Magnetic resonance elastography for the detection and staging of liver fibrosis in chronic hepatitis B

Objectives: We measured the accuracy of magnetic resonance elastography (MRE) for the detection and staging of liver fibrosis in chronic hepatitis B (CHB) and compared it with serum fibrosis markers. Methods: Prospective comparison of MRE and routine serum fibrosis markers, namely serum alanine aminotransferase (ALT), serum aspartate aminotransferase (AST), ALT/AST ratio (AAR), AST to platelet ratio index (APRI) and prothrombin index (PI), was performed in 63 consecutive CHB patients who underwent MRE and histological confirmation of liver fibrosis within a 6-month interval. Diagnostic performance of MRE and serum markers for staging fibrosis (≥F1), significant fibrosis (≥F2), advanced fibrosis (≥F3) and cirrhosis (F4) was compared. Results: The study group comprised 63 patients (19 female; mean age±SD, 50±11.9 years). MRE (ρ = 0.94, P <0.0001), APRI (ρ = 0.42, P =0.0006), PI (ρ = 0.42, P =0.0006) and AST (ρ = 0.28, P =0.028) results correlated significantly with fibrosis stage. MRE was significantlymore accurate than serum fibrosis markers for the detection of significant fibrosis (0.99 vs. 0.55- 0.73) and cirrhosis (0.98 vs. 0.53-0.77). Sensitivity, specificity, positive predictive and negative predictive values for MRE for significant fibrosis and cirrhosis were 97.4%, 100%, 100% and 96%, and 100%, 95.2%, 91.3% and 100%, respectively. Conclusion: MRE is an accurate non-invasive technique for the detection and staging of liver fibrosis in CHB. Key Points: • Magnetic resonance elastography is accurate for liver fibrosis detection and staging. • MR elastography is more accurate than serum tests for staging liver fibrosis. • MR elastography can potentially replace liver biopsy in chronic hepatitis B.