Magnetic Resonance Elastography for Staging Liver Fibrosis in Chronic Hepatitis C

Abstract

Purpose: We evaluated the use of magnetic resonance (MR) elastography (MRE) for staging liverˆbrosis in patients with chronic hepatitis C and compared the ability of MRE and serumˆbrosis markers for discriminating each stage ofˆbrosis.Methods: We evaluated 114 patients with chronic hepatitis C in whom the pathological brosis stage was determined (ˆbrosis stage 0 [F0], 3; F1, 15; F2, 28; F3, 25; and F4, 43). All patients underwent MRE using a 1.5-tesla MR system and pneumatic driver system. We measured stiŠness values (kPa) of the liver in a circular region of interest placed on elastograms. We determined the optimal cutoŠ value and diagnostic ability for discriminating each stage ofˆbrosis using receiver operating characteristic (ROC) curve analysis and compared the discriminative ability of MRE with that of serumˆbrosis markers. Conclusion: MRE is a reliable technique for staging liverˆbrosis and discriminating liver brosis stages in patients with chronic hepatitis C.

Asian-Pacific Association for the Study of the Liver (APASL) consensus guidelines on invasive and non-invasive assessment of hepatic fibrosis: a 2016 update

“…As MRE is proving to be an accurate and reliable test, many single etiology studies with MRE in diseases such as hepatitis B, hepatitis C, alcoholic liver disease and NASH have emerged [141,[146][147][148][149], and all show high performance (accuracy [ 0.90) of MRE in the detection of fibrosis. Large population studies are still lacking.…”

“…The total costs associated with the LB alone strategy for men and women were US $195,169 and US $214,760, respectively. The authors of this study concluded that in clinical settings where testing is required prior to treatment, FT alone is more effective and less costly than LB although the actual cost savings appear minimal and may have less value because of the decreased accuracy of FT [146]. The cost-effectiveness of TE performed annually was found to be better than LB performed every 7 years in the evaluation of liver fibrosis in patients with HIV/HCV coinfection [157].…”

Bayesian prediction for liver fibrosis staging: Combined use of elastography and serum fibrosis markers

“…Respective cut-off values for the APRI, UTE, and MRE were 0.5, 5.2, and 3.2 kPa for significant fibrosis (!F2) and 2.0, 12.9, and 4.6 kPa for cirrhosis (F4). 6,7 Accuracy of fibrosis staging was com- , had an APRI of 1.65, indicating significant fibrosis, but not cirrhosis. A value of 16.0 kPa, by UTE, indicated cirrhosis, whereas noncirrhosis, but significant fibrosis, were suggested by a 3.6-kPa value by MRE.…”

Validity and Reliability of Magnetic Resonance Elastography for Staging Hepatic Fibrosis in Patients with Chronic Hepatitis B

“…16 It is believed that CHB has a tendency to involve more advanced focal necrosis and inflammatory cell infiltration than CHC. Unfortunately, the number of MRE studies is limited for groups with a single etiology, such as CHC, 13 CHB, 17,18 alcoholic hepatitis, 19 nonalcoholic steatohepatitis (NASH), 20,21 and Gaucher disease. 22 Accordingly, it appears that more evidence would have to be collected using subjects with single-etiology liver disease to establish the use of MRE in clinical settings.…”