Imaging of Hepatic Fibrosis

Area of Science:

• Radiology and Medical Imaging
• Hepatology
• Biomedical Engineering

Background:

• Liver fibrosis (LF) assessment is crucial for managing chronic liver diseases.
• Non-invasive imaging techniques are increasingly preferred over liver biopsy.
• Accurate staging of LF guides therapeutic decisions and prognosis.

Purpose of the Study:

• To review current non-invasive imaging techniques for liver fibrosis (LF) assessment.
• To highlight the accuracy and limitations of various imaging modalities.
• To discuss emerging techniques and future directions in LF imaging.

Main Methods:

• Review of elastography-based techniques, including MR elastography (MRE) and ultrasound-based vibration-controlled transient elastography (VCTE).
• Evaluation of other promising imaging methods: diffusion-weighted imaging (DWI), contrast-enhanced MRI (HCE), T1 relaxometry, T1ρ imaging, textural analysis, liver surface nodularity, susceptibility-weighted imaging, and perfusion imaging.
• Discussion of technical improvements and confounding factors affecting accuracy.

Main Results:

• Elastography techniques are the most utilized for LF evaluation.
• MR elastography (MRE) demonstrates the highest accuracy for LF detection and staging.
• Ultrasound-based VCTE is widely used but has limitations, particularly in obese patients.

Conclusions:

• MR elastography (MRE) is the most accurate non-invasive imaging technique for liver fibrosis assessment.
• Ongoing innovations in elastography aim to improve accuracy and overcome limitations.
• Further clinical validation is required for other promising imaging modalities.