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

Abstract

Purpose: We evaluated the validity and reliability of magnetic resonance elastography (MRE) for staging hepatic fibrosis in patients with chronic hepatitis B.Methods: The study included 73 patients with chronic hepatitis B and confirmed stages of pathological fibrosis. Two radiologists measured liver stiffness using MRE in all cases. We compared the area under the receiver operating characteristic (ROC) curve (Az) for distinguishing stages of fibrosis compared with MRE liver stiffness measurements and serum fibrosis markers. We used intraclass correlation coefficients to analyze interobserver agreement for measurements of liver stiffness and 2 one-sided t-tests to test the equivalence of the measurements by the 2 observers.Results: ROC analyses revealed the significantly superior discrimination abilities of MRE for liver fibrosis staging (Az = 0.945 to 0.978 [Observer 1] and 0.936 to 0.967 [Observer 2]) to those of serum fibrosis markers (0.491 to 0.742) for both observers (P < 0.0004). The intraclass correlation coefficient between the 2 observers was excellent (µ = 0.971), and the measurements of liver stiffness by the 2 observers were statistically equivalent within a 0.1-kPa difference (P = 0.0157) Conclusion: MRE is a valid and reliable technique for discriminating the stage of hepatic fibrosis in patients with chronic hepatitis B.

Noninvasive hepatic fibrosis staging using mr elastography: The usefulness of the bayesian prediction method

“…Likewise, only one observer evaluated the ROI on MRE. This could be acceptable because some recent studies indicated high interobserver agreement for MRE‐based measurements of liver stiffness . It was also a limitation that valid validation was not done with a separate dataset.…”

“…The etiologies of chronic liver disease were hepatitis C ( n = 176), hepatitis B ( n = 78), hepatitis B and C ( n = 2), alcoholic steatohepatitis ( n = 34), nonalcoholic steatohepatitis (NASH) ( n = 5), autoimmune hepatitis ( n = 2), primary biliary cirrhosis ( n = 3), primary sclerosing cholangitis ( n = 2), and uncertain liver disease with elevated liver enzyme level ( n = 7). In this study the MRE results in 238 patients were shared with previous studies that have been published . However, the Bayesian method was not used in those studies.…”

“…Magnetic resonance elastography (MRE), a modified phase‐contrast technique developed to characterize the elasticity of tissues, is a new technique employed for staging of noninvasive liver fibrosis. Recent studies have indicated MRE as a promising, highly reproducible tool with advanced diagnostic capacity for the noninvasive staging of hepatic fibrosis . Previous reports have described the cutoff method for predicting liver fibrosis stage .…”

Comparison of diagnostic accuracies of two‐ and three‐dimensional MR elastography of the liver

“…Several elastography methods have been developed and validated, including ultrasonography-based transient elastography (8) and MR elastography (MRE) (9,10). Recent studies have revealed that MRE has a very high repeatability (11–13) and validity (14–18) for evaluating liver fibrosis (10), and when used for the assessment of viral hepatitis (19–22) and other diffuse liver diseases (23,24). …”

Magnetic resonance elastography is as accurate as liver biopsy for liver fibrosis staging

“…Recently, it has been shown that liver MRE has a high repeatability and has been crossvalidated with ultrasonography‐based elastography for evaluating liver fibrosis. In prior studies, MRE could not be directly compared to liver biopsy because biopsy was used as a reference standard . As discussed above, liver biopsy is not a robust approach for fibrosis staging due to sampling effects.…”