Prospective prevalence study of adult NAFLD/NASH utilizing multi-modality imaging compared with liver bopsy

Multiparametric MR mapping in clinical decision-making for diffuse liver disease

“…The diagnostic accuracy of fibrosis using cT1 is either equivalent or inferior to diagnosis by elastography based on comparative studies in NAFLD-only cohorts, with equivalent AUROC of 0.83 reported for cT1-based diagnosis of NASH or significant fibrosis in predominantly NAFLD cohorts as published and preliminary data indicate [32,85,102]. This may reflect the relatively small percent change in collagen percentage area that differentiates between stages of fibrosis [7], especially as mouse models of [16,28] No, a confounder that can be overcome by T2* or SE-EPI sequences [35,89,90] Diagnosis of NASH and disease activity Not applicable cT1 AUROC for NASH: 0.69-0.72 [85,102] cT1 AUROC for NAFLD: 0.93 [102] cT1 AUROC for ballooning: 0.84 [adapted from [32]] cT1 AUROC for NAS ≥ 5: 0.74 [102] AUROC for NASH: 0.58 [85] Diagnosis of steatosis Volumetric fat fraction of liver tissue (% fat) rather than PDFF available as HepaFatScan PDFF AUROC for steatosis grades:…”

“…This could be overcome by dedicated freehand ROI selection under supervision of an experienced radiologist or by using additional software to aid in this process [84]. The accuracy of MRE for early fibrosis is reportedly superior to transient elastography (TE) but equivalent in cases of advanced fibrosis [34,[85][86][87], and MRE shear waves may propagate through small-and medium-sized ascites. MRE has a lower measurement failure rate than TE and has reportedly better repeatability [88].…”

“…≥ G1: 0.93 [85] ≥ G2: 0.96 [85] ≥ G3: 0.94 [85] Not applicable but can add PDFF [36,40] Diagnosis of fibrosis Not applicable but can combine with T1 or DWI or MRE [35,41,45,89] cT1 AUROC for fibrosis stages: 11.0% [88] Confounded by iron…”

“…Accuracy improves when cT1 is applied as a composite biomarker with blood biomarkers (AUROC of 0.84-0.97 are reported for detection of NASH with significant fibrosis, as published and preliminary data indicate [46,137]). Using MRE, the accuracy of diagnosis of fibrosis (AUROC of 0.84-0.93 reported, depending on the fibrosis stage) is better than for identification of NASH only (AUROC of 0.58-0.73), although higher accuracy has been reported in mainly fibrotic NASH cohorts [34,82,85,87,135,138,139]. 3D-MRE was shown to be superior to 2D-MRE for advanced fibrosis and equivalent for NASH [78].…”