TY - JOUR
T1 - Magnetic resonance elastography biomarkers for detection of histologic alterations in nonalcoholic fatty liver disease in the absence of fibrosis
AU - Qu, Yali
AU - Middleton, Michael S.
AU - Loomba, Rohit
AU - Glaser, Kevin J.
AU - Chen, Jun
AU - Hooker, Jonathan C.
AU - Wolfson, Tanya
AU - Covarrubias, Yesenia
AU - Valasek, Mark A.
AU - Fowler, Kathryn J.
AU - Zhang, Yingzhen N.
AU - Sy, Ethan
AU - Gamst, Anthony C.
AU - Wang, Kang
AU - Mamidipalli, Adrija
AU - Schwimmer, Jeffrey B.
AU - Song, Bin
AU - Reeder, Scott B.
AU - Yin, Meng
AU - Ehman, Richard L.
AU - Sirlin, Claude B.
N1 - Funding Information:
J. B. S. reports grant funding from Intercept, Genfit, and Seraphina.
Funding Information:
C. B. S. reports grants from GE, Siemens, Philips, Bayer, Foundation of NIH, and Gilead; personal consultation fees from Blade, Boehringer, and Epigenomics; consultation under the auspices of the University to AMRA, BMS, Exact Sciences, GE Digital, IBM-Watson, and Pfizer; lab service agreements from Enanta, Gilead, ICON, Intercept, Nusirt, Shire, Synageva, Takeda; royalties from Wolters Kluwer for educational material outside the submitted work; honoraria to the institution from Medscape for educational material outside the submitted work; ownership of stock in Livivos; serving on advisory board to Quantix Bio.
Funding Information:
This study has received funding by National Institutes of Health (NIH) grants (K23DK090303, R01DK083380, R01DK088925, R01DK100651, K24DK102595, R01DK106419, EB001981, EB017197), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) grant (U01DK061718), and Mayo Clinic Center for Individualized Medicine Imaging Biomarker Discovery Program.
Funding Information:
The authors wish to thank GE Healthcare which provides research support to the University of California, San Diego, CA and the University of Wisconsin, Madison, WI.
Publisher Copyright:
© 2021, European Society of Radiology.
PY - 2021/11
Y1 - 2021/11
N2 - Objectives: To investigate associations between histology and hepatic mechanical properties measured using multiparametric magnetic resonance elastography (MRE) in adults with known or suspected nonalcoholic fatty liver disease (NAFLD) without histologic fibrosis. Methods: This was a retrospective analysis of 88 adults who underwent 3T MR exams including hepatic MRE and MR imaging to estimate proton density fat fraction (MRI-PDFF) within 180 days of liver biopsy. Associations between MRE mechanical properties (mean shear stiffness (|G*|) by 2D and 3D MRE, and storage modulus (G′), loss modulus (G″), wave attenuation (α), and damping ratio (ζ) by 3D MRE) and histologic, demographic and anthropometric data were assessed. Results: In univariate analyses, patients with lobular inflammation grade ≥ 2 had higher 2D |G*| and 3D G″ than those with grade ≤ 1 (p = 0.04). |G*| (both 2D and 3D), G′, and G″ increased with age (rho = 0.25 to 0.31; p ≤ 0.03). In multivariable regression analyses, the association between inflammation grade ≥ 2 remained significant for 2D |G*| (p = 0.01) but not for 3D G″ (p = 0.06); age, sex, or BMI did not affect the MRE-inflammation relationship (p > 0.20). Conclusions: 2D |G*| and 3D G″ were weakly associated with moderate or severe lobular inflammation in patients with known or suspected NAFLD without fibrosis. With further validation and refinement, these properties might become useful biomarkers of inflammation. Age adjustment may help MRE interpretation, at least in patients with early-stage disease. Key Points: • Moderate to severe lobular inflammation was associated with hepatic elevated shear stiffness and elevated loss modulus (p =0.04) in patients with known or suspected NAFLD without liver fibrosis; this suggests that with further technical refinement these MRE-assessed mechanical properties may permit detection of inflammation before the onset of fibrosis in NAFLD. • Increasing age is associated with higher hepatic shear stiffness, and storage and loss moduli (rho = 0.25 to 0.31; p ≤ 0.03); this suggests that age adjustment may help interpret MRE results, at least in patients with early-stage NAFLD.
AB - Objectives: To investigate associations between histology and hepatic mechanical properties measured using multiparametric magnetic resonance elastography (MRE) in adults with known or suspected nonalcoholic fatty liver disease (NAFLD) without histologic fibrosis. Methods: This was a retrospective analysis of 88 adults who underwent 3T MR exams including hepatic MRE and MR imaging to estimate proton density fat fraction (MRI-PDFF) within 180 days of liver biopsy. Associations between MRE mechanical properties (mean shear stiffness (|G*|) by 2D and 3D MRE, and storage modulus (G′), loss modulus (G″), wave attenuation (α), and damping ratio (ζ) by 3D MRE) and histologic, demographic and anthropometric data were assessed. Results: In univariate analyses, patients with lobular inflammation grade ≥ 2 had higher 2D |G*| and 3D G″ than those with grade ≤ 1 (p = 0.04). |G*| (both 2D and 3D), G′, and G″ increased with age (rho = 0.25 to 0.31; p ≤ 0.03). In multivariable regression analyses, the association between inflammation grade ≥ 2 remained significant for 2D |G*| (p = 0.01) but not for 3D G″ (p = 0.06); age, sex, or BMI did not affect the MRE-inflammation relationship (p > 0.20). Conclusions: 2D |G*| and 3D G″ were weakly associated with moderate or severe lobular inflammation in patients with known or suspected NAFLD without fibrosis. With further validation and refinement, these properties might become useful biomarkers of inflammation. Age adjustment may help MRE interpretation, at least in patients with early-stage disease. Key Points: • Moderate to severe lobular inflammation was associated with hepatic elevated shear stiffness and elevated loss modulus (p =0.04) in patients with known or suspected NAFLD without liver fibrosis; this suggests that with further technical refinement these MRE-assessed mechanical properties may permit detection of inflammation before the onset of fibrosis in NAFLD. • Increasing age is associated with higher hepatic shear stiffness, and storage and loss moduli (rho = 0.25 to 0.31; p ≤ 0.03); this suggests that age adjustment may help interpret MRE results, at least in patients with early-stage NAFLD.
KW - Elasticity imaging techniques
KW - Inflammation
KW - Magnetic resonance imaging
KW - Nonalcoholic fatty liver disease
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U2 - 10.1007/s00330-021-07988-6
DO - 10.1007/s00330-021-07988-6
M3 - Article
C2 - 33899143
AN - SCOPUS:85105229151
VL - 31
SP - 8408
EP - 8419
JO - European Radiology
JF - European Radiology
SN - 0938-7994
IS - 11
ER -