Heng Zhao1, Jun Chen1, Duane D Meixner1, Hua Xie1, Vijay Shamdasani1, Shiwei Zhou1, Jean-Luc Robert1, Matthew W Urban1, William Sanchez1, Matthew R Callstrom1, Richard L Ehman1, James F Greenleaf1, Shigao Chen2. 1. Departments of Physiology and Biomedical Engineering (H.Z., M.W.U., J.F.G., S.C.), Radiology (J.C., D.D.M., M.R.C., R.L.E.), and Gastroenterology and Hepatology (W.S.), Mayo Clinic College of Medicine, Rochester, Minnesota USA; Philips Research North America, Briarcliff Manor, New York USA (H.X., S.Z., J.-L.R.); and Philips Healthcare, Bothell, Washington USA (V.S.). 2. Departments of Physiology and Biomedical Engineering (H.Z., M.W.U., J.F.G., S.C.), Radiology (J.C., D.D.M., M.R.C., R.L.E.), and Gastroenterology and Hepatology (W.S.), Mayo Clinic College of Medicine, Rochester, Minnesota USA; Philips Research North America, Briarcliff Manor, New York USA (H.X., S.Z., J.-L.R.); and Philips Healthcare, Bothell, Washington USA (V.S.). chen.shigao@mayo.edu.
Abstract
OBJECTIVES: Magnetic resonance elastography (MRE) has excellent performance in detecting liver fibrosis and is becoming an alternative to liver biopsy in clinical practice. Ultrasound techniques based on measuring the propagation speed of the shear waves induced by acoustic radiation force also have shown promising results for liver fibrosis staging. The objective of this study was to compare ultrasound-based shear wave measurement to MRE. METHODS: In this study, 50 patients (28 female and 22 male; age range, 19-81 years) undergoing liver MRE examinations were studied with an ultrasound scanner modified with shear wave measurement functionality. For each patient, 27 shear wave speed measurements were obtained at various locations in the liver parenchyma away from major vessels. The median shear wave speed from all measurements was used to calculate a representative shear modulus (μ) for each patient. Magnetic resonance elastographic data processing was done by a single analyst blinded to the ultrasound measurement results. RESULTS: Ultrasound and MRE measurements were correlated (r = 0.86; P < .001). Receiver operating characteristic (ROC) analysis was applied to the ultrasound measurement results with the MRE diagnosis as the "ground truth." The area under the ROC curve for separating patients with minimum fibrosis (defined as μ(MRE) ≤2.9 kPa) was 0.89 (95% confidence interval, 0.77-0.95), and the area under the ROC curve for separating patients with advanced fibrosis (defined as μ(MRE) ≥5.0 kPa) was 0.96 (95% confidence interval, 0.87-0.99). CONCLUSIONS: Results indicate that the ultrasound-based shear wave measurement correlates with MRE and is a promising method for liver fibrosis staging.
OBJECTIVES: Magnetic resonance elastography (MRE) has excellent performance in detecting liver fibrosis and is becoming an alternative to liver biopsy in clinical practice. Ultrasound techniques based on measuring the propagation speed of the shear waves induced by acoustic radiation force also have shown promising results for liver fibrosis staging. The objective of this study was to compare ultrasound-based shear wave measurement to MRE. METHODS: In this study, 50 patients (28 female and 22 male; age range, 19-81 years) undergoing liver MRE examinations were studied with an ultrasound scanner modified with shear wave measurement functionality. For each patient, 27 shear wave speed measurements were obtained at various locations in the liver parenchyma away from major vessels. The median shear wave speed from all measurements was used to calculate a representative shear modulus (μ) for each patient. Magnetic resonance elastographic data processing was done by a single analyst blinded to the ultrasound measurement results. RESULTS: Ultrasound and MRE measurements were correlated (r = 0.86; P < .001). Receiver operating characteristic (ROC) analysis was applied to the ultrasound measurement results with the MRE diagnosis as the "ground truth." The area under the ROC curve for separating patients with minimum fibrosis (defined as μ(MRE) ≤2.9 kPa) was 0.89 (95% confidence interval, 0.77-0.95), and the area under the ROC curve for separating patients with advanced fibrosis (defined as μ(MRE) ≥5.0 kPa) was 0.96 (95% confidence interval, 0.87-0.99). CONCLUSIONS: Results indicate that the ultrasound-based shear wave measurement correlates with MRE and is a promising method for liver fibrosis staging.
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