Magnetic resonance elastography in the assessment of hepatic fibrosis: a study comparing transient elastography and histological data in the same patients

Toguchi, Masafumi; Tsurusaki, Masakatsu; Yada, Norihisa; Sofue, Keitaro; Hyodo, Toru; Onoda, Mitsuyoshi; Numoto, Isao; Matsuki, Mitsuru; Imaoka, Izumi; Kudo, Masatoshi; Murakami, Takamichi

doi:10.1007/s00261-017-1045-3

Cited by 17 publications

(33 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When the stiffness cut-off values for differentiation of Ludwig stage 0-1 versus stage 2 or higher fibrosis derived from the entire population were applied to the subpopulation of patients with histologic steatosis (Fig 4), the cut-off value of 2.27 kPa had a sensitivity of 52.1% (95% CI: 39.8%, 64.5%) and specificity of 71.4% (95% CI: 60.3%, 82.6%). The cut-off value of 1.67 (1)(2)(3)(13)(14)(15)(16)(17). For identification of stage 2 or higher fibrosis, however, the performance of MR elastography in our pediatric population is less good than reported in these adult studies, where AUCs were 0.83-0.99 (1,(12)(13)(14)(15)(16)(17).…”

Section: Identification Of Significant Fibrosis: Patients With Histolmentioning

confidence: 69%

Diagnostic Performance of MR Elastography for Liver Fibrosis in Children and Young Adults with a Spectrum of Liver Diseases

Trout¹,

Sheridan²,

Serai³

et al. 2018

Radiology

View full text Add to dashboard Cite

Purpose To assess the diagnostic performance of magnetic resonance (MR) elastography-derived liver stiffness to detect liver fibrosis in a pediatric and young adult population with a spectrum of liver diseases. Materials and Methods This retrospective study included patients younger than 21 years of age who underwent MR elastography and liver biopsy within 3 months of one another between January 2012 and September 2016 for indications other than liver transplantation or Fontan palliation of congenital heart disease. MR elastography examinations were reprocessed by a single observer, blinded to pathologic findings. Pathology specimens were reviewed by a single pathologist who scored steatosis (lipid in ≥ 5% of hepatocytes) and staged fibrosis. Receiver operating characteristic (ROC) curves were used to assess diagnostic performance. Results A total of 86 patients, 49 (57%) male with a median age of 14.2 years (range, 0.3-20.6 years), were included. Fifty-one patients (59.3%) had Ludwig stage 2 or higher fibrosis; 44 patients (51.2%) had hepatic steatosis. The area under the ROC curve for Ludwig stage 0-1 versus stage 2 or higher fibrosis was 0.70 (95% confidence interval [CI]: 0.59, 0.81) for the whole population and was significantly lower for patients with steatosis versus those without (0.53 [95% CI: 0.35, 0.71] vs 0.82 [95% CI: 0.67, 0.96], P = .014). Optimal stiffness cut-offs for the entire population were 2.27 kPa with 68.6% sensitivity (95% CI: 57.2%, 80.1%) and 74.3% specificity (95% CI: 63.5%, 85.1%) or 1.67 kPa with 35.3% sensitivity (95% CI: 23.5%, 47.1%) and 91.4% specificity (95% CI: 84.5%, 98.3%). Conclusion In children and young adults, MR elastography performs significantly better for distinguishing stage 0-1 versus stage 2 or higher fibrosis in patients without steatosis than in those with steatosis. This suggests a confounding effect of steatosis or inflammation in the population with nonalcoholic fatty liver disease. RSNA, 2018.

show abstract

Section: Identification Of Significant Fibrosis: Patients With Histolmentioning

confidence: 69%

Diagnostic Performance of MR Elastography for Liver Fibrosis in Children and Young Adults with a Spectrum of Liver Diseases

Trout¹,

Sheridan²,

Serai³

et al. 2018

Radiology

View full text Add to dashboard Cite

show abstract

“…In another study performed in a group of 24 healthy individuals, it was reported that the different methods had significant differences in measurement variability and that the ROI in a large liver segment had the best reproducibility, while different liver segments had significantly different stiffness values . In still another study, the choice of a single, small circular ROI was found to be superior to the freehand positioning for the detection of significant fibrosis, but the diagnostic performance was equivalent in higher fibrosis stages . In the case of large freehand positioning, the exclusion of regions with low wave propagation was shown to improve the measurement consistency, although these findings were obtained in a study with a small number of patients …”

Section: Methods For Liver and Spleen Mrementioning

confidence: 97%

“…74 In still another study, the choice of a single, small circular ROI was found to be superior to the freehand positioning for the detection of significant fibrosis, but the diagnostic performance was equivalent in higher fibrosis stages. 75 In the case of large freehand positioning, the exclusion of regions with low wave propagation was shown to improve the measurement consistency, although these findings were obtained in a study with a small number of patients. 76 Overall, the selection of the largest ROIs avoiding organ edges and large vessel structures (due to the boundary conditions they introduce), while respecting a reconstruction quality criterion, seems to be the recommended approach.…”

Section: Effect Of Region Of Interest Selectionmentioning

confidence: 95%

See 1 more Smart Citation

Magnetic resonance elastography of liver and spleen: Methods and applications

2018

View full text Add to dashboard Cite

The viscoelastic properties of the liver and spleen can be assessed with magnetic resonance elastography (MRE). Several actuators, MRI acquisition sequences and reconstruction algorithms have been proposed for this purpose. Reproducible results are obtained, especially when the examination is performed in standard conditions with the patient fasting. Accurate staging of liver fibrosis can be obtained by measuring liver stiffness or elasticity with MRE. Moreover, emerging evidence shows that assessing the tissue viscous parameters with MRE is useful for characterizing liver inflammation, non-alcoholic steatohepatitis, hepatic congestion, portal hypertension, and hepatic tumors. Further advances such as multifrequency acquisitions and compression-sensitive MRE may provide novel quantitative markers of hepatic and splenic mechanical properties that may improve the diagnosis of hepatic and splenic diseases.

show abstract

“…This effect was not ruled out in our study, so it might be possible that in patients with modest biliary obstruction administration of Gd-EOB-DTPA might cause a transient rise in liver stiffness. Another drawback is that no histological correlation was available; however, the purpose of our study was not to evaluate whether hepatic MRE findings correlated with clinical or histological findings (which have been assessed in several other studies [41,42]), but to compare the results within individuals' data. Furthermore, it was not possible to prove that MRI without passive driver administration really improves the quality of the examination because our study did not include MRI examinations without a passive driver.…”

Section: Discussionmentioning

confidence: 99%

Does gadoxetate disodium affect MRE measurements in the delayed hepatobiliary phase?

et al. 2018

View full text Add to dashboard Cite

Objectives To assess if the administration of gadoxetate disodium (Gd-EOB-DTPA) significantly affects hepatic magnetic resonance elastography (MRE) measurements in the delayed hepatobiliary phase (DHBP). Methods A total of 47 patients (15 females, 32 males; age range 23-78 years, mean 54.28 years) were assigned to standard hepatic magnetic resonance imaging (MRI) with application of Gd-EOB-DTPA and hepatic MRE. MRE was performed before injection of Gd-EOB-DTPA and after 40-50 min in the DHBP. Liver stiffness values were obtained before and after contrast media application and differences between pre-and post-Gd-EOB-DTPA values were evaluated using a Bland-Altman plot and the Mann-Whitney-Wilcoxon test. In addition, the data were compared with regard to the resulting fibrosis classification. Results Mean hepatic stiffness for pre-Gd-EOB-DTPA measurements was 4.01 kPa and post-Gd-EOB-DTPA measurements yielded 3.95 kPa. We found a highly significant individual correlation between pre-and post-Gd-EOB-DTPA stiffness values (Pearson correlation coefficient of r = 0.95 (p < 0.001) with no significant difference between the two measurements (p =0.49)). Bland-Altman plot did not show a systematic effect for the difference between pre-and post-stiffness measurements (mean difference: 0.06 kPa, SD 0.81). Regarding the classification of fibrosis stages, the overall agreement was 87.23% and the intraclass correlation coefficient was 96.4%, indicating excellent agreement. Conclusions Administration of Gd-EOB-DTPA does not significantly influence MRE stiffness measurements of the liver in the DHBP. Therefore, MRE can be performed in the DHBP. Key Points • MRE of the liver can reliably be performed in the delayed hepatobiliary phase.• Gd-EOB-DTPA does not significantly influence MRE stiffness measurements of the liver.• MRE performed in the delayed hepatobiliary-phase is reasonable in patients with reduced liver function.

show abstract

Magnetic resonance elastography in the assessment of hepatic fibrosis: a study comparing transient elastography and histological data in the same patients

Abstract: MRE and TE detected liver fibrosis with comparable accuracy. In particular, the srROIs method was effective for detecting of significant fibrosis.

Cited by 17 publications

References 23 publications

Diagnostic Performance of MR Elastography for Liver Fibrosis in Children and Young Adults with a Spectrum of Liver Diseases

Diagnostic Performance of MR Elastography for Liver Fibrosis in Children and Young Adults with a Spectrum of Liver Diseases

Magnetic resonance elastography of liver and spleen: Methods and applications

Does gadoxetate disodium affect MRE measurements in the delayed hepatobiliary phase?

Contact Info

Product

Resources

About