Correlation of MR elastography with morphometric quantification of liver fibrosis (fibro-C-index) in chronic hepatitis B

Purpose: We evaluated the correlation of MR Elastography (MRE) with morphometric assessment of liver fibrosis in chronic hepatitis B (CHB). Methods: Thirty-two patients with CHB underwent both MRE and a liver biopsy within a 6-month interval. MRE was performed using standard MRE sequence on a 1.5 Tesla clinical scanner. The liver stiffness (LS) was measured on automatically generated stiffness maps. Morphometric quantification of fibrosis of liver biopsies was performed using a semiautomated image analysis program and expressed as percentage area (Fibro-C-Index). Correlations between MRE, Fibro-CIndex, and histologic fibrosis stages were evaluated. Receiver operating curve (ROC) analysis of MRE and Fibro-C-index for differentiating fibrosis (≥F1), significant fibrosis (≥F2), advanced fibrosis (≥F3), and cirrhosis (F4) was performed. Results: MRE showed excellent correlation with both Fibro-CIndex (r=0.78, 95% confidence interval [CI], 0.59'0.88, P<0.001) and histologic staging (rho=0.87, 95% CI, 0.72' 0.94, P<0.0001). Significant differences in MRE (P=0.0001) and Fibro-C-Index (P=0.003) among different stages of liver fibrosis was found. MRE and Fibro-C-Index had similar accuracies for differentiating fibrosis stages: ≥F1 (0.87 versus 0.81, P=0.6), ≥F2 (0.95 versus 0.94, P=0.78), ≥F3 (0.98 versus 0.96, P=0.76), and F4 (1.00 versus 0.92, P=0.10). Conclusion: MRE is an excellent noninvasive indicator of liver fibrosis burden in CHB.