MR elastography of the liver: comparison of three measurement methods

Kim, M.; Kang, Bo Kyeong; Jun, Dae Won; Kim, Y.

doi:10.1016/j.crad.2020.05.015

Cited by 4 publications

(5 citation statements)

References 24 publications

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“…The ROI included the largest part of the liver parenchyma, avoiding voxels with cross-hatching marks, large vessels, liver edge, fissures, and other organs such as the kidney and gallbladder. The average liver stiffness values from the four ROIs of the four sections were used 14 . Inter-observer and intra-observer agreement was 0.991 and 0.995, respectively 14 .…”

Section: Methodsmentioning

confidence: 99%

“…The average liver stiffness values from the four ROIs of the four sections were used 14 . Inter-observer and intra-observer agreement was 0.991 and 0.995, respectively 14 . The results are expressed as the mean stiffness (kPa), as shown in Fig.…”

Section: Methodsmentioning

confidence: 99%

“…To quantify liver fat, three non-overlapping circular ROIs with an area of 100 mm 2 were placed within each Couinaud segment, avoiding areas with large vessels, bile ducts, organ boundaries, focal hepatic lesions, or imaging artifacts. In total, 27 ROIs were obtained per patient, and the average of these measurements was considered as the representative hepatic fat fraction of the patient 14 . Liver stiffness and steatosis measurements obtained at the time of examination were entered into the database and extracted for this study.…”

Section: Methodsmentioning

confidence: 99%

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Role of FIB-4 for reassessment of hepatic fibrosis burden in referral center

Roh

Kang

Jun

et al. 2021

Sci Rep

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Low cut-off of FIB-4 is a widely used formula to exclude advanced liver fibrosis in primary care centers. However, the range of reported threshold of FIB-4 to rule in advanced fibrosis is too broad across etiologies, and no consensus has been reached. In the present study, we investigated the role of FIB-4 for a reassessment of hepatic fibrosis burden in a referral center. We compared the diagnostic performance of FIB-4 among patients with liver disease of various causes and tried to find an optimal cut-off value for predicting advanced fibrosis. Among 1068 patients, the AUROC of FIB-4 to diagnose advanced fibrosis showed no significant difference among the various etiologies of liver disease, ranging from 0.783 to 0.821. The optimal cut-off value obtained by maximizing Youden's index was 2.68, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for predicting advanced fibrosis were 70.7%, 79.1%, 43.5%, and 92.2%, respectively. The PPV was low in patients with autoimmune disease (6.67%). When we incorporated the new cut-off of FIB-4 into abdominal ultrasound findings, 81% of unnecessary work-ups would be appropriately avoided. In conclusion, the cut-off value of 2.68 showed an acceptable PPV while maintaining a high NPV to predict advanced fibrosis, most etiology except for autoimmune diseases. This result could assist in establishing an appropriate timing to reassess the hepatic fibrosis burden during monitoring in the referral center.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Role of FIB-4 for reassessment of hepatic fibrosis burden in referral center

Roh

Kang

Jun

et al. 2021

Sci Rep

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“…The central readers manually drew a region of interest (ROI) on the elastogram results of each slice to include as much liver tissue as possible, where a consistent shear wave is visible. The mean stiffness value of the liver was calculated and used [20]. For fat measurement, three-dimensional volumetric chemical shift encoded MRI image data were acquired in the axial orientation.…”

Section: Assessment Of Mri-pdff and Mrementioning

confidence: 99%

A Phase 2a, Randomized, Double-Blind, Placebo-Controlled Study to Assess the Efficacy and Safety of ALS-L1023 in Non-Alcoholic Fatty Liver Disease

et al. 2023

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Preclinical data have shown that the herbal extract, ALS-L1023, from Melissa officinalis reduces visceral fat and hepatic steatosis. We aimed to assess the safety and efficacy of ALS-L1023 as the treatment of non-alcoholic fatty liver disease (NAFLD). We conducted a 24-week randomized, double-blind, placebo-controlled 2a study in patients with NAFLD (MRI-proton density fat fraction [MRI-PDFF] ≥ 8% and liver fibrosis ≥ 2.5 kPa on MR elastography [MRE]) in Korea. Patients were randomly assigned to 1800 mg ALS-L1023 (n = 19), 1200 mg ALS-L1023 (n = 21), or placebo (n = 17) groups. Efficacy endpoints included changes in liver fat on MRI-PDFF, liver stiffness on MRE, and liver enzymes. For the full analysis set, a relative hepatic fat reduction from baseline was significant in the 1800 mg ALS-L1023 group (−15.0%, p = 0.03). There was a significant reduction in liver stiffness from baseline in the 1200 mg ALS-L1023 group (−10.7%, p = 0.03). Serum alanine aminotransferase decreased by −12.4% in the 1800 mg ALS-L1023 group, −29.8% in the 1200 mg ALS-L1023 group, and −4.9% in the placebo group. ALS-L1023 was well tolerated and there were no differences in the incidence of adverse events among the study groups. ALS-L1023 could reduce hepatic fat content in patients with NAFLD.

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“…Recently, there were two studies about quantifying the heterogeneity of the diffuse liver stiffness (LS) on MRE by different measurement methods. One study showed that LS calculated using ROIs that include the largest part of the liver parenchyma was significantly more reliable than circular ROIs with a radius of 1 cm [13], the other study showed that volumetric segmentation may potentially improve the detection of heterogeneous fibrosis and the accuracy of LS measurement than ROI-based method [14]. The purpose of this study was to evaluate the effect of different ROI positioning methods on the MRE measured tumor stiffness of HCCs, and their performance in differentiating pathologic grade of HCCs.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of 3D magnetic resonance elastography for assessing histologic grade of hepatocellular carcinoma: comparison of three methods for positioning region of interest

et al. 2021

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Purpose-To assess the influence of region of interest (ROI) placement on the predictive value of 3D MRE in differentiating the histologic grade of HCC.Methods-85 patients with pathologically confirmed HCCs were analyzed using 3D MRE imaging, two radiologists measured the tumor stiffness with three different ROI positioning methods. Intraclass correlation coefficient (ICC) was expressed in terms of inter-and intra observer agreements. Kruskal-Wallis rank test or one-way ANOVA was used to compare the difference in MRE stiffness across the three-ROI positioning methods. Receiver operating characteristic curve analysis (ROC) was performed, and the area under curve (AUC) was measured to evaluate the diagnostic performance.Results-There were 64 (75%) well-or-moderately differentiated HCCs and 21(25%) poorly differentiated HCCs included finally. Almost excellent inter-and intra-observer agreements (all ICC > 0.82) were observed for all three-ROI methods, the volumetric method has the highest values 0.926, respectively). The mean stiffnesses of poorly differentiated HCC obtained by two readers were significantly higher than well-or-moderately differentiated HCC with volumetric method (7.

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MR elastography of the liver: comparison of three measurement methods

Cited by 4 publications

References 24 publications

Role of FIB-4 for reassessment of hepatic fibrosis burden in referral center

Role of FIB-4 for reassessment of hepatic fibrosis burden in referral center

A Phase 2a, Randomized, Double-Blind, Placebo-Controlled Study to Assess the Efficacy and Safety of ALS-L1023 in Non-Alcoholic Fatty Liver Disease

Diagnostic accuracy of 3D magnetic resonance elastography for assessing histologic grade of hepatocellular carcinoma: comparison of three methods for positioning region of interest

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