Magnetic resonance elastography predicts advanced fibrosis in patients with nonalcoholic fatty liver disease: A prospective study

Rohit Loomba, Tanya Wolfson, Brandon Ang, Jonathan Hooker, Cynthia Behling, Michael Peterson, Mark Valasek, Grace Lin, David Brenner, Anthony Gamst, Richard Lorne Ehman, Claude Sirlin

Research output: Contribution to journalArticle

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Abstract

Retrospective studies have shown that two-dimensional magnetic resonance elastography (2D-MRE), a novel MR method for assessment of liver stiffness, correlates with advanced fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). Prospective data on diagnostic accuracy of 2D-MRE in the detection of advanced fibrosis in NAFLD are needed. The aim of this study is to prospectively assess the diagnostic accuracy of 2D-MRE, a noninvasive imaging biomarker, in predicting advanced fibrosis (stage 3 or 4) in well-characterized patients with biopsy-proven NAFLD. This is a cross-sectional analysis of a prospective study including 117 consecutive patients (56% women) with biopsy-proven NAFLD who underwent a standardized research visit: history, exam, liver biopsy assessment (using the nonalcoholic steatohepatitis Clinical Research Network histological scoring system), and 2D-MRE from 2011 to 2013. The radiologist and pathologist were blinded to clinical and pathology/imaging data, respectively. Receiver operating characteristics (ROCs) were examined to assess the diagnostic test performance of 2D-MRE in predicting advanced fibrosis. The mean (± standard deviation) of age and body mass index was 50.1 (± 13.4) years and 32.4 (± 5.0) kg/m2, respectively. The median time interval between biopsy and 2D-MRE was 45 days (interquartile range: 50 days). The number of patients with fibrosis stages 0, 1, 2, 3, and 4 was 43, 39, 13, 12, and 10, respectively. The area under the ROC curve for 2D-MRE discriminating advanced fibrosis (stage 3-4) from stage 0-2 fibrosis was 0.924 (P<0.0001). A threshold of >3.63 kPa had a sensitivity of 0.86 (95% confidence interval [CI]: 0.65-0.97), specificity of 0.91 (95% CI: 0.83-0.96), positive predictive value of 0.68 (95% CI: 0.48-0.84), and negative predictive value of 0.97 (95% CI: 0.91-0.99). Conclusions: MRE is accurate in predicting advanced fibrosis and may be utilized for noninvasive diagnosis of advanced fibrosis in patients with NAFLD. (Hepatology 2014;60:1919-1927).

Original languageEnglish (US)
Pages (from-to)1920-1928
Number of pages9
JournalHepatology
Volume60
Issue number6
DOIs
StatePublished - Dec 1 2014

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Elasticity Imaging Techniques
Fibrosis
Prospective Studies
Confidence Intervals
Biopsy
ROC Curve
Non-alcoholic Fatty Liver Disease
Clinical Pathology
Liver
Gastroenterology
Research
Routine Diagnostic Tests
Body Mass Index
Retrospective Studies
Cross-Sectional Studies
Biomarkers
History

ASJC Scopus subject areas

  • Hepatology
  • Medicine(all)

Cite this

Loomba, R., Wolfson, T., Ang, B., Hooker, J., Behling, C., Peterson, M., ... Sirlin, C. (2014). Magnetic resonance elastography predicts advanced fibrosis in patients with nonalcoholic fatty liver disease: A prospective study. Hepatology, 60(6), 1920-1928. https://doi.org/10.1002/hep.27362

Magnetic resonance elastography predicts advanced fibrosis in patients with nonalcoholic fatty liver disease : A prospective study. / Loomba, Rohit; Wolfson, Tanya; Ang, Brandon; Hooker, Jonathan; Behling, Cynthia; Peterson, Michael; Valasek, Mark; Lin, Grace; Brenner, David; Gamst, Anthony; Ehman, Richard Lorne; Sirlin, Claude.

In: Hepatology, Vol. 60, No. 6, 01.12.2014, p. 1920-1928.

Research output: Contribution to journalArticle

Loomba, R, Wolfson, T, Ang, B, Hooker, J, Behling, C, Peterson, M, Valasek, M, Lin, G, Brenner, D, Gamst, A, Ehman, RL & Sirlin, C 2014, 'Magnetic resonance elastography predicts advanced fibrosis in patients with nonalcoholic fatty liver disease: A prospective study', Hepatology, vol. 60, no. 6, pp. 1920-1928. https://doi.org/10.1002/hep.27362
Loomba, Rohit ; Wolfson, Tanya ; Ang, Brandon ; Hooker, Jonathan ; Behling, Cynthia ; Peterson, Michael ; Valasek, Mark ; Lin, Grace ; Brenner, David ; Gamst, Anthony ; Ehman, Richard Lorne ; Sirlin, Claude. / Magnetic resonance elastography predicts advanced fibrosis in patients with nonalcoholic fatty liver disease : A prospective study. In: Hepatology. 2014 ; Vol. 60, No. 6. pp. 1920-1928.
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abstract = "Retrospective studies have shown that two-dimensional magnetic resonance elastography (2D-MRE), a novel MR method for assessment of liver stiffness, correlates with advanced fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). Prospective data on diagnostic accuracy of 2D-MRE in the detection of advanced fibrosis in NAFLD are needed. The aim of this study is to prospectively assess the diagnostic accuracy of 2D-MRE, a noninvasive imaging biomarker, in predicting advanced fibrosis (stage 3 or 4) in well-characterized patients with biopsy-proven NAFLD. This is a cross-sectional analysis of a prospective study including 117 consecutive patients (56{\%} women) with biopsy-proven NAFLD who underwent a standardized research visit: history, exam, liver biopsy assessment (using the nonalcoholic steatohepatitis Clinical Research Network histological scoring system), and 2D-MRE from 2011 to 2013. The radiologist and pathologist were blinded to clinical and pathology/imaging data, respectively. Receiver operating characteristics (ROCs) were examined to assess the diagnostic test performance of 2D-MRE in predicting advanced fibrosis. The mean (± standard deviation) of age and body mass index was 50.1 (± 13.4) years and 32.4 (± 5.0) kg/m2, respectively. The median time interval between biopsy and 2D-MRE was 45 days (interquartile range: 50 days). The number of patients with fibrosis stages 0, 1, 2, 3, and 4 was 43, 39, 13, 12, and 10, respectively. The area under the ROC curve for 2D-MRE discriminating advanced fibrosis (stage 3-4) from stage 0-2 fibrosis was 0.924 (P<0.0001). A threshold of >3.63 kPa had a sensitivity of 0.86 (95{\%} confidence interval [CI]: 0.65-0.97), specificity of 0.91 (95{\%} CI: 0.83-0.96), positive predictive value of 0.68 (95{\%} CI: 0.48-0.84), and negative predictive value of 0.97 (95{\%} CI: 0.91-0.99). Conclusions: MRE is accurate in predicting advanced fibrosis and may be utilized for noninvasive diagnosis of advanced fibrosis in patients with NAFLD. (Hepatology 2014;60:1919-1927).",
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AU - Hooker, Jonathan

AU - Behling, Cynthia

AU - Peterson, Michael

AU - Valasek, Mark

AU - Lin, Grace

AU - Brenner, David

AU - Gamst, Anthony

AU - Ehman, Richard Lorne

AU - Sirlin, Claude

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N2 - Retrospective studies have shown that two-dimensional magnetic resonance elastography (2D-MRE), a novel MR method for assessment of liver stiffness, correlates with advanced fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). Prospective data on diagnostic accuracy of 2D-MRE in the detection of advanced fibrosis in NAFLD are needed. The aim of this study is to prospectively assess the diagnostic accuracy of 2D-MRE, a noninvasive imaging biomarker, in predicting advanced fibrosis (stage 3 or 4) in well-characterized patients with biopsy-proven NAFLD. This is a cross-sectional analysis of a prospective study including 117 consecutive patients (56% women) with biopsy-proven NAFLD who underwent a standardized research visit: history, exam, liver biopsy assessment (using the nonalcoholic steatohepatitis Clinical Research Network histological scoring system), and 2D-MRE from 2011 to 2013. The radiologist and pathologist were blinded to clinical and pathology/imaging data, respectively. Receiver operating characteristics (ROCs) were examined to assess the diagnostic test performance of 2D-MRE in predicting advanced fibrosis. The mean (± standard deviation) of age and body mass index was 50.1 (± 13.4) years and 32.4 (± 5.0) kg/m2, respectively. The median time interval between biopsy and 2D-MRE was 45 days (interquartile range: 50 days). The number of patients with fibrosis stages 0, 1, 2, 3, and 4 was 43, 39, 13, 12, and 10, respectively. The area under the ROC curve for 2D-MRE discriminating advanced fibrosis (stage 3-4) from stage 0-2 fibrosis was 0.924 (P<0.0001). A threshold of >3.63 kPa had a sensitivity of 0.86 (95% confidence interval [CI]: 0.65-0.97), specificity of 0.91 (95% CI: 0.83-0.96), positive predictive value of 0.68 (95% CI: 0.48-0.84), and negative predictive value of 0.97 (95% CI: 0.91-0.99). Conclusions: MRE is accurate in predicting advanced fibrosis and may be utilized for noninvasive diagnosis of advanced fibrosis in patients with NAFLD. (Hepatology 2014;60:1919-1927).

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