Assessment of chronic hepatitis and fibrosis: Comparison of MR elastography and diffusion-weighted imaging

Yi Wang, Daniel R. Ganger, Josh Levitsky, Laura A. Sternick, Robert J. McCarthy, Zongming E. Chen, Charles W. Fasanati, Bradley Bolster, Saurabh Shah, Sven Zuehlsdorff, Reed A. Omary, Richard Lorne Ehman, Frank H. Miller

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155 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of our study was to compare the utility of MR elastography (MRE) and diffusion-weighted imaging (DWI) in characterizing fibrosis and chronic hepatitis in patients with chronic liver diseases. SUBJECTS AND METHODS. Seventy-six patients with chronic liver disease underwent abdominal MRI, MRE, and DWI. Severities of liver fibrosis and chronic hepatitis were graded by histopathologic analysis according to standard disease-specific classifications. The overall predictive ability of MRE and DWI in assessment of fibrosis was compared by constructing a receiver operating characteristic (ROC) curve and calculating the area under the curve (AUC) on the basis of histopathologic analysis. RESULTS. Using ROC analysis, MRE showed greater capability than DWI in discriminating stage 2 or greater (≥ F2), stage 3 or greater (≥ F3), and cirrhosis (≥ F4), shown as significant differences in AUC (p = 0.003, p = 0.001, and p = 0.001, respectively). Higher sensitivity and specificity were shown by MRE in predicting fibrosis scores ≥ F2 (91% and 97%), scores ≥ F3 (92% and 95%), and scores F4 (95% and 87%) compared with DWI (84% and 82%, 88% and 76%, and 85% and 68%, respectively). Although MRE had higher ability in identification of liver with fibrosis scores ≥ F1 than DWI, a significant difference was not seen (p = 0.398). Stiffness values on MRE increased in relation to increasing severity of fibrosis confirmed by histopathology scores; however, a consistent relationship between apparent diffusion coefficient (ADC) values and stage of fibrosis was not shown. In addition, liver tissue with chronic hepatitis preceding fibrosis may account for mild elevation of liver stiffness. CONCLUSION. MRE had greater predictive ability in distinguishing the stages of liver fibrosis than DWI.

Original languageEnglish (US)
Pages (from-to)553-561
Number of pages9
JournalAmerican Journal of Roentgenology
Volume196
Issue number3
DOIs
StatePublished - Mar 2011

Fingerprint

Elasticity Imaging Techniques
Chronic Hepatitis
Fibrosis
Liver Cirrhosis
ROC Curve
Area Under Curve
Liver Diseases
Chronic Disease
Liver
Sensitivity and Specificity

Keywords

  • Chronic hepatitis
  • Diffusion-weighted imaging (DWI)
  • Fibrosis
  • Liver
  • MR elastography (MRE)

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Wang, Y., Ganger, D. R., Levitsky, J., Sternick, L. A., McCarthy, R. J., Chen, Z. E., ... Miller, F. H. (2011). Assessment of chronic hepatitis and fibrosis: Comparison of MR elastography and diffusion-weighted imaging. American Journal of Roentgenology, 196(3), 553-561. https://doi.org/10.2214/AJR.10.4580

Assessment of chronic hepatitis and fibrosis : Comparison of MR elastography and diffusion-weighted imaging. / Wang, Yi; Ganger, Daniel R.; Levitsky, Josh; Sternick, Laura A.; McCarthy, Robert J.; Chen, Zongming E.; Fasanati, Charles W.; Bolster, Bradley; Shah, Saurabh; Zuehlsdorff, Sven; Omary, Reed A.; Ehman, Richard Lorne; Miller, Frank H.

In: American Journal of Roentgenology, Vol. 196, No. 3, 03.2011, p. 553-561.

Research output: Contribution to journalArticle

Wang, Y, Ganger, DR, Levitsky, J, Sternick, LA, McCarthy, RJ, Chen, ZE, Fasanati, CW, Bolster, B, Shah, S, Zuehlsdorff, S, Omary, RA, Ehman, RL & Miller, FH 2011, 'Assessment of chronic hepatitis and fibrosis: Comparison of MR elastography and diffusion-weighted imaging', American Journal of Roentgenology, vol. 196, no. 3, pp. 553-561. https://doi.org/10.2214/AJR.10.4580
Wang, Yi ; Ganger, Daniel R. ; Levitsky, Josh ; Sternick, Laura A. ; McCarthy, Robert J. ; Chen, Zongming E. ; Fasanati, Charles W. ; Bolster, Bradley ; Shah, Saurabh ; Zuehlsdorff, Sven ; Omary, Reed A. ; Ehman, Richard Lorne ; Miller, Frank H. / Assessment of chronic hepatitis and fibrosis : Comparison of MR elastography and diffusion-weighted imaging. In: American Journal of Roentgenology. 2011 ; Vol. 196, No. 3. pp. 553-561.
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abstract = "OBJECTIVE. The purpose of our study was to compare the utility of MR elastography (MRE) and diffusion-weighted imaging (DWI) in characterizing fibrosis and chronic hepatitis in patients with chronic liver diseases. SUBJECTS AND METHODS. Seventy-six patients with chronic liver disease underwent abdominal MRI, MRE, and DWI. Severities of liver fibrosis and chronic hepatitis were graded by histopathologic analysis according to standard disease-specific classifications. The overall predictive ability of MRE and DWI in assessment of fibrosis was compared by constructing a receiver operating characteristic (ROC) curve and calculating the area under the curve (AUC) on the basis of histopathologic analysis. RESULTS. Using ROC analysis, MRE showed greater capability than DWI in discriminating stage 2 or greater (≥ F2), stage 3 or greater (≥ F3), and cirrhosis (≥ F4), shown as significant differences in AUC (p = 0.003, p = 0.001, and p = 0.001, respectively). Higher sensitivity and specificity were shown by MRE in predicting fibrosis scores ≥ F2 (91{\%} and 97{\%}), scores ≥ F3 (92{\%} and 95{\%}), and scores F4 (95{\%} and 87{\%}) compared with DWI (84{\%} and 82{\%}, 88{\%} and 76{\%}, and 85{\%} and 68{\%}, respectively). Although MRE had higher ability in identification of liver with fibrosis scores ≥ F1 than DWI, a significant difference was not seen (p = 0.398). Stiffness values on MRE increased in relation to increasing severity of fibrosis confirmed by histopathology scores; however, a consistent relationship between apparent diffusion coefficient (ADC) values and stage of fibrosis was not shown. In addition, liver tissue with chronic hepatitis preceding fibrosis may account for mild elevation of liver stiffness. CONCLUSION. MRE had greater predictive ability in distinguishing the stages of liver fibrosis than DWI.",
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AU - McCarthy, Robert J.

AU - Chen, Zongming E.

AU - Fasanati, Charles W.

AU - Bolster, Bradley

AU - Shah, Saurabh

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N2 - OBJECTIVE. The purpose of our study was to compare the utility of MR elastography (MRE) and diffusion-weighted imaging (DWI) in characterizing fibrosis and chronic hepatitis in patients with chronic liver diseases. SUBJECTS AND METHODS. Seventy-six patients with chronic liver disease underwent abdominal MRI, MRE, and DWI. Severities of liver fibrosis and chronic hepatitis were graded by histopathologic analysis according to standard disease-specific classifications. The overall predictive ability of MRE and DWI in assessment of fibrosis was compared by constructing a receiver operating characteristic (ROC) curve and calculating the area under the curve (AUC) on the basis of histopathologic analysis. RESULTS. Using ROC analysis, MRE showed greater capability than DWI in discriminating stage 2 or greater (≥ F2), stage 3 or greater (≥ F3), and cirrhosis (≥ F4), shown as significant differences in AUC (p = 0.003, p = 0.001, and p = 0.001, respectively). Higher sensitivity and specificity were shown by MRE in predicting fibrosis scores ≥ F2 (91% and 97%), scores ≥ F3 (92% and 95%), and scores F4 (95% and 87%) compared with DWI (84% and 82%, 88% and 76%, and 85% and 68%, respectively). Although MRE had higher ability in identification of liver with fibrosis scores ≥ F1 than DWI, a significant difference was not seen (p = 0.398). Stiffness values on MRE increased in relation to increasing severity of fibrosis confirmed by histopathology scores; however, a consistent relationship between apparent diffusion coefficient (ADC) values and stage of fibrosis was not shown. In addition, liver tissue with chronic hepatitis preceding fibrosis may account for mild elevation of liver stiffness. CONCLUSION. MRE had greater predictive ability in distinguishing the stages of liver fibrosis than DWI.

AB - OBJECTIVE. The purpose of our study was to compare the utility of MR elastography (MRE) and diffusion-weighted imaging (DWI) in characterizing fibrosis and chronic hepatitis in patients with chronic liver diseases. SUBJECTS AND METHODS. Seventy-six patients with chronic liver disease underwent abdominal MRI, MRE, and DWI. Severities of liver fibrosis and chronic hepatitis were graded by histopathologic analysis according to standard disease-specific classifications. The overall predictive ability of MRE and DWI in assessment of fibrosis was compared by constructing a receiver operating characteristic (ROC) curve and calculating the area under the curve (AUC) on the basis of histopathologic analysis. RESULTS. Using ROC analysis, MRE showed greater capability than DWI in discriminating stage 2 or greater (≥ F2), stage 3 or greater (≥ F3), and cirrhosis (≥ F4), shown as significant differences in AUC (p = 0.003, p = 0.001, and p = 0.001, respectively). Higher sensitivity and specificity were shown by MRE in predicting fibrosis scores ≥ F2 (91% and 97%), scores ≥ F3 (92% and 95%), and scores F4 (95% and 87%) compared with DWI (84% and 82%, 88% and 76%, and 85% and 68%, respectively). Although MRE had higher ability in identification of liver with fibrosis scores ≥ F1 than DWI, a significant difference was not seen (p = 0.398). Stiffness values on MRE increased in relation to increasing severity of fibrosis confirmed by histopathology scores; however, a consistent relationship between apparent diffusion coefficient (ADC) values and stage of fibrosis was not shown. In addition, liver tissue with chronic hepatitis preceding fibrosis may account for mild elevation of liver stiffness. CONCLUSION. MRE had greater predictive ability in distinguishing the stages of liver fibrosis than DWI.

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KW - Fibrosis

KW - Liver

KW - MR elastography (MRE)

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