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A Three-Dimensional Digital Model for Early Diagnosis of Hepatic Fibrosis Based on Magnetic Resonance Elastography
Published on: July 21, 2023
Susceptibility-weighted MR imaging in the grading of liver fibrosis: a feasibility study
Csilla Balassy1, Diana Feier, Markus Peck-Radosavljevic
1From the Departments of Radiology (C.B., D.F., A.B.), Gastroenterology (M.P.), Pathology (F.W.), and Nuclear Medicine (S.W.), Medical University of Vienna, General Hospital of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria; Department of Radiology, Medical University of Cluj Napoca, Cluj Napoca, Romania (D.F.); Siemens Healthcare, Erlangen, Germany (B.K.); Siemens Healthcare, Graz, Austria (G.R.); and Siemens Healthcare, Shanghai, China (Y.D.).
Purpose:
To assess the feasiblity of magnetic resonance (MR) susceptibility-weighted (SW) imaging as a tool to evaluate liver fibrosis grades in patients with chronic liver diseases (CLD) utilizing signal intensity (SI) measurements, with histopathologic findings as the reference standard.
Materials And Methods:
This retrospective study was approved by the local ethics committee. All subjects gave written informed consent. Eighty consecutive patients (mean age, 56.8 years), 60% of whom were male [n = 48] and 40% of whom were female [n = 32], with CLD due to various underlying causes and histopathologically proved liver fibrosis were included. Biopsies were evaluated for liver fibrosis and necroinflammatory activity (according to METAVIR scoring system), iron load, and steatosis. Two radiologists, blinded to the clinical data, assessed regions of interest in the liver and spinal muscle in consensus. Liver-to-muscle SI ratios were calculated and correlated to histopathologic findings and clinical data by using univariate and multivariate regression analysis.
Results:
Liver-to-muscle SI ratio decreased in parallel with the increasing grade of liver fibrosis and correlated strongly with liver fibrosis (r = -0.81, P < .0001) and moderately with necroinflammatory activity (r = -0.52, P < .0001) and iron load (r = -0.37, P = .0002) but did not correlate with steatosis (r = -0.18, P = .11). In multiple regression analysis, liver fibrosis and iron load independently influenced SW imaging measurements, explaining 69% of the variance of liver-to-muscle SI ratio (R(2) = 0.69, P < .001). Liver-to-muscle SI ratio performed well in grading liver fibrosis, with an area under the receiver operating characteristic curve of 0.92 for scores of F2 or higher and 0.93 for score of F4 (liver cirrhosis).
Conclusion:
SW imaging is a feasible noninvasive tool to detect moderate and advanced liver fibrosis in CLD patients.
Insights
Magnetic resonance susceptibility-weighted (SW) imaging effectively assesses liver fibrosis in chronic liver diseases (CLD). This noninvasive tool correlates signal intensity ratios with fibrosis grades, offering a feasible method for detecting moderate to advanced liver fibrosis.
Area of Science:
- Radiology
- Medical Imaging
- Hepatology
Background:
- Chronic liver diseases (CLD) encompass a range of conditions leading to liver fibrosis.
- Accurate staging of liver fibrosis is crucial for patient management and treatment decisions.
- Histopathology remains the gold standard but is invasive.
Purpose of the Study:
- To evaluate the feasibility of magnetic resonance (MR) susceptibility-weighted (SW) imaging for assessing liver fibrosis.
- To correlate SW imaging signal intensity (SI) measurements with histopathologically determined liver fibrosis grades in CLD patients.
Main Methods:
- Retrospective analysis of 80 CLD patients with histopathologically confirmed liver fibrosis.
- MR SW imaging was performed, and liver-to-muscle signal intensity (SI) ratios were calculated.
- SI ratios were correlated with fibrosis grade, necroinflammatory activity, iron load, and steatosis using regression analysis.
Main Results:
- Liver-to-muscle SI ratio showed a strong negative correlation with liver fibrosis (r = -0.81, P < .0001).
- The ratio also correlated with necroinflammatory activity and iron load but not steatosis.
- SW imaging demonstrated high accuracy in grading liver fibrosis, with an AUC of 0.92 for F2+ and 0.93 for F4 (cirrhosis).
Conclusions:
- MR SW imaging is a feasible noninvasive tool for detecting moderate and advanced liver fibrosis in CLD patients.
- The technique shows promise as an alternative to liver biopsy for fibrosis staging.
