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Published on: July 21, 2023
Intravoxel incoherent motion assessment of liver fibrosis staging in MASLD
Hao Ren1, Hui Xu1, Dawei Yang1
1Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Yongan Road 95, West District, Beijing, 100050, China.
Purpose:
Partial correlation analysis was performed to account for the interference of steatosis changes and inflammatory factors, to determine the true correlation between fibrosis and IVIM parameters (Dfast, Dslow, and F), and to evaluate the diagnostic efficacy of IVIM for liver fibrosis.
Methods:
A total of 106 patients with metabolic dysfunction-associated steatotic liver disease (MASLD) examined by IVIM from November 2016 to November 2023 at our hospital were retrospectively included. Preliminary analysis of each IVIM parameter and correlations with pathological findings were performed using Spearman correlation analysis, and partial correlation analysis was used to exclude the interference of other pathological factors, thus yielding the true correlations between IVIM parameters (Dfast, Dslow, and F) and pathology. The diagnostic efficacy of IVIM parameters for diagnosing MASLD was assessed via receiver operating characteristic (ROC) curve analysis.
Results:
Spearman correlation analysis of all the IVIM parameters revealed correlations with steatosis, lobular inflammation, and ballooning. Partial correlation analysis indicated that Dfast was correlated with the pathological fibrosis stage (r = - 0.593, P < 0.001), Dslow was correlated with the pathological steatosis score (r = - 0.313, P < 0.05), and F was correlated with the pathological fibrosis stage and steatosis score (r = - 0.456 and 0.255, P < 0.001 and P < 0.05). In the diagnosis of hepatic fibrosis, significant hepatic fibrosis, advanced liver fibrosis and cirrhosis, Dfast achieved areas under the ROC curve of 0.763, 0.801, 0.853, and 0.897, respectively. The threshold values for diagnosing different fibrosis stages using Dfast (10-3 mm2/s) were 57.613, 54.587, 52.714, and 51.978, respectively.
Conclusion:
According to our partial correlation analysis, there was a moderate correlation between Dfast and F according to fibrosis stage, and Dfast was not influenced by inflammation or steatosis when diagnosing fibrosis in MASLD patients. A relatively close Dfast threshold is insufficient for accurately and noninvasively assessing various stages of MASLD fibrosis. In clinical practice, this approach can be considered an alternative method for the preliminary assessment of fibrosis in MASLD patients.
Insights
Diffusion imaging (IVIM) parameters show promise for assessing liver fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD). Dfast, a key parameter, correlates with fibrosis and can help diagnose its stages noninvasively.
Area of Science:
- Radiology and Imaging Science
- Hepatology and Liver Disease Research
- Medical Physics and Biomedical Engineering
Background:
- Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing health concern, often progressing to liver fibrosis.
- Accurate, non-invasive assessment of liver fibrosis is crucial for patient management and treatment decisions.
- Diffusion-weighted imaging, specifically Intravoxel Incoherent Motion (IVIM) imaging, offers potential for characterizing liver tissue microstructure.
Purpose of the Study:
- To determine the true correlation between Intravoxel Incoherent Motion (IVIM) parameters (Dfast, Dslow, and F) and liver fibrosis in MASLD patients.
- To evaluate the diagnostic efficacy of IVIM parameters for assessing liver fibrosis stages.
- To account for the interference of steatosis and inflammatory factors using partial correlation analysis.
Main Methods:
- Retrospective analysis of 106 MASLD patients who underwent IVIM imaging.
- Spearman correlation analysis to assess correlations between IVIM parameters and pathological findings (steatosis, inflammation, ballooning).
- Partial correlation analysis to isolate the relationship between IVIM parameters and fibrosis, controlling for other factors.
- Receiver operating characteristic (ROC) curve analysis to evaluate diagnostic performance.
Main Results:
- Dfast showed a significant negative correlation with the pathological fibrosis stage (r = -0.593, P < 0.001).
- F also correlated with fibrosis stage (r = -0.456, P < 0.001) and steatosis score (r = 0.255, P < 0.05).
- Dfast demonstrated good diagnostic efficacy for significant hepatic fibrosis (AUC = 0.763) and cirrhosis (AUC = 0.897).
Conclusions:
- Dfast is a reliable indicator of liver fibrosis in MASLD patients, independent of inflammation and steatosis.
- While Dfast shows diagnostic potential, specific thresholds are needed for accurate staging of MASLD fibrosis.
- IVIM imaging, particularly using Dfast, can serve as a valuable non-invasive tool for preliminary fibrosis assessment in MASLD.
