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Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis
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Association between liver diffusion-weighted imaging apparent diffusion coefficient values and other measures of

Nadeen Abu Ata1, Jonathan R Dillman2,3,4, Deep B Gandhi5

  • 1Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.

Abdominal Radiology (New York)
|May 29, 2020
PubMed
Abstract

Insights

Quantitative magnetic resonance imaging (MRI) diffusion-weighted imaging (DWI) apparent diffusion coefficient (ADC) values correlate with liver stiffness and sex in pediatric autoimmune liver disease (AILD). These findings suggest liver ADC may aid in predicting liver disease severity.

Area of Science:

  • Radiology
  • Hepatology
  • Pediatric Medicine

Background:

  • Quantitative magnetic resonance imaging (MRI) methods, including diffusion-weighted imaging (DWI), are used to assess liver fibrosis noninvasively.
  • Autoimmune liver disease (AILD) in pediatric patients requires accurate methods for monitoring disease progression and fibrosis severity.

Purpose of the Study:

  • To investigate the associations between liver MRI DWI apparent diffusion coefficient (ADC) values and clinical factors in pediatric patients diagnosed with AILD.
  • To explore the relationship between liver ADC values and other quantitative MRI metrics, such as liver and spleen stiffness and iron-corrected T1 (cT1).

Main Methods:

  • Fifty-seven pediatric AILD patients underwent liver MRI examinations.
  • Liver DWI ADC values, liver and spleen stiffness, and cT1 were measured.
  • Correlations with patient age, sex, and laboratory markers (ALT, total bilirubin, alkaline phosphatase, GGT) were analyzed using Spearman's rank-order correlation and multiple linear regression.

Main Results:

  • Liver ADC values demonstrated moderate correlations with liver stiffness (r=-0.42), spleen stiffness (r=-0.34), whole-liver mean cT1 (r=-0.39), ALT (r=-0.50), and GGT (r=-0.48).
  • Multiple linear regression identified liver stiffness (p=0.0009) and sex (p=0.023) as independent predictors of liver ADC values.
  • Mean liver DWI ADC value was 1.34 (0.14 × 10-3) mm2/s in the study cohort.

Conclusions:

  • Liver DWI ADC values are significantly associated with liver and spleen stiffness, liver cT1, ALT, GGT, and participant sex.
  • Liver stiffness and sex were identified as independent predictors of liver ADC values in multivariable analysis.
  • Liver ADC holds potential as a component in multi-parametric assessments for predicting the severity of chronic liver disease and fibrosis.
Keywords:
Apparent diffusion coefficient (ADC)Autoimmune liver diseaseChildrenDiffusion weighted imagingFibrosisMagnetic resonance elastographyMultiparametric magnetic resonance imaging

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