Paul Murphy1, Jonathan Hooker1, Brandon Ang2, Tanya Wolfson3, Anthony Gamst3, Mark Bydder1, Michael Middleton1, Michael Peterson4, Cynthia Behling5, Rohit Loomba2,6, Claude Sirlin1. 1. Liver Imaging Group, Department of Radiology, University of California - San Diego, San Diego, California, USA. 2. NAFLD Translational Research Unit, Division of Gastroenterology, Department of Medicine, University of California - San Diego, San Diego, California, USA. 3. Computational and Applied Statistics Lab, San Diego Supercomputing Center, San Diego, California, USA. 4. Western Washington Pathology, Tacoma, Washington, USA. 5. Pacific Rim Pathology, San Diego, California, USA. 6. Division of Epidemiology, Department of Family and Preventative Medicine, University of California - San Diego, San Diego, California, USA.
Abstract
PURPOSE: To investigate in adults the associations between histologic features of nonalcoholic fatty liver disease (NAFLD) and quantitative measures derived from diffusion-weighted imaging (DWI). MATERIALS AND METHODS: Eighty-nine adults undergoing standard-of-care liver biopsy for NAFLD were recruited for DWI. Biopsies were scored for histologic features of NAFLD. DWI was performed using b-values of 0, 100, and 500 s/mm(2) . Images were reconstructed using either conventional magnitude averaging (CMA) or a method to address bulk motion artifacts (Beta*LogNormal, BLN). The apparent diffusion coefficient (ADC) and the diffusivity (D) and perfusion fraction (F) of the intravoxel incoherent motion (IVIM) model were measured in the right hepatic lobe using both reconstructions. Associations between histologic features and DWI-derived measures were tested statistically with several methods including multiple linear regression. RESULTS: Using CMA and BLN reconstructions, respectively, the means (and ranges) were 1.7 (1.1-3.5) and 1.4 (1.0-3.2) × 10(-3) mm(2) /s for ADC, 1.1 (0.84-1.4) and 0.84 (0.53-1.1) × 10(-3) mm(2) /s for D, and 17 and 18 (2.3-35)% for F. For both reconstruction methods, D decreased with steatosis and F decreased with fibrosis (P < 0.05). ADC was not independently associated with any histologic feature. CONCLUSION: Steatosis and fibrosis have significant independent effects on D and F in adults undergoing biopsy for NAFLD.
PURPOSE: To investigate in adults the associations between histologic features of nonalcoholic fatty liver disease (NAFLD) and quantitative measures derived from diffusion-weighted imaging (DWI). MATERIALS AND METHODS: Eighty-nine adults undergoing standard-of-care liver biopsy for NAFLD were recruited for DWI. Biopsies were scored for histologic features of NAFLD. DWI was performed using b-values of 0, 100, and 500 s/mm(2) . Images were reconstructed using either conventional magnitude averaging (CMA) or a method to address bulk motion artifacts (Beta*LogNormal, BLN). The apparent diffusion coefficient (ADC) and the diffusivity (D) and perfusion fraction (F) of the intravoxel incoherent motion (IVIM) model were measured in the right hepatic lobe using both reconstructions. Associations between histologic features and DWI-derived measures were tested statistically with several methods including multiple linear regression. RESULTS: Using CMA and BLN reconstructions, respectively, the means (and ranges) were 1.7 (1.1-3.5) and 1.4 (1.0-3.2) × 10(-3) mm(2) /s for ADC, 1.1 (0.84-1.4) and 0.84 (0.53-1.1) × 10(-3) mm(2) /s for D, and 17 and 18 (2.3-35)% for F. For both reconstruction methods, D decreased with steatosis and F decreased with fibrosis (P < 0.05). ADC was not independently associated with any histologic feature. CONCLUSION:Steatosis and fibrosis have significant independent effects on D and F in adults undergoing biopsy for NAFLD.
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