Dual‐frequency MR elastography to differentiate between inflammation and fibrosis of the liver: Comparison with histopathology. Issue 4 (18th August 2019)

• Record Type: Journal Article
• Authors: Sofue, Keitaro; Onoda, Minori; Tsurusaki, Masakatsu; Morimoto, Daisuke; Yada, Norihisa; Kudo, Masatoshi; Murakami, Takamichi
• Is Part Of: Journal of magnetic resonance imaging. Volume 51:Issue 4(2020)
• Page Start: 1053
• Page End: 1064
• Publication Date: 2019-08-18
• Subjects: MR elastography -- inflammation -- fibrosis -- liver; Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.26903
• Languages: English
• ISSNs: 1053-1807

Abstract

Abstract : Background: Differentiation between inflammation and fibrosis is an important clinical distinction in patients with chronic liver disease, which has been difficult so far with MR elastography. Purpose: To investigate whether dual‐frequency MR elastography can estimate necroinflammation of the liver and improve diagnostic performance for the staging of liver fibrosis. Study Type: Retrospective. Subjects: In all, 30 patients (14 males, 16 females) with chronic liver disease. Field Strength/Sequence: 1.5T/dual‐frequency MR elastography at 60‐Hz and 80‐Hz vibration frequencies. [Correction added on November 12, 2019, after first online publication: The field strength in the preceding sentence was corrected.] Assessment: Necroinflammation activity and fibrosis were assessed using the METAVIR scoring system. Stiffness values at 60‐Hz (G60‐Hz ) and 80‐Hz (G80‐Hz ) were obtained with an MR elastogram. The difference value between G80‐Hz and G60‐Hz (ΔG) was calculated. Four values (G60‐Hz, G80‐Hz, G60‐Hz – ΔG, and G80‐Hz + ΔG) were generated to estimate necroinflammation and fibrosis. Statistical Tests: The ΔG were correlated with necroinflammation activity grade and fibrosis stage using Spearman's rank correlation. Diagnostic performance of the four values for necroinflammation activity grade and fibrous stage was assessed by using area under the receiver operating characteristic curve (AUC). Results: The mean value of G80‐Hz (6.23 ± 3.67 kPa) was significantly higher than that of G60‐Hz (5.27 ± 3.14 kPa) ( P < 0.0001). The ΔG demonstrated a strong correlation with necroinflammation grade (ρ = 0.625, P < 0.001) and no correlation with fibrosis stage (ρ = 0.306, P = 0.113). The AUC of the G80‐Hz and G80‐Hz + ΔG showed higher accuracy for necroinflammation, and optimal cutoff values yielded better discrimination of ≥A1, ≥A2, and = A3. The AUC demonstrated that all the generated values had high diagnostic performance (≥0.87 for all) for fibrosis. Data Conclusion: Dual‐frequency MR elastography shows potential in estimating necroinflammation of the liver and may improve diagnostic performance for staging liver fibrosis. Level of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:1053–1064.