Computed Tomography-Derived Extracellular Volume Fraction and Splenic Size for Liver Fibrosis Staging.

Area of Science:

• Radiology
• Hepatology
• Medical Imaging

Background:

• Liver fibrosis staging is crucial for patient management.
• Radiological markers like extracellular volume fraction (fECV) and organ size are explored for non-invasive fibrosis assessment.
• Previous studies suggest correlations between fECV, liver/spleen size, and fibrosis severity.

Purpose of the Study:

• To evaluate the predictive value of fECV alone for liver fibrosis severity.
• To assess the combined predictive value of fECV and liver/spleen size for liver fibrosis.
• To compare the accuracy of these radiological markers in predicting significant and advanced liver fibrosis.

Main Methods:

• Retrospective analysis of 95 subjects (65 with liver biopsy, 30 controls).
• Spearman rank correlation assessed relationships between radiological markers and fibrosis stage.
• Receiver operating characteristic (ROC) analysis determined discriminative ability for significant (F2+), advanced (F3+), and cirrhotic (F4) fibrosis, reporting Area Under the Curve (AUC).

Main Results:

• Spleen volume demonstrated the strongest individual correlation (r=0.552, P<0.001) and highest AUCs for significant, advanced fibrosis, and cirrhosis.
• Combining fECV with spleen length improved AUCs compared to spleen length alone.
• Adding fECV to spleen volume did not enhance AUCs for fibrosis prediction.

Conclusions:

• Spleen size (length or volume) correlates better with liver fibrosis stages than fECV.
• The combination of fECV and spleen length offers improved accuracy for predicting liver fibrosis severity compared to individual markers.