Visual morphometry and three non-invasive markers in the evaluation of liver fibrosis in chronic liver disease

Agrawal, Swastik; Hoad, Caroline L.; Francis, Susan T.; Guha, Indra Neil; Kaye, Philip; Aithal, Guruprasad P.

doi:10.1080/00365521.2016.1233578

Cited by 15 publications

(32 citation statements)

References 25 publications

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“…Here we present validation of our MRI measures against the gold standard, showing the correlation of T 1 with the continuous biopsy variable of visual morphometry in METAVIR fibrosis stage F4, in agreement with previous reports in the literature across a wider range of fibrosis scores obtained from histology. 17,19 Further, we show that liver perfusion assessed in this CC cohort shows a significant correlation with indocyanine green (ICG-PDR and ICGR15). A recent study 33 assessed ICG continuous clearance and HVPG measurement against 2D PC-MRI of portal venous and hepatic arterial flow.…”

Section: Healthymentioning

confidence: 57%

“…The percentage of fibrous tissue relative to the total biopsy area was estimated for each biopsy by visual morphometry. 17 A Spearman's rank correlation coefficient (in terms of R value) was computed between the continuous variables of visual morphometry and liver tissue T 1 .…”

Section: Cardiacmentioning

confidence: 99%

“…Recent advances in non-invasive magnetic resonance imaging (MRI) techniques allow the assessment of blood flow to organs, 14 tissue perfusion, 15,16 and compositional changes including fibrosis and inflammation, [17][18][19] in the key organs associated with cirrhosis. Until now, such measures have only been examined in single organs rather than using a comprehensive multi-organ approach in a single scan session.…”

Section: Introductionmentioning

confidence: 99%

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Multi-organ assessment of compensated cirrhosis patients using quantitative magnetic resonance imaging

Bradley

Cox

Scott

et al. 2018

Journal of Hepatology

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Section: Healthymentioning

confidence: 57%

Section: Cardiacmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Multi-organ assessment of compensated cirrhosis patients using quantitative magnetic resonance imaging

Bradley

Cox

Scott

et al. 2018

Journal of Hepatology

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“…Our study used scanned digital slides of 94 good sized liver biopsies, of minimum length 23 mm, which had been used previously as part of a study comparing histopathological assessment of fibrosis with three non-invasive markers of fibrosis 12. The biopsies were from consecutive patients investigated for chronic liver disease with interpretable liver biopsy specimens.…”

Section: Methodsmentioning

confidence: 99%

Can reference images improve interobserver agreement in reporting liver fibrosis?

et al. 2017

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Staging of fibrosis in medical liver biopsies has inherent interobserver variability. There are a number of disease-specific scoring systems available. While recognising the importance of these scoring systems, there is scope to consider how concordance amongst histopathologists could be improved using a generic fibrosis staging system.Using virtual slides, we approached both specialist liver histopathologists and general histopathologists from the UK to assess the degree of fibrosis against a proposed four-tiered reporting system. Example reference images were then produced and distributed to the same responders who were asked to rate a second set of slides to assess if the use of reference images improved concordance between pathologists.The use of reference images eliminated spread across three categories (from 15% to 0%). Overall, agreement was already good; our study showed an improved agreement amongst all participants for percentage agreement (67.79% to 70.08%) and interobserver agreement improved (Fleiss' Kappa 0.55 to 0.59).

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“…Proton MRS provides a noninvasive, operator-independent measure of liver fat-fractions. Development and evaluation of quantitative MRI technology should consider treating MR parameters as continuous variables that reflect the disease process, which lead to the accumulation of fat, inflammation and fibrosis as well as interventions resulting in their resolution [61,66] . Multinuclear MRS allows for the investigation of underlying metabolism and using these technologies in parallel gives a full picture of the key factor relevant to the cause and progression of metabolic disorders.…”

Section: Discussionmentioning

confidence: 99%

Current and Future Magnetic Resonance Technologies for Assessing Liver Disease in Clinical and Experimental Medicine

Bawden

Scott²,

Aithal³

2017

Dig Dis

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Background: In the past decades, a number of non-invasive methods have emerged for detecting and estimating liver fibrosis; these include both serum-based panels and imaging-based technology. Some of these methods are now being incorporated in clinical practice. However, the limitations of the current techniques include lack of organ specificity, sampling errors and limited ability to reflect the efficacy of interventions. Key Messages: Novel magnetic resonance (MR)-based techniques provide an opportunity to bring about further changes in the investigations and management of patients with liver diseases. Multimodal quantitative MR techniques enable the estimation of fat, iron accumulation, degree of liver injury/inflammation and fibrosis within the whole liver without the need for administering contrast agents. Architectural changes within the liver can be evaluated concurrently with portal haemodynamic changes allowing non-invasive assessment of portal hypertension and effects of interventions. A combination ultra-high field (7T) provides greater sensitivity with a potential to distinguish inflammation from fibrosis on imaging and determine specific types of fats (saturated vs. unsaturated) present within the liver using MR spectroscopy. ¹³C MR spectroscopy can estimate glutathione flux and rate of beta oxidation in-vivo providing novel tools for experimental studies that evaluate the efficacy of interventions as well as underlying mechanisms. Conclusions: Translational research should focus on converting the potentials of these innovative methodologies into clinical applications for the benefit of patients.

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Visual morphometry and three non-invasive markers in the evaluation of liver fibrosis in chronic liver disease

Abstract: Non-invasive markers of fibrosis LSM, ELF and T relaxation time provide continuous surrogates for categorical histopathological staging of fibrosis which can be useful as markers of progression and regression of fibrosis on follow-up.

Cited by 15 publications

References 25 publications

Multi-organ assessment of compensated cirrhosis patients using quantitative magnetic resonance imaging

Multi-organ assessment of compensated cirrhosis patients using quantitative magnetic resonance imaging

Can reference images improve interobserver agreement in reporting liver fibrosis?

Current and Future Magnetic Resonance Technologies for Assessing Liver Disease in Clinical and Experimental Medicine

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