Kento Imajo1, Yasushi Honda1, Takashi Kobayashi1, Koki Nagai1, Anna Ozaki1, Michihiro Iwaki1, Takaomi Kessoku1, Yuji Ogawa1, Hirokazu Takahashi2, Yusuke Saigusa3, Masato Yoneda1, Hiroyuki Kirikoshi4, Daisuke Utsunomiya5, Shinichi Aishima6, Satoru Saito1, Atsushi Nakajima7. 1. Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. 2. Liver Center, Saga University Hospital, Faculty of Medicine, Saga University, Saga-shi, Japan. 3. Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan. 4. Department of Clinical Laboratory, Yokohama City University Hospital, Yokohama, Japan. 5. Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. 6. Department of Pathology & Microbiology, Faculty of Medicine, Saga University, Saga, Japan. 7. Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. Electronic address: nakajima-tky@umin.ac.jp.
Abstract
BACKGROUND & AIMS: As alternatives to the expensive liver biopsy for assessing liver fibrosis stage in patients with nonalcoholic fatty liver disease (NAFLD), we directly compared the diagnostic abilities of magnetic resonance elastography (MRE), vibration-controlled transient elastography (VCTE), and two-dimensional shear wave elastography (2D-SWE). METHODS: Overall, 231 patients with biopsy-proven NAFLD were included. Intra- and inter-observer reproducibility was analyzed using intraclass correlation coefficient in a sub-group of 70 participants, in whom liver stiffness measurement (LSM) was performed by an elastography expert and an ultrasound expert who was an elastography trainee on the same day. RESULTS: Valid LSMs were obtained for 227, 220, 204, and 201 patients using MRE, VCTE, 2D-SWE, and all three modalities combined, respectively. Although the area under the curve did not differ between the modalities for detecting stage ≥1, ≥2, and ≥3 liver fibrosis, it was higher for MRE than VCTE and 2D-SWE for stage 4. Sex was a significant predictor of discordance between VCTE and liver fibrosis stage. Skin-capsule distance and the ratio of the interquartile range of liver stiffness to the median were significantly associated with discordance between 2D-SWE and liver fibrosis stage. However, no factors were associated with discordance between MRE and liver fibrosis stage. Intra- and inter-observer reproducibility in detecting liver fibrosis was higher for MRE than VCTE and 2D-SWE. CONCLUSIONS: MRE, VCTE, and 2D-SWE demonstrated excellent diagnostic accuracy in detecting liver fibrosis in patients with NAFLD. MRE demonstrated the highest diagnostic accuracy for stage 4 detection and intra- and inter-observer reproducibility. UMIN Clinical Trials Registry No. UMIN000031491.
BACKGROUND & AIMS: As alternatives to the expensive liver biopsy for assessing liver fibrosis stage in patients with nonalcoholic fatty liver disease (NAFLD), we directly compared the diagnostic abilities of magnetic resonance elastography (MRE), vibration-controlled transient elastography (VCTE), and two-dimensional shear wave elastography (2D-SWE). METHODS: Overall, 231 patients with biopsy-proven NAFLD were included. Intra- and inter-observer reproducibility was analyzed using intraclass correlation coefficient in a sub-group of 70 participants, in whom liver stiffness measurement (LSM) was performed by an elastography expert and an ultrasound expert who was an elastography trainee on the same day. RESULTS: Valid LSMs were obtained for 227, 220, 204, and 201 patients using MRE, VCTE, 2D-SWE, and all three modalities combined, respectively. Although the area under the curve did not differ between the modalities for detecting stage ≥1, ≥2, and ≥3 liver fibrosis, it was higher for MRE than VCTE and 2D-SWE for stage 4. Sex was a significant predictor of discordance between VCTE and liver fibrosis stage. Skin-capsule distance and the ratio of the interquartile range of liver stiffness to the median were significantly associated with discordance between 2D-SWE and liver fibrosis stage. However, no factors were associated with discordance between MRE and liver fibrosis stage. Intra- and inter-observer reproducibility in detecting liver fibrosis was higher for MRE than VCTE and 2D-SWE. CONCLUSIONS: MRE, VCTE, and 2D-SWE demonstrated excellent diagnostic accuracy in detecting liver fibrosis in patients with NAFLD. MRE demonstrated the highest diagnostic accuracy for stage 4 detection and intra- and inter-observer reproducibility. UMIN Clinical Trials Registry No. UMIN000031491.
Authors: Giada Sebastiani; Keyur Patel; Vlad Ratziu; Jordan J Feld; Brent A Neuschwander-Tetri; Massimo Pinzani; Salvatore Petta; Annalisa Berzigotti; Peter Metrakos; Naglaa Shoukry; Elizabeth M Brunt; An Tang; Jeremy F Cobbold; Jean-Marie Ekoe; Karen Seto; Peter Ghali; Stéphanie Chevalier; Quentin M Anstee; Heather Watson; Harpreet Bajaj; James Stone; Mark G Swain; Alnoor Ramji Journal: Can Liver J Date: 2022-02-04
Authors: Yingzhen N Zhang; Kathryn J Fowler; Andrew S Boehringer; Vivian Montes; Alexandra N Schlein; Yesenia Covarrubias; Tanya Wolfson; Cheng W Hong; Mark A Valasek; Michael P Andre; Rohit Loomba; Claude B Sirlin Journal: Eur Radiol Date: 2021-12-02 Impact factor: 7.034