Magnetic resonance elastography can discriminate normal vs. abnormal liver biopsy in candidates for live liver donation

Juan F. Gallegos-Orozco, Alvin C Silva, Mashal J. Batheja, Yu Hui Chang, Kathleen L. Hansen, Dora Lam-Himlin, Giovanni De Petris, Bashar A. Aqel, Thomas J. Byrne, Elizabeth J. Carey, David D. Douglas, David C. Mulligan, Annelise M. Silva, Jorge Rakela, Hugo E Vargas

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: The aim of this study was to define liver shear stiffness by magnetic resonance elastography (MRE) that distinguishes normal from abnormal liver biopsy, especially when steatosis ≥20%, among potential live liver donors.

Methods: Baseline clinical, laboratory, imaging, MRE, and liver biopsy results were recorded. Using MRE, hepatic shear stiffness in kilopascals (kPa) was measured and compared to liver biopsy. Comparison between groups was done using χ2 or Fisher’s exact test for categorical variables and Wilcoxon test for continuous variables. Receiver operating characteristic (ROC) curve was calculated to assess diagnostic accuracy. Statistical significance was set at p < 0.05.

Results: 38 healthy adults were included. Liver biopsy was normal in 27 and abnormal in 11. ROC curve for MRE defined optimal cutoff at 2.6 kPa (sensitivity 0.72, specificity 0.85, AUC 0.81) to distinguish these 2 groups. Hepatic steatosis ≥20% on biopsy is a contraindication for liver donation in our center. We evaluated the ability of MRE to distinguish this degree of steatosis: 8 persons had steatosis ≥20% and were excluded from donation. ROC curve for MRE defined optimal cutoff at 2.82 kPa (sensitivity 0.88, specificity 1, AUC 0.98) to identify this group.

Conclusions: Liver stiffness measured by MRE, even in the absence of liver fibrosis, can be useful in differentiating normal from abnormal liver histology, and most importantly in patients under evaluation for live liver donation, can very accurately distinguish those with complicated hepatic steatosis ≥20%, our cutoff for donation. In the future, MRE might provide supplementary information to make liver biopsy unnecessary in the donor evaluation process.

Original languageEnglish (US)
JournalAbdominal Imaging
DOIs
StateAccepted/In press - Dec 2 2014

Fingerprint

Elasticity Imaging Techniques
Biopsy
Liver
ROC Curve
Area Under Curve
Tissue Donors
Sensitivity and Specificity
Liver Cirrhosis

Keywords

  • Elastography
  • Live donor liver transplantation
  • Live liver donation
  • Liver steatosis
  • Liver stiffness

ASJC Scopus subject areas

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

Cite this

Magnetic resonance elastography can discriminate normal vs. abnormal liver biopsy in candidates for live liver donation. / Gallegos-Orozco, Juan F.; Silva, Alvin C; Batheja, Mashal J.; Chang, Yu Hui; Hansen, Kathleen L.; Lam-Himlin, Dora; De Petris, Giovanni; Aqel, Bashar A.; Byrne, Thomas J.; Carey, Elizabeth J.; Douglas, David D.; Mulligan, David C.; Silva, Annelise M.; Rakela, Jorge; Vargas, Hugo E.

In: Abdominal Imaging, 02.12.2014.

Research output: Contribution to journalArticle

Gallegos-Orozco, JF, Silva, AC, Batheja, MJ, Chang, YH, Hansen, KL, Lam-Himlin, D, De Petris, G, Aqel, BA, Byrne, TJ, Carey, EJ, Douglas, DD, Mulligan, DC, Silva, AM, Rakela, J & Vargas, HE 2014, 'Magnetic resonance elastography can discriminate normal vs. abnormal liver biopsy in candidates for live liver donation', Abdominal Imaging. https://doi.org/10.1007/s00261-014-0310-y
Gallegos-Orozco, Juan F. ; Silva, Alvin C ; Batheja, Mashal J. ; Chang, Yu Hui ; Hansen, Kathleen L. ; Lam-Himlin, Dora ; De Petris, Giovanni ; Aqel, Bashar A. ; Byrne, Thomas J. ; Carey, Elizabeth J. ; Douglas, David D. ; Mulligan, David C. ; Silva, Annelise M. ; Rakela, Jorge ; Vargas, Hugo E. / Magnetic resonance elastography can discriminate normal vs. abnormal liver biopsy in candidates for live liver donation. In: Abdominal Imaging. 2014.
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abstract = "Purpose: The aim of this study was to define liver shear stiffness by magnetic resonance elastography (MRE) that distinguishes normal from abnormal liver biopsy, especially when steatosis ≥20{\%}, among potential live liver donors.Methods: Baseline clinical, laboratory, imaging, MRE, and liver biopsy results were recorded. Using MRE, hepatic shear stiffness in kilopascals (kPa) was measured and compared to liver biopsy. Comparison between groups was done using χ2 or Fisher’s exact test for categorical variables and Wilcoxon test for continuous variables. Receiver operating characteristic (ROC) curve was calculated to assess diagnostic accuracy. Statistical significance was set at p < 0.05.Results: 38 healthy adults were included. Liver biopsy was normal in 27 and abnormal in 11. ROC curve for MRE defined optimal cutoff at 2.6 kPa (sensitivity 0.72, specificity 0.85, AUC 0.81) to distinguish these 2 groups. Hepatic steatosis ≥20{\%} on biopsy is a contraindication for liver donation in our center. We evaluated the ability of MRE to distinguish this degree of steatosis: 8 persons had steatosis ≥20{\%} and were excluded from donation. ROC curve for MRE defined optimal cutoff at 2.82 kPa (sensitivity 0.88, specificity 1, AUC 0.98) to identify this group.Conclusions: Liver stiffness measured by MRE, even in the absence of liver fibrosis, can be useful in differentiating normal from abnormal liver histology, and most importantly in patients under evaluation for live liver donation, can very accurately distinguish those with complicated hepatic steatosis ≥20{\%}, our cutoff for donation. In the future, MRE might provide supplementary information to make liver biopsy unnecessary in the donor evaluation process.",
keywords = "Elastography, Live donor liver transplantation, Live liver donation, Liver steatosis, Liver stiffness",
author = "Gallegos-Orozco, {Juan F.} and Silva, {Alvin C} and Batheja, {Mashal J.} and Chang, {Yu Hui} and Hansen, {Kathleen L.} and Dora Lam-Himlin and {De Petris}, Giovanni and Aqel, {Bashar A.} and Byrne, {Thomas J.} and Carey, {Elizabeth J.} and Douglas, {David D.} and Mulligan, {David C.} and Silva, {Annelise M.} and Jorge Rakela and Vargas, {Hugo E}",
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T1 - Magnetic resonance elastography can discriminate normal vs. abnormal liver biopsy in candidates for live liver donation

AU - Gallegos-Orozco, Juan F.

AU - Silva, Alvin C

AU - Batheja, Mashal J.

AU - Chang, Yu Hui

AU - Hansen, Kathleen L.

AU - Lam-Himlin, Dora

AU - De Petris, Giovanni

AU - Aqel, Bashar A.

AU - Byrne, Thomas J.

AU - Carey, Elizabeth J.

AU - Douglas, David D.

AU - Mulligan, David C.

AU - Silva, Annelise M.

AU - Rakela, Jorge

AU - Vargas, Hugo E

PY - 2014/12/2

Y1 - 2014/12/2

N2 - Purpose: The aim of this study was to define liver shear stiffness by magnetic resonance elastography (MRE) that distinguishes normal from abnormal liver biopsy, especially when steatosis ≥20%, among potential live liver donors.Methods: Baseline clinical, laboratory, imaging, MRE, and liver biopsy results were recorded. Using MRE, hepatic shear stiffness in kilopascals (kPa) was measured and compared to liver biopsy. Comparison between groups was done using χ2 or Fisher’s exact test for categorical variables and Wilcoxon test for continuous variables. Receiver operating characteristic (ROC) curve was calculated to assess diagnostic accuracy. Statistical significance was set at p < 0.05.Results: 38 healthy adults were included. Liver biopsy was normal in 27 and abnormal in 11. ROC curve for MRE defined optimal cutoff at 2.6 kPa (sensitivity 0.72, specificity 0.85, AUC 0.81) to distinguish these 2 groups. Hepatic steatosis ≥20% on biopsy is a contraindication for liver donation in our center. We evaluated the ability of MRE to distinguish this degree of steatosis: 8 persons had steatosis ≥20% and were excluded from donation. ROC curve for MRE defined optimal cutoff at 2.82 kPa (sensitivity 0.88, specificity 1, AUC 0.98) to identify this group.Conclusions: Liver stiffness measured by MRE, even in the absence of liver fibrosis, can be useful in differentiating normal from abnormal liver histology, and most importantly in patients under evaluation for live liver donation, can very accurately distinguish those with complicated hepatic steatosis ≥20%, our cutoff for donation. In the future, MRE might provide supplementary information to make liver biopsy unnecessary in the donor evaluation process.

AB - Purpose: The aim of this study was to define liver shear stiffness by magnetic resonance elastography (MRE) that distinguishes normal from abnormal liver biopsy, especially when steatosis ≥20%, among potential live liver donors.Methods: Baseline clinical, laboratory, imaging, MRE, and liver biopsy results were recorded. Using MRE, hepatic shear stiffness in kilopascals (kPa) was measured and compared to liver biopsy. Comparison between groups was done using χ2 or Fisher’s exact test for categorical variables and Wilcoxon test for continuous variables. Receiver operating characteristic (ROC) curve was calculated to assess diagnostic accuracy. Statistical significance was set at p < 0.05.Results: 38 healthy adults were included. Liver biopsy was normal in 27 and abnormal in 11. ROC curve for MRE defined optimal cutoff at 2.6 kPa (sensitivity 0.72, specificity 0.85, AUC 0.81) to distinguish these 2 groups. Hepatic steatosis ≥20% on biopsy is a contraindication for liver donation in our center. We evaluated the ability of MRE to distinguish this degree of steatosis: 8 persons had steatosis ≥20% and were excluded from donation. ROC curve for MRE defined optimal cutoff at 2.82 kPa (sensitivity 0.88, specificity 1, AUC 0.98) to identify this group.Conclusions: Liver stiffness measured by MRE, even in the absence of liver fibrosis, can be useful in differentiating normal from abnormal liver histology, and most importantly in patients under evaluation for live liver donation, can very accurately distinguish those with complicated hepatic steatosis ≥20%, our cutoff for donation. In the future, MRE might provide supplementary information to make liver biopsy unnecessary in the donor evaluation process.

KW - Elastography

KW - Live donor liver transplantation

KW - Live liver donation

KW - Liver steatosis

KW - Liver stiffness

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