Hyo Jung Cho1, Jaewon Choi2, Bohyun Kim3,4, JeongGil Ko2, Joon-Il Choi5, Jimi Huh6, Jei Hee Lee6, Jai Keun Kim6. 1. Department of Gastroenterology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Republic of Korea. 2. School of Integrated Technology, College of Engineering, Yonsei University, Incheon, Republic of Korea. 3. Department of Radiology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Republic of Korea. kbh@catholic.ac.kr. 4. Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. kbh@catholic.ac.kr. 5. Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 6. Department of Radiology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Republic of Korea.
Abstract
PURPOSE: Hepatic surface nodularity quantified on CT images has shown promising results in staging hepatic fibrosis in chronic hepatitis C. The aim of this study was to evaluate hepatic surface nodularity, serum fibrosis indices, and a linear combination of them for staging fibrosis in chronic liver disease, mainly chronic hepatitis B. METHODS: We developed a semiautomated software quantifying hepatic surface nodularity on CT images. Hepatic surface nodularity and serum fibrosis indices were assessed in the development group of 125 patients to generate 3 linear models combining hepatic surface nodularity with the aspartate aminotransferase to platelet ratio index, fibrosis-4 index, or platelet count in reference to the METAVIR scoring system. The models were validated in 183 patients. RESULTS: Hepatic surface nodularity and serum fibrosis indices all significantly correlated with fibrosis stages. For binary classifications into cirrhosis (F4), advanced fibrosis (≥ F3), and significant fibrosis (≥ F2), hepatic surface nodularity was significantly different across categories. The areas under the curve (AUCs) of the best model were 0.901, 0.872, and 0.794 for cirrhosis, advanced fibrosis, and significant fibrosis, respectively, higher than serum fibrosis indices alone (0.797-0.802, 0.799-0.818, and 0.761-0.773). In the validation group, the same model likewise showed higher AUCs (0.872, 0.831, and 0.850) compared to serum fibrosis indices (0.722-0.776, 0.692-0.768, and 0.695-0.769; p < 0.001 for F4). CONCLUSION: Hepatic surface nodularity combined with serum blood test could be a practical method to predict cirrhosis, advanced fibrosis, and significant fibrosis in chronic liver disease patients, providing higher accuracy than using serum fibrosis indices alone.
PURPOSE: Hepatic surface nodularity quantified on CT images has shown promising results in staging hepatic fibrosis in chronic hepatitis C. The aim of this study was to evaluate hepatic surface nodularity, serum fibrosis indices, and a linear combination of them for staging fibrosis in chronic liver disease, mainly chronic hepatitis B. METHODS: We developed a semiautomated software quantifying hepatic surface nodularity on CT images. Hepatic surface nodularity and serum fibrosis indices were assessed in the development group of 125 patients to generate 3 linear models combining hepatic surface nodularity with the aspartate aminotransferase to platelet ratio index, fibrosis-4 index, or platelet count in reference to the METAVIR scoring system. The models were validated in 183 patients. RESULTS: Hepatic surface nodularity and serum fibrosis indices all significantly correlated with fibrosis stages. For binary classifications into cirrhosis (F4), advanced fibrosis (≥ F3), and significant fibrosis (≥ F2), hepatic surface nodularity was significantly different across categories. The areas under the curve (AUCs) of the best model were 0.901, 0.872, and 0.794 for cirrhosis, advanced fibrosis, and significant fibrosis, respectively, higher than serum fibrosis indices alone (0.797-0.802, 0.799-0.818, and 0.761-0.773). In the validation group, the same model likewise showed higher AUCs (0.872, 0.831, and 0.850) compared to serum fibrosis indices (0.722-0.776, 0.692-0.768, and 0.695-0.769; p < 0.001 for F4). CONCLUSION: Hepatic surface nodularity combined with serum blood test could be a practical method to predict cirrhosis, advanced fibrosis, and significant fibrosis in chronic liver disease patients, providing higher accuracy than using serum fibrosis indices alone.
Authors: Meng Yin; Jayant A Talwalkar; Kevin J Glaser; Armando Manduca; Roger C Grimm; Phillip J Rossman; Jeff L Fidler; Richard L Ehman Journal: Clin Gastroenterol Hepatol Date: 2007-10 Impact factor: 11.382
Authors: Timothy J S Cross; Paolo Rizzi; Philip A Berry; Matthew Bruce; Bernard Portmann; Phillip M Harrison Journal: Eur J Gastroenterol Hepatol Date: 2009-07 Impact factor: 2.566