Correlation of hepatic fractional extracellular space using gadolinium enhanced MRI with liver stiffness using magnetic resonance elastography

Michael Wells, Michael R. Moynagh, Rickey E. Carter, Robert A. Childs, Cameron E. Leitch, Joel Garland Fletcher, Benjamin M. Yeh, Sudhakar K Venkatesh

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: To compare MR hepatic fractional extracellular space (fECS) to liver stiffness (LS) with magnetic resonance elastography (MRE) for evaluation of liver fibrosis. Methods and materials: 71 consecutive patients with suspected chronic liver disease underwent standard liver MRI with MR elastography and additional delayed Gd-DTPA-enhanced sequences at 5 and 10 min in order to calculate hepatic fECS (%) and LS (kilopascals, kPa). Two radiologists blinded to clinical history examined MR images and calculated fECS and LS in identical locations for every patient. Interobserver agreement was calculated using the intraclass correlation coefficient. Pearson’s correlation was calculated for LS and fECS measures, as was the area under the receiver operatic curve (AUROC), sensitivity and specificity of fECS to predict liver stiffness ≥2.93 and ≥5 kPa. The sensitivity of fECS for detecting fibrosis was separately analyzed in the subgroup of patients without anatomic findings of cirrhosis. Results: Substantial to excellent interobserver agreement for both LS and fECS measurements was seen with intraclass correlation of 0.88 (95% CI 0.81–0.92) for LS, 0.77 (95% CI 0.66–0.85) for fECS5 and 0.76 (95% CI 0.64–0.84) for fECS10. A significant correlation was found between MRE and fECS5 (r = 0.47, p < 0.0001) and fECS10 (r = 0.44, p < 0.0001). The performance of fECS improved for detection of advanced fibrosis (≥5 kPa) with AUROC, sensitivity and specificity of 0.72, 38%, and 94% for fECS5 and 0.72, 67%, and 66% for fECS10. Conclusion: fECS correlates modestly with MRE-determined LS. fECS at MRI is a simple calculation to perform and may represent a practical way to suggest the presence of fibrosis during routine liver evaluation.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalAbdominal Radiology
DOIs
StateAccepted/In press - Aug 10 2016

Fingerprint

Elasticity Imaging Techniques
Gadolinium
Extracellular Space
Liver
Fibrosis
Sensitivity and Specificity
Gadolinium DTPA
Liver Cirrhosis
Liver Diseases
Chronic Disease

Keywords

  • Fractional extracellular space
  • Gadolinium
  • Hepatic extracellular space
  • Hepatic fibrosis
  • Liver fibrosis
  • Liver stiffness
  • MR elastography
  • MRI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology
  • Radiological and Ultrasound Technology

Cite this

@article{be60ae8bca434b3fac8dbd0ec8f57b3c,
title = "Correlation of hepatic fractional extracellular space using gadolinium enhanced MRI with liver stiffness using magnetic resonance elastography",
abstract = "Purpose: To compare MR hepatic fractional extracellular space (fECS) to liver stiffness (LS) with magnetic resonance elastography (MRE) for evaluation of liver fibrosis. Methods and materials: 71 consecutive patients with suspected chronic liver disease underwent standard liver MRI with MR elastography and additional delayed Gd-DTPA-enhanced sequences at 5 and 10 min in order to calculate hepatic fECS ({\%}) and LS (kilopascals, kPa). Two radiologists blinded to clinical history examined MR images and calculated fECS and LS in identical locations for every patient. Interobserver agreement was calculated using the intraclass correlation coefficient. Pearson’s correlation was calculated for LS and fECS measures, as was the area under the receiver operatic curve (AUROC), sensitivity and specificity of fECS to predict liver stiffness ≥2.93 and ≥5 kPa. The sensitivity of fECS for detecting fibrosis was separately analyzed in the subgroup of patients without anatomic findings of cirrhosis. Results: Substantial to excellent interobserver agreement for both LS and fECS measurements was seen with intraclass correlation of 0.88 (95{\%} CI 0.81–0.92) for LS, 0.77 (95{\%} CI 0.66–0.85) for fECS5 and 0.76 (95{\%} CI 0.64–0.84) for fECS10. A significant correlation was found between MRE and fECS5 (r = 0.47, p < 0.0001) and fECS10 (r = 0.44, p < 0.0001). The performance of fECS improved for detection of advanced fibrosis (≥5 kPa) with AUROC, sensitivity and specificity of 0.72, 38{\%}, and 94{\%} for fECS5 and 0.72, 67{\%}, and 66{\%} for fECS10. Conclusion: fECS correlates modestly with MRE-determined LS. fECS at MRI is a simple calculation to perform and may represent a practical way to suggest the presence of fibrosis during routine liver evaluation.",
keywords = "Fractional extracellular space, Gadolinium, Hepatic extracellular space, Hepatic fibrosis, Liver fibrosis, Liver stiffness, MR elastography, MRI",
author = "Michael Wells and Moynagh, {Michael R.} and Carter, {Rickey E.} and Childs, {Robert A.} and Leitch, {Cameron E.} and Fletcher, {Joel Garland} and Yeh, {Benjamin M.} and Venkatesh, {Sudhakar K}",
year = "2016",
month = "8",
day = "10",
doi = "10.1007/s00261-016-0867-8",
language = "English (US)",
pages = "1--8",
journal = "Abdominal Radiology",
issn = "2366-004X",
publisher = "Springer New York",

}

TY - JOUR

T1 - Correlation of hepatic fractional extracellular space using gadolinium enhanced MRI with liver stiffness using magnetic resonance elastography

AU - Wells, Michael

AU - Moynagh, Michael R.

AU - Carter, Rickey E.

AU - Childs, Robert A.

AU - Leitch, Cameron E.

AU - Fletcher, Joel Garland

AU - Yeh, Benjamin M.

AU - Venkatesh, Sudhakar K

PY - 2016/8/10

Y1 - 2016/8/10

N2 - Purpose: To compare MR hepatic fractional extracellular space (fECS) to liver stiffness (LS) with magnetic resonance elastography (MRE) for evaluation of liver fibrosis. Methods and materials: 71 consecutive patients with suspected chronic liver disease underwent standard liver MRI with MR elastography and additional delayed Gd-DTPA-enhanced sequences at 5 and 10 min in order to calculate hepatic fECS (%) and LS (kilopascals, kPa). Two radiologists blinded to clinical history examined MR images and calculated fECS and LS in identical locations for every patient. Interobserver agreement was calculated using the intraclass correlation coefficient. Pearson’s correlation was calculated for LS and fECS measures, as was the area under the receiver operatic curve (AUROC), sensitivity and specificity of fECS to predict liver stiffness ≥2.93 and ≥5 kPa. The sensitivity of fECS for detecting fibrosis was separately analyzed in the subgroup of patients without anatomic findings of cirrhosis. Results: Substantial to excellent interobserver agreement for both LS and fECS measurements was seen with intraclass correlation of 0.88 (95% CI 0.81–0.92) for LS, 0.77 (95% CI 0.66–0.85) for fECS5 and 0.76 (95% CI 0.64–0.84) for fECS10. A significant correlation was found between MRE and fECS5 (r = 0.47, p < 0.0001) and fECS10 (r = 0.44, p < 0.0001). The performance of fECS improved for detection of advanced fibrosis (≥5 kPa) with AUROC, sensitivity and specificity of 0.72, 38%, and 94% for fECS5 and 0.72, 67%, and 66% for fECS10. Conclusion: fECS correlates modestly with MRE-determined LS. fECS at MRI is a simple calculation to perform and may represent a practical way to suggest the presence of fibrosis during routine liver evaluation.

AB - Purpose: To compare MR hepatic fractional extracellular space (fECS) to liver stiffness (LS) with magnetic resonance elastography (MRE) for evaluation of liver fibrosis. Methods and materials: 71 consecutive patients with suspected chronic liver disease underwent standard liver MRI with MR elastography and additional delayed Gd-DTPA-enhanced sequences at 5 and 10 min in order to calculate hepatic fECS (%) and LS (kilopascals, kPa). Two radiologists blinded to clinical history examined MR images and calculated fECS and LS in identical locations for every patient. Interobserver agreement was calculated using the intraclass correlation coefficient. Pearson’s correlation was calculated for LS and fECS measures, as was the area under the receiver operatic curve (AUROC), sensitivity and specificity of fECS to predict liver stiffness ≥2.93 and ≥5 kPa. The sensitivity of fECS for detecting fibrosis was separately analyzed in the subgroup of patients without anatomic findings of cirrhosis. Results: Substantial to excellent interobserver agreement for both LS and fECS measurements was seen with intraclass correlation of 0.88 (95% CI 0.81–0.92) for LS, 0.77 (95% CI 0.66–0.85) for fECS5 and 0.76 (95% CI 0.64–0.84) for fECS10. A significant correlation was found between MRE and fECS5 (r = 0.47, p < 0.0001) and fECS10 (r = 0.44, p < 0.0001). The performance of fECS improved for detection of advanced fibrosis (≥5 kPa) with AUROC, sensitivity and specificity of 0.72, 38%, and 94% for fECS5 and 0.72, 67%, and 66% for fECS10. Conclusion: fECS correlates modestly with MRE-determined LS. fECS at MRI is a simple calculation to perform and may represent a practical way to suggest the presence of fibrosis during routine liver evaluation.

KW - Fractional extracellular space

KW - Gadolinium

KW - Hepatic extracellular space

KW - Hepatic fibrosis

KW - Liver fibrosis

KW - Liver stiffness

KW - MR elastography

KW - MRI

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U2 - 10.1007/s00261-016-0867-8

DO - 10.1007/s00261-016-0867-8

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C2 - 27511365

AN - SCOPUS:84981248741

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JO - Abdominal Radiology

JF - Abdominal Radiology

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