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Author Spotlight: Advancing Hepatic Fibrosis Diagnosis Using Magnetic Resonance Elastography and AI
Published on: July 21, 2023
Assessment of advanced hepatic MR elastography methods for susceptibility artifact suppression in clinical patients
Jin Wang1,2, Kevin J Glaser2, Tianhui Zhang1
1Department of Radiology, Third Affiliated Hospital, Sun Yat-Sen University (SYSU), Guangzhou, Guangdong, P.R China.
Purpose:
To assess the success rate, image quality, and the ability to stage liver fibrosis of a standard 2D gradient-recalled echo (GRE) and four different spin-echo (SE) magnetic resonance elastography (MRE) sequences in patients with different liver iron concentrations.
Materials And Methods:
A total of 332 patients who underwent 3T MRE examinations that included liver fat and iron quantification were enrolled, including 136 patients with all five MRE techniques. Thirty-four patients had biopsy results for fibrosis staging. The liver stiffness, region of interest area, image quality, and success rate of the five sequences were compared in 115/136 patients. The area under the receiver operating characteristic curves (AUCs) and the accuracies for diagnosing early-stage fibrosis and advanced fibrosis were compared. The effect of BMI (body mass index), the R2* relaxation time, and fat fraction on the image quality and liver stiffness measurements were analyzed.
Results:
The success rates were significantly higher in the four SE sequences (99.1-100%) compared with GRE MRE (85.3%) (all P < 0.001). There were significant differences of the mean ROI area between every pair of sequences (all P < 0.0001). There were no significant differences in the AUC of the five MRE sequences for discriminating advanced fibrosis (10 P-values ranging from 0.2410-0.9171). R2* had a significant effect on the success rate and image quality for the noniron 2D echo-planar imaging (EPI), 3D EPI and 2D GRE (all P < 0.001) sequences. BMI had a significant effect on the iron 2D EPI (P = 0.0230) and iron 2D SE (P = 0.0040) sequences.
Conclusion:
All five techniques showed good diagnostic performance in staging liver fibrosis. The SE MRE sequences had higher success rates and better image quality than GRE MRE in 3T clinical hepatic imaging.
Level Of Evidence:
3 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;47:976-987.
Insights
Spin-echo (SE) magnetic resonance elastography (MRE) sequences demonstrate superior success rates and image quality compared to gradient-recalled echo (GRE) MRE for liver fibrosis staging. These findings highlight SE MRE as a more effective technique in clinical hepatic imaging.
Area of Science:
- Medical Imaging
- Hepatology
- Biophysics
Background:
- Liver fibrosis staging is crucial for patient management.
- Magnetic resonance elastography (MRE) is an emerging non-invasive technique for assessing liver stiffness.
- Liver iron concentration can potentially affect MRE accuracy.
Purpose of the Study:
- To compare the efficacy of standard 2D gradient-recalled echo (GRE) and four spin-echo (SE) MRE sequences.
- To evaluate success rate, image quality, and fibrosis staging ability across different MRE sequences.
- To assess the impact of liver iron concentration on MRE performance.
Main Methods:
- 3T MRE examinations were performed on 332 patients, with 136 undergoing all five MRE techniques.
- Liver stiffness, region of interest area, image quality, and success rates were compared.
- Diagnostic performance for fibrosis staging was assessed using receiver operating characteristic curves (AUCs).
Main Results:
- SE MRE sequences exhibited significantly higher success rates (99.1-100%) than GRE MRE (85.3%).
- No significant differences were found in AUCs for discriminating advanced fibrosis among the five sequences.
- Liver iron concentration (R2*) and BMI significantly affected success rates and image quality in specific MRE sequences.
Conclusions:
- All five MRE techniques demonstrated good performance in staging liver fibrosis.
- SE MRE sequences offer higher success rates and superior image quality compared to GRE MRE in 3T hepatic imaging.
- SE MRE is a more reliable technique for non-invasive liver fibrosis assessment.
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