed tomography (CT), and MRI, [ 12 , 13 ] recent studies demonstrated that quantitative LSN score using these novel imaging techniques has the potential to predict the early cirrhosis stage (F4). [ 14 , 15 ] Whereas, the results of these studies are insufficiently robust with a small sample size, and no clear consensus has been reached about the diagnostic accuracy of LSN score with varied cut-off values; in addition, there has been no previous published meta-analysis evaluating the diagnostic performance of quantitative LSN score based on imaging procedures.…”

Section: Introductionmentioning

confidence: 99%

Quantitative liver surface nodularity score based on imaging for assessment of early cirrhosis in patients with chronic liver disease

Yan

Zhang

2021

Medicine

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Background: Early stage of cirrhosis is of great value in the diagnosis and management in patients with chronic liver disease (CLD). Recent studies have shown that quantitative liver surface nodularity (LSN) score based on imaging techniques can be used to predict the early cirrhosis stage noninvasively, with varied diagnostic accuracy and limited sample size. Hence, this study will evaluate the diagnostic accuracy of LSN in the prediction of early cirrhosis. Methods: We will conduct a comprehensive search in PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases to identify eligible studies. The literature screening, data extraction, data analysis, and quality assessment will then be carried out. The summary receiver-operating-characteristic (ROC) and pooled sensitivity, specificity will be calculated to summarize the diagnostic performance of LSN using a random-effect model. A meta-regression analysis will be performed to investigate the underlying cause of the heterogeneity. Results: This study will evaluate the diagnostic accuracy of LSN score in the identification of early cirrhosis, which may further determine whether this method can be used as an alternative in the assessment of CLD patients. Conclusions: This study will help to determine the diagnostic accuracy and summarize the recent evidence on this issue. Study registration: INPLASY2020100096.

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The many faces of cirrhosis

et al. 2019

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Diagnosis of Cirrhosis by Spiral Computed Tomography

Abstract: Spiral CT demonstrates high accuracy and interobserver agreement in the diagnosis of cirrhosis, suggesting CT may be a supplementary diagnostic test in patients who have contraindications to biopsy or have equivocal biopsy findings.

Cited by 17 publications

References 18 publications

Feasibility and reproducibility of liver surface nodularity quantification for the assessment of liver cirrhosis using CT and MRI

Feasibility and reproducibility of liver surface nodularity quantification for the assessment of liver cirrhosis using CT and MRI

Quantitative liver surface nodularity score based on imaging for assessment of early cirrhosis in patients with chronic liver disease

The many faces of cirrhosis

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