Literature DB >> 29030995

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

Hiroyuki Morisaka1,2, Utaroh Motosugi1, Shintaro Ichikawa1, Tadao Nakazawa3, Tetsuo Kondo3, Satoshi Funayama1, Masanori Matsuda4, Tomoaki Ichikawa2, Hiroshi Onishi1.   

Abstract

BACKGROUND: Liver MR elastography (MRE) is available for the noninvasive assessment of liver fibrosis; however, no previous studies have compared the diagnostic ability of MRE with that of liver biopsy.
PURPOSE: To compare the diagnostic accuracy of liver fibrosis staging between MRE-based methods and liver biopsy using the resected liver specimens as the reference standard. STUDY TYPE: A retrospective study at a single institution. POPULATION: In all, 200 patients who underwent preoperative MRE and subsequent surgical liver resection were included in this study. Data from 80 patients were used to estimate cutoff and distributions of liver stiffness values measured by MRE for each liver fibrosis stage (F0-F4, METAVIR system). In the remaining 120 patients, liver biopsy specimens were obtained from the resected liver tissues using a standard biopsy needle. FIELD STRENGTH/SEQUENCE: 2D liver MRE with gradient-echo based sequence on a 1.5 or 3T scanner was used. ASSESSMENT: Two radiologists independently measured the liver stiffness value on MRE and two types of MRE-based methods (threshold and Bayesian prediction method) were applied. Two pathologists evaluated all biopsy samples independently to stage liver fibrosis. Surgically resected whole tissue specimens were used as the reference standard. STATISTICAL TESTS: The accuracy for liver fibrosis staging was compared between liver biopsy and MRE-based methods with a modified McNemar's test.
RESULTS: Accurate fibrosis staging was achieved in 53.3% (64/120) and 59.1% (71/120) of patients using MRE with threshold and Bayesian methods, respectively, and in 51.6% (62/120) with liver biopsy. Accuracies of MRE-based methods for diagnoses of ≥F2 (90-91% [108-9/120]), ≥F3 (79-81% [95-97/120]), and F4 (82-85% [98-102/120]) were statistically equivalent to those of liver biopsy (≥F2, 79% [95/120], P ≤ 0.01; ≥F3, 88% [105/120], P ≤ 0.006; and F4, 82% [99/120], P ≤ 0.017). DATA
CONCLUSION: MRE can be an alternative to liver biopsy for fibrosis staging. LEVEL OF EVIDENCE: 3. Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1268-1275.
© 2017 International Society for Magnetic Resonance in Medicine.

Entities:  

Keywords:  liver biopsy; liver fibrosis staging; magnetic resonance elastography

Mesh:

Year:  2017        PMID: 29030995     DOI: 10.1002/jmri.25868

Source DB:  PubMed          Journal:  J Magn Reson Imaging        ISSN: 1053-1807            Impact factor:   4.813


  10 in total

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8.  Feasibility of measuring spleen stiffness with MR elastography and splenic volume to predict hepatic fibrosis stage.

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9.  Free-breathing radial magnetic resonance elastography of the liver in children at 3 T: a pilot study.

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10.  Sequential Combination of FIB-4 Followed by M2BPGi Enhanced Diagnostic Performance for Advanced Hepatic Fibrosis in an Average Risk Population.

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  10 in total

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