Advanced fibrosis in nonalcoholic fatty liver disease: Noninvasive assessment with MR elastography

Donghee Kim, W. Ray Kim, Jayant A. Talwalkar, Hwa Jung Kim, Richard Lorne Ehman

Research output: Contribution to journalArticle

125 Citations (Scopus)

Abstract

Purpose: To evaluate the diagnostic accuracy of magnetic resonance (MR) elastography as a method to help diagnose clinically substantial fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) and, by using MR elastography as a reference standard, to compare various laboratory marker panels in the identification of patients with NAFLD and advanced fibrosis. Materials and Methods: This retrospective study was institutional review board approved and HIPAA complaint. Informed consent was waived. This study was conducted in patients with NAFLD, who were identified by imaging characteristics consistent with steatosis in a prospective database that tracks all MR elastographic examinations. Six laboratory-based models of fibrosis were compared with MR elastographic results as well as fibrosis stage from liver biopsy results. The area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, positive predictive value, and negative predictive value of each data set were compared. Results: Among 325 patients with NAFLD with MR elastographic data, there were 142 patients who underwent liver biopsy within 1 year of MR elastography. When comparing MR elastography results with liver biopsy results, the best cutoff for advanced fibrosis (stage F3-F4, 4±[32.4%] of 142) was 4.15 kPa (AUROC = 0.954, sensitivity = 0.85, specificity = 0.929). This cutoff value identified 104 patients with advanced fibrosis (32.0% of 325 patients). The FIB-4 score (AUROC = 0.827) and NAFLD fibrosis score (AUROC = 0.821) had the best diagnostic accuracy for advanced fibrosis, with high negative predictive values (NAFLD fibrosis score = 0.90 and FIB-4 score = 0.899). Conclusion: MR elastography is a useful diagnostic tool for detecting advanced fibrosis in NAFLD. Of the laboratory-based methods, the NAFLD fibrosis and FIB-4 scores can most reliably detect advanced fibrosis.

Original languageEnglish (US)
Pages (from-to)411-419
Number of pages9
JournalRadiology
Volume268
Issue number2
DOIs
StatePublished - Aug 2013

Fingerprint

Elasticity Imaging Techniques
Fibrosis
ROC Curve
Liver Cirrhosis
Magnetic Resonance Spectroscopy
Biopsy
Health Insurance Portability and Accountability Act
Sensitivity and Specificity
Non-alcoholic Fatty Liver Disease
Research Ethics Committees
Liver
Informed Consent
Retrospective Studies
Biomarkers
Databases

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Advanced fibrosis in nonalcoholic fatty liver disease : Noninvasive assessment with MR elastography. / Kim, Donghee; Kim, W. Ray; Talwalkar, Jayant A.; Kim, Hwa Jung; Ehman, Richard Lorne.

In: Radiology, Vol. 268, No. 2, 08.2013, p. 411-419.

Research output: Contribution to journalArticle

Kim, Donghee ; Kim, W. Ray ; Talwalkar, Jayant A. ; Kim, Hwa Jung ; Ehman, Richard Lorne. / Advanced fibrosis in nonalcoholic fatty liver disease : Noninvasive assessment with MR elastography. In: Radiology. 2013 ; Vol. 268, No. 2. pp. 411-419.
@article{bb20ec9688634dbdba949a409a6ae719,
title = "Advanced fibrosis in nonalcoholic fatty liver disease: Noninvasive assessment with MR elastography",
abstract = "Purpose: To evaluate the diagnostic accuracy of magnetic resonance (MR) elastography as a method to help diagnose clinically substantial fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) and, by using MR elastography as a reference standard, to compare various laboratory marker panels in the identification of patients with NAFLD and advanced fibrosis. Materials and Methods: This retrospective study was institutional review board approved and HIPAA complaint. Informed consent was waived. This study was conducted in patients with NAFLD, who were identified by imaging characteristics consistent with steatosis in a prospective database that tracks all MR elastographic examinations. Six laboratory-based models of fibrosis were compared with MR elastographic results as well as fibrosis stage from liver biopsy results. The area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, positive predictive value, and negative predictive value of each data set were compared. Results: Among 325 patients with NAFLD with MR elastographic data, there were 142 patients who underwent liver biopsy within 1 year of MR elastography. When comparing MR elastography results with liver biopsy results, the best cutoff for advanced fibrosis (stage F3-F4, 4±[32.4{\%}] of 142) was 4.15 kPa (AUROC = 0.954, sensitivity = 0.85, specificity = 0.929). This cutoff value identified 104 patients with advanced fibrosis (32.0{\%} of 325 patients). The FIB-4 score (AUROC = 0.827) and NAFLD fibrosis score (AUROC = 0.821) had the best diagnostic accuracy for advanced fibrosis, with high negative predictive values (NAFLD fibrosis score = 0.90 and FIB-4 score = 0.899). Conclusion: MR elastography is a useful diagnostic tool for detecting advanced fibrosis in NAFLD. Of the laboratory-based methods, the NAFLD fibrosis and FIB-4 scores can most reliably detect advanced fibrosis.",
author = "Donghee Kim and Kim, {W. Ray} and Talwalkar, {Jayant A.} and Kim, {Hwa Jung} and Ehman, {Richard Lorne}",
year = "2013",
month = "8",
doi = "10.1148/radiol.13121193",
language = "English (US)",
volume = "268",
pages = "411--419",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "2",

}

TY - JOUR

T1 - Advanced fibrosis in nonalcoholic fatty liver disease

T2 - Noninvasive assessment with MR elastography

AU - Kim, Donghee

AU - Kim, W. Ray

AU - Talwalkar, Jayant A.

AU - Kim, Hwa Jung

AU - Ehman, Richard Lorne

PY - 2013/8

Y1 - 2013/8

N2 - Purpose: To evaluate the diagnostic accuracy of magnetic resonance (MR) elastography as a method to help diagnose clinically substantial fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) and, by using MR elastography as a reference standard, to compare various laboratory marker panels in the identification of patients with NAFLD and advanced fibrosis. Materials and Methods: This retrospective study was institutional review board approved and HIPAA complaint. Informed consent was waived. This study was conducted in patients with NAFLD, who were identified by imaging characteristics consistent with steatosis in a prospective database that tracks all MR elastographic examinations. Six laboratory-based models of fibrosis were compared with MR elastographic results as well as fibrosis stage from liver biopsy results. The area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, positive predictive value, and negative predictive value of each data set were compared. Results: Among 325 patients with NAFLD with MR elastographic data, there were 142 patients who underwent liver biopsy within 1 year of MR elastography. When comparing MR elastography results with liver biopsy results, the best cutoff for advanced fibrosis (stage F3-F4, 4±[32.4%] of 142) was 4.15 kPa (AUROC = 0.954, sensitivity = 0.85, specificity = 0.929). This cutoff value identified 104 patients with advanced fibrosis (32.0% of 325 patients). The FIB-4 score (AUROC = 0.827) and NAFLD fibrosis score (AUROC = 0.821) had the best diagnostic accuracy for advanced fibrosis, with high negative predictive values (NAFLD fibrosis score = 0.90 and FIB-4 score = 0.899). Conclusion: MR elastography is a useful diagnostic tool for detecting advanced fibrosis in NAFLD. Of the laboratory-based methods, the NAFLD fibrosis and FIB-4 scores can most reliably detect advanced fibrosis.

AB - Purpose: To evaluate the diagnostic accuracy of magnetic resonance (MR) elastography as a method to help diagnose clinically substantial fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) and, by using MR elastography as a reference standard, to compare various laboratory marker panels in the identification of patients with NAFLD and advanced fibrosis. Materials and Methods: This retrospective study was institutional review board approved and HIPAA complaint. Informed consent was waived. This study was conducted in patients with NAFLD, who were identified by imaging characteristics consistent with steatosis in a prospective database that tracks all MR elastographic examinations. Six laboratory-based models of fibrosis were compared with MR elastographic results as well as fibrosis stage from liver biopsy results. The area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, positive predictive value, and negative predictive value of each data set were compared. Results: Among 325 patients with NAFLD with MR elastographic data, there were 142 patients who underwent liver biopsy within 1 year of MR elastography. When comparing MR elastography results with liver biopsy results, the best cutoff for advanced fibrosis (stage F3-F4, 4±[32.4%] of 142) was 4.15 kPa (AUROC = 0.954, sensitivity = 0.85, specificity = 0.929). This cutoff value identified 104 patients with advanced fibrosis (32.0% of 325 patients). The FIB-4 score (AUROC = 0.827) and NAFLD fibrosis score (AUROC = 0.821) had the best diagnostic accuracy for advanced fibrosis, with high negative predictive values (NAFLD fibrosis score = 0.90 and FIB-4 score = 0.899). Conclusion: MR elastography is a useful diagnostic tool for detecting advanced fibrosis in NAFLD. Of the laboratory-based methods, the NAFLD fibrosis and FIB-4 scores can most reliably detect advanced fibrosis.

UR - http://www.scopus.com/inward/record.url?scp=84880649809&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84880649809&partnerID=8YFLogxK

U2 - 10.1148/radiol.13121193

DO - 10.1148/radiol.13121193

M3 - Article

C2 - 23564711

AN - SCOPUS:84880649809

VL - 268

SP - 411

EP - 419

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 2

ER -