Magnetic Resonance Imaging More Accurately Classifies Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease Than Transient Elastography.
By Kento Imajo, Takaomi Kessoku, Y. Honda, Wataru Tomeno, Yuji Ogawa, H. Mawatari, K. Fujita, M. Yoneda, M. Taguri, H. Hyogo and 8 more. Gastroenterology, 2016
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BACKGROUND & AIMS Noninvasive methods have been evaluated for the assessment of liver fibrosis and steatosis in patients with nonalcoholic fatty liver disease (NAFLD). We compared the ability of transient elastography (TE) with the M-probe, and magnetic resonance elastography (MRE) to assess liver fibrosis. Findings from magnetic resonance imaging (MRI)-based proton density fat fraction (PDFF) measurements were compared with those from TE-based controlled attenuation parameter (CAP) measurements to assess steatosis. METHODS We performed a cross-sectional study of 142 patients with NAFLD (identified by liver biopsy; mean body mass index, 28.1 kg/m(2)) in Japan from July 2013 through April 2015. Our study also included 10 comparable subjects without NAFLD (controls). All study subjects were evaluated by TE (including CAP measurements), MRI using the MRE and PDFF techniques. RESULTS TE identified patients with fibrosis stage ≥2 with an area under the receiver operating characteristic (AUROC) curve value of 0.82 (95% confidence interval [CI]: 0.74-0.89), whereas MRE identified these patients with an AUROC curve value of 0.91 (95% CI: 0.86-0.96; P = .001). TE-based CAP measurements identified patients with hepatic steatosis grade ≥2 with an AUROC curve value of 0.73 (95% CI: 0.64-0.81) and PDFF methods identified them with an AUROC curve value of 0.90 (95% CI: 0.82-0.97; P < .001). Measurement of serum keratin 18 fragments or alanine aminotransferase did not add value to TE or MRI for identifying nonalcoholic steatohepatitis. CONCLUSIONS MRE and PDFF methods have higher diagnostic performance in noninvasive detection of liver fibrosis and steatosis in patients with NAFLD than TE and CAP methods. MRI-based noninvasive assessment of liver fibrosis and steatosis is a potential alternative to liver biopsy in clinical practice. UMIN Clinical Trials Registry No. UMIN000012757.
Subfields: Epidemiology, Physiology, Radiology, Nuclear Medicine and Imaging
View Paper: https://www.semanticscholar.org/paper/bffac27e96e806c53be0d989d0b9b0e0473aab3f
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Citations in the corpus
- Individual patient data meta-analysis of controlled attenuation parameter (CAP) technology for assessing steatosis. (2017, background): “At the observed prevalence of 22%, the NPV was 97%, but at the price of a somewhat lower PPV of 72% and 47% unclassified patients.”
- The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases (2018, result): “A recent study that compared various risk scores and elastography (MR as well as TE) against liver histology showed that NFS and FIB-4 were (1) better than other indices such as BARD, APRI, and AST/ALT ratio and (2) as good as MRE for predicting advanced fibrosis in patients with biopsy-proven NAFLD”
- Accuracy of FibroScan Controlled Attenuation Parameter and Liver Stiffness Measurement in Assessing Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease. (2019, background): “LDL cholesterol (mg/dL) 350 102 [51] [3-189]”
- Comparison of laboratory tests, ultrasound, or magnetic resonance elastography to detect fibrosis in patients with nonalcoholic fatty liver disease: A meta‐analysis (2017, background): “Some investigators have discussed the possible reasons why MRE is more accurate than FibroScan for staging fibrosis and its advantages.((13,24)) In our previous meta-analysis, we showed that the summary AUROC values of APRI and FIB-4 for the diagnosis of SF, AF, and cirrhosis are 0.”
- Easl Clinical Practice Guidelines (Cpgs) On Non-Invasive Tests For Evaluation Of Liver Disease Severity And Prognosis- 2020 Update. (2021, methodology): “%) were more likely to have NASH resolution (41% vs 7%, p<0.001; OR 5.45, 95% CI 1.53-19.46, p=0.009) compared to MRI-PDFF non-responders.”
- Current and future pharmacological therapies for NAFLD/NASH (2017, methodology): “Median liver stiffness, a noninvasive marker of fibrosis, declined from 3.4 to 3.1 kPa at week 12 (p = 0.049), as assessed by magnetic resonance elastography (MRE).”