TY - JOUR
T1 - Assessing liver fibrosis
T2 - Comparison of arterial enhancement fraction and diffusion-weighted imaging
AU - Bonekamp, David
AU - Bonekamp, Susanne
AU - Ou, Hsin You
AU - Torbenson, Michael S.
AU - Corona-Villalobos, Celia Pamela
AU - Mezey, Esteban
AU - Kamel, Ihab R.
N1 - Publisher Copyright:
© 2013 Wiley Periodicals, Inc.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Purpose: Noninvasive markers have been developed to reduce the need for liver biopsy. The aim of this study was to compare the strength of association of the arterial enhancement fraction (AEF), apparent diffusion coefficient (ADC), and serum biomarkers for staging hepatic fibrosis.Materials and Methods: Eighty-five patients with chronic liver disease underwent triple-phase contrast-enhanced MRI, used to calculate AEF, and diffusion-weighted MRI (b=0,750 s/mm2), used to calculate ADC. Hepatic fibrosis was staged according METAVIR criteria. The overall association of the four biomarkers (AEF, ADC, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, and aspartate aminotransferase to platelet ratio index [APRI]) was compared using nonparametric tests and receiver operating characteristic (ROC) curve, using histopathologic analysis as the reference standard.Results: AEF and ADC values differed significantly between histopathologic fibrosis stages. AEF values correlated with fibrosis stage, ADC values correlated negatively with fibrosis stage. Compared with ADC, AEF showed a trend toward an improved capability of discriminating fibrosis stages. A weighted composite score of AEF and ADC had significantly better diagnostic accuracy than ADC alone (P≤0.023). Imaging parameters had a significantly better diagnostic accuracy than AST/ALT ratio or APRI.Conclusion: AEF may be able to detect the presence of mild, moderate, and advanced liver fibrosis, and its value is increased with concomitant use of ADC.
AB - Purpose: Noninvasive markers have been developed to reduce the need for liver biopsy. The aim of this study was to compare the strength of association of the arterial enhancement fraction (AEF), apparent diffusion coefficient (ADC), and serum biomarkers for staging hepatic fibrosis.Materials and Methods: Eighty-five patients with chronic liver disease underwent triple-phase contrast-enhanced MRI, used to calculate AEF, and diffusion-weighted MRI (b=0,750 s/mm2), used to calculate ADC. Hepatic fibrosis was staged according METAVIR criteria. The overall association of the four biomarkers (AEF, ADC, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, and aspartate aminotransferase to platelet ratio index [APRI]) was compared using nonparametric tests and receiver operating characteristic (ROC) curve, using histopathologic analysis as the reference standard.Results: AEF and ADC values differed significantly between histopathologic fibrosis stages. AEF values correlated with fibrosis stage, ADC values correlated negatively with fibrosis stage. Compared with ADC, AEF showed a trend toward an improved capability of discriminating fibrosis stages. A weighted composite score of AEF and ADC had significantly better diagnostic accuracy than ADC alone (P≤0.023). Imaging parameters had a significantly better diagnostic accuracy than AST/ALT ratio or APRI.Conclusion: AEF may be able to detect the presence of mild, moderate, and advanced liver fibrosis, and its value is increased with concomitant use of ADC.
KW - Apparent diffusion coefficient
KW - Arterial enhancement fraction
KW - Diffuse liver disease
KW - Hepatic fibrosis
KW - Quantitative imaging
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U2 - 10.1002/jmri.24472
DO - 10.1002/jmri.24472
M3 - Article
C2 - 24989329
AN - SCOPUS:84913618354
SN - 1053-1807
VL - 40
SP - 1137
EP - 1146
JO - Journal of Magnetic Resonance Imaging
JF - Journal of Magnetic Resonance Imaging
IS - 5
ER -