Kumaresan Sandrasegaran1, Paul Territo2, Reem M Elkady2,3, Yuning Lin2,4, Pauley Gasparis2, Gitasree Borthakur2, Chen Lin2. 1. Department of Radiology, Indiana University School of Medicine, 550 N University Blvd, UH 0279, Indianapolis, IN, 46202, USA. ksandras@iupui.edu. 2. Department of Radiology, Indiana University School of Medicine, 550 N University Blvd, UH 0279, Indianapolis, IN, 46202, USA. 3. Department of Radiology, Assiut University, Assiut, Egypt. 4. Department of Radiology, Fuzhou General Hospital, Fuzhou, China.
Abstract
OBJECTIVE: To investigate the usefulness of intravoxel incoherent motion (IVIM) in determining the severity of hepatic fibrosis, steatosis, and inflammation in patients with chronic liver disease. METHODS: Forty-nine patients who had liver MRI with IVIM sequence and liver biopsy within three months of MRI were enrolled. A reviewer, blinded to histology, placed regions of interest of 1-2 cm2 in the right liver lobe. In addition, the first twenty patients were assessed with a second reviewer. Perfusion fraction (f), pseudodiffusion coefficient (D fast), true diffusion coefficient (D slow), and apparent diffusion coefficient (ADC) were calculated from normalized signal intensities that were fitted into a biexponential model. Errors in the model were minimized with global stochastic optimization using Simulated Annealing. ANOVA with post hoc Tukey-Kramer test and multivariate generalized linear model analysis were performed, using histological findings as the gold standard. RESULTS: The most common etiologies for liver disease were hepatitis C and alcohol, accounting together for 76% (37/49) of patients. Low-grade fibrosis (F0, F1), hepatic steatosis, and inflammation were seen in 24% (12/49), 31% (15/49), and 29% (14/49) of patients, respectively. The interobserver correlation was poor for D fast and D slow (0.105, 0.173) and moderate for f and ADC (0.461, 0.418). ANOVA showed a strong inverse association between D fast and liver fibrosis grade (p = 0.001). A weak inverse association was seen between ADC and hepatic steatosis (p = 0.059). Multivariate general linear model revealed that the only significant association between IVIM parameters and pathological features was between D fast and fibrosis. On ROC curve analysis, D fast < 23.4 × 10-3 mm2/s had a sensitivity of 82.8% and a specificity of 64.3% in predicting high-grade fibrosis. CONCLUSION: D fast has the strongest association with hepatic fibrosis but has weak interobserver correlation. IVIM parameters were not significantly associated with hepatic inflammation or steatosis.
OBJECTIVE: To investigate the usefulness of intravoxel incoherent motion (IVIM) in determining the severity of hepatic fibrosis, steatosis, and inflammation in patients with chronic liver disease. METHODS: Forty-nine patients who had liver MRI with IVIM sequence and liver biopsy within three months of MRI were enrolled. A reviewer, blinded to histology, placed regions of interest of 1-2 cm2 in the right liver lobe. In addition, the first twenty patients were assessed with a second reviewer. Perfusion fraction (f), pseudodiffusion coefficient (D fast), true diffusion coefficient (D slow), and apparent diffusion coefficient (ADC) were calculated from normalized signal intensities that were fitted into a biexponential model. Errors in the model were minimized with global stochastic optimization using Simulated Annealing. ANOVA with post hoc Tukey-Kramer test and multivariate generalized linear model analysis were performed, using histological findings as the gold standard. RESULTS: The most common etiologies for liver disease were hepatitis C and alcohol, accounting together for 76% (37/49) of patients. Low-grade fibrosis (F0, F1), hepatic steatosis, and inflammation were seen in 24% (12/49), 31% (15/49), and 29% (14/49) of patients, respectively. The interobserver correlation was poor for D fast and D slow (0.105, 0.173) and moderate for f and ADC (0.461, 0.418). ANOVA showed a strong inverse association between D fast and liver fibrosis grade (p = 0.001). A weak inverse association was seen between ADC and hepatic steatosis (p = 0.059). Multivariate general linear model revealed that the only significant association between IVIM parameters and pathological features was between D fast and fibrosis. On ROC curve analysis, D fast < 23.4 × 10-3 mm2/s had a sensitivity of 82.8% and a specificity of 64.3% in predicting high-grade fibrosis. CONCLUSION: D fast has the strongest association with hepatic fibrosis but has weak interobserver correlation. IVIM parameters were not significantly associated with hepatic inflammation or steatosis.
Authors: Zhong-Wei Chen; Huan-Ming Xiao; Xinjian Ye; Kun Liu; Rafael S Rios; Kenneth I Zheng; Yi Jin; Giovanni Targher; Christopher D Byrne; Junping Shi; Zhihan Yan; Xiao-Ling Chi; Ming-Hua Zheng Journal: Hepatobiliary Surg Nutr Date: 2022-04 Impact factor: 7.293
Authors: Guilherme Moura Cunha; Patrick J Navin; Kathryn J Fowler; Sudhakar K Venkatesh; Richard L Ehman; Claude B Sirlin Journal: Br J Radiol Date: 2021-02-26 Impact factor: 3.629