Novel 3D Magnetic Resonance Elastography for the Noninvasive Diagnosis of Advanced Fibrosis in NAFLD: A Prospective Study

Rohit Loomba; Jeffrey Cui; Tanya Wolfson; William Haufe; Jonathan Hooker; Nikolaus Szeverenyi; Brandon Ang; Archana Bhatt; Kang Wang; Hamed Aryafar; Cindy Behling; Mark A. Valasek; Grace Y. Lin; Anthony Gamst; David A. Brenner; Meng Yin; Kevin J. Glaser; Richard L. Ehman; Claude B. Sirlin

doi:10.1038/ajg.2016.65

Novel 3D Magnetic Resonance Elastography for the Noninvasive Diagnosis of Advanced Fibrosis in NAFLD: A Prospective Study

Rohit Loomba, Jeffrey Cui, Tanya Wolfson, William Haufe, Jonathan Hooker, Nikolaus Szeverenyi, Brandon Ang, Archana Bhatt, Kang Wang, Hamed Aryafar, Cindy Behling, Mark A. Valasek, Grace Y. Lin, Anthony Gamst, David A. Brenner, Meng Yin, Kevin J. Glaser, Richard L. Ehman, Claude B. Sirlin

Radiology

Research output: Contribution to journal › Article › peer-review

102 Scopus citations

Abstract

OBJECTIVES: Recent studies show two-dimensional (2D)-magnetic resonance elastography (MRE) is accurate in diagnosing advanced fibrosis (stages 3 and 4) in nonalcoholic fatty liver disease (NAFLD) patients. Three-dimensional (3D)-MRE is a more advanced version of the technology that can image shear-wave fields in 3D of the entire liver. The aim of this study was to prospectively compare the diagnostic accuracy of 3D-MRE and 2D-MRE for diagnosing advanced fibrosis in patients with biopsy-proven NAFLD. METHODS: This cross-sectional analysis of a prospective study included 100 consecutive patients (56% women) with biopsy-proven NAFLD who also underwent MRE. Area under the receiver operating characteristic (AUROC) analysis was performed to assess the accuracy of 2D- and 3D-MRE in diagnosing advanced fibrosis. RESULTS: The mean (±s.d.) of age and body mass index were 50.2 (±13.6) years and 32.1 (±5.0) kg/m 2, respectively. The AUROC for diagnosing advanced fibrosis was 0.981 for 3D-MRE at 40 Hz, 0.927 for 3D-MRE at 60 Hz (standard shear-wave frequency), and 0.921 for 2D-MRE at 60 Hz (standard shear-wave frequency). At a threshold of 2.43 kPa, 3D-MRE at 40 Hz had sensitivity 1.0, specificity 0.94, positive predictive value 0.72, and negative predictive value 1.0 for diagnosing advanced fibrosis. 3D-MRE at 40 Hz had significantly higher AUROC (P<0.05) than 2D-MRE at 60 Hz for diagnosing advanced fibrosis. CONCLUSIONS: Utilizing a prospective study design, we demonstrate that 3D MRE at 40 Hz has the highest diagnostic accuracy in diagnosing NAFLD advanced fibrosis. Both 2D- and 3D-MRE at 60 Hz, the standard shear-wave frequency, are also highly accurate in diagnosing NAFLD advanced fibrosis.

Original language	English (US)
Pages (from-to)	986-994
Number of pages	9
Journal	American Journal of Gastroenterology
Volume	111
Issue number	7
DOIs	https://doi.org/10.1038/ajg.2016.65
State	Published - Jul 1 2016

ASJC Scopus subject areas

Hepatology
Gastroenterology

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10.1038/ajg.2016.65

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Loomba, R., Cui, J., Wolfson, T., Haufe, W., Hooker, J., Szeverenyi, N., Ang, B., Bhatt, A., Wang, K., Aryafar, H., Behling, C., Valasek, M. A., Lin, G. Y., Gamst, A., Brenner, D. A., Yin, M., Glaser, K. J., Ehman, R. L., & Sirlin, C. B. (2016). Novel 3D Magnetic Resonance Elastography for the Noninvasive Diagnosis of Advanced Fibrosis in NAFLD: A Prospective Study. American Journal of Gastroenterology, 111(7), 986-994. https://doi.org/10.1038/ajg.2016.65

Loomba, R, Cui, J, Wolfson, T, Haufe, W, Hooker, J, Szeverenyi, N, Ang, B, Bhatt, A, Wang, K, Aryafar, H, Behling, C, Valasek, MA, Lin, GY, Gamst, A, Brenner, DA, Yin, M, Glaser, KJ, Ehman, RL & Sirlin, CB 2016, 'Novel 3D Magnetic Resonance Elastography for the Noninvasive Diagnosis of Advanced Fibrosis in NAFLD: A Prospective Study', American Journal of Gastroenterology, vol. 111, no. 7, pp. 986-994. https://doi.org/10.1038/ajg.2016.65

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title = "Novel 3D Magnetic Resonance Elastography for the Noninvasive Diagnosis of Advanced Fibrosis in NAFLD: A Prospective Study",

abstract = "OBJECTIVES: Recent studies show two-dimensional (2D)-magnetic resonance elastography (MRE) is accurate in diagnosing advanced fibrosis (stages 3 and 4) in nonalcoholic fatty liver disease (NAFLD) patients. Three-dimensional (3D)-MRE is a more advanced version of the technology that can image shear-wave fields in 3D of the entire liver. The aim of this study was to prospectively compare the diagnostic accuracy of 3D-MRE and 2D-MRE for diagnosing advanced fibrosis in patients with biopsy-proven NAFLD. METHODS: This cross-sectional analysis of a prospective study included 100 consecutive patients (56% women) with biopsy-proven NAFLD who also underwent MRE. Area under the receiver operating characteristic (AUROC) analysis was performed to assess the accuracy of 2D- and 3D-MRE in diagnosing advanced fibrosis. RESULTS: The mean (±s.d.) of age and body mass index were 50.2 (±13.6) years and 32.1 (±5.0) kg/m 2, respectively. The AUROC for diagnosing advanced fibrosis was 0.981 for 3D-MRE at 40 Hz, 0.927 for 3D-MRE at 60 Hz (standard shear-wave frequency), and 0.921 for 2D-MRE at 60 Hz (standard shear-wave frequency). At a threshold of 2.43 kPa, 3D-MRE at 40 Hz had sensitivity 1.0, specificity 0.94, positive predictive value 0.72, and negative predictive value 1.0 for diagnosing advanced fibrosis. 3D-MRE at 40 Hz had significantly higher AUROC (P<0.05) than 2D-MRE at 60 Hz for diagnosing advanced fibrosis. CONCLUSIONS: Utilizing a prospective study design, we demonstrate that 3D MRE at 40 Hz has the highest diagnostic accuracy in diagnosing NAFLD advanced fibrosis. Both 2D- and 3D-MRE at 60 Hz, the standard shear-wave frequency, are also highly accurate in diagnosing NAFLD advanced fibrosis.",

author = "Rohit Loomba and Jeffrey Cui and Tanya Wolfson and William Haufe and Jonathan Hooker and Nikolaus Szeverenyi and Brandon Ang and Archana Bhatt and Kang Wang and Hamed Aryafar and Cindy Behling and Valasek, {Mark A.} and Lin, {Grace Y.} and Anthony Gamst and Brenner, {David A.} and Meng Yin and Glaser, {Kevin J.} and Ehman, {Richard L.} and Sirlin, {Claude B.}",

note = "Publisher Copyright: {\textcopyright} 2016 by the American College of Gastroenterology.",

year = "2016",

month = jul,

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doi = "10.1038/ajg.2016.65",

language = "English (US)",

volume = "111",

pages = "986--994",

journal = "American Journal of Gastroenterology",

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T1 - Novel 3D Magnetic Resonance Elastography for the Noninvasive Diagnosis of Advanced Fibrosis in NAFLD

T2 - A Prospective Study

AU - Loomba, Rohit

AU - Cui, Jeffrey

AU - Wolfson, Tanya

AU - Haufe, William

AU - Hooker, Jonathan

AU - Szeverenyi, Nikolaus

AU - Ang, Brandon

AU - Bhatt, Archana

AU - Wang, Kang

AU - Aryafar, Hamed

AU - Behling, Cindy

AU - Valasek, Mark A.

AU - Lin, Grace Y.

AU - Gamst, Anthony

AU - Brenner, David A.

AU - Yin, Meng

AU - Glaser, Kevin J.

AU - Ehman, Richard L.

AU - Sirlin, Claude B.

PY - 2016/7/1

Y1 - 2016/7/1

N2 - OBJECTIVES: Recent studies show two-dimensional (2D)-magnetic resonance elastography (MRE) is accurate in diagnosing advanced fibrosis (stages 3 and 4) in nonalcoholic fatty liver disease (NAFLD) patients. Three-dimensional (3D)-MRE is a more advanced version of the technology that can image shear-wave fields in 3D of the entire liver. The aim of this study was to prospectively compare the diagnostic accuracy of 3D-MRE and 2D-MRE for diagnosing advanced fibrosis in patients with biopsy-proven NAFLD. METHODS: This cross-sectional analysis of a prospective study included 100 consecutive patients (56% women) with biopsy-proven NAFLD who also underwent MRE. Area under the receiver operating characteristic (AUROC) analysis was performed to assess the accuracy of 2D- and 3D-MRE in diagnosing advanced fibrosis. RESULTS: The mean (±s.d.) of age and body mass index were 50.2 (±13.6) years and 32.1 (±5.0) kg/m 2, respectively. The AUROC for diagnosing advanced fibrosis was 0.981 for 3D-MRE at 40 Hz, 0.927 for 3D-MRE at 60 Hz (standard shear-wave frequency), and 0.921 for 2D-MRE at 60 Hz (standard shear-wave frequency). At a threshold of 2.43 kPa, 3D-MRE at 40 Hz had sensitivity 1.0, specificity 0.94, positive predictive value 0.72, and negative predictive value 1.0 for diagnosing advanced fibrosis. 3D-MRE at 40 Hz had significantly higher AUROC (P<0.05) than 2D-MRE at 60 Hz for diagnosing advanced fibrosis. CONCLUSIONS: Utilizing a prospective study design, we demonstrate that 3D MRE at 40 Hz has the highest diagnostic accuracy in diagnosing NAFLD advanced fibrosis. Both 2D- and 3D-MRE at 60 Hz, the standard shear-wave frequency, are also highly accurate in diagnosing NAFLD advanced fibrosis.

AB - OBJECTIVES: Recent studies show two-dimensional (2D)-magnetic resonance elastography (MRE) is accurate in diagnosing advanced fibrosis (stages 3 and 4) in nonalcoholic fatty liver disease (NAFLD) patients. Three-dimensional (3D)-MRE is a more advanced version of the technology that can image shear-wave fields in 3D of the entire liver. The aim of this study was to prospectively compare the diagnostic accuracy of 3D-MRE and 2D-MRE for diagnosing advanced fibrosis in patients with biopsy-proven NAFLD. METHODS: This cross-sectional analysis of a prospective study included 100 consecutive patients (56% women) with biopsy-proven NAFLD who also underwent MRE. Area under the receiver operating characteristic (AUROC) analysis was performed to assess the accuracy of 2D- and 3D-MRE in diagnosing advanced fibrosis. RESULTS: The mean (±s.d.) of age and body mass index were 50.2 (±13.6) years and 32.1 (±5.0) kg/m 2, respectively. The AUROC for diagnosing advanced fibrosis was 0.981 for 3D-MRE at 40 Hz, 0.927 for 3D-MRE at 60 Hz (standard shear-wave frequency), and 0.921 for 2D-MRE at 60 Hz (standard shear-wave frequency). At a threshold of 2.43 kPa, 3D-MRE at 40 Hz had sensitivity 1.0, specificity 0.94, positive predictive value 0.72, and negative predictive value 1.0 for diagnosing advanced fibrosis. 3D-MRE at 40 Hz had significantly higher AUROC (P<0.05) than 2D-MRE at 60 Hz for diagnosing advanced fibrosis. CONCLUSIONS: Utilizing a prospective study design, we demonstrate that 3D MRE at 40 Hz has the highest diagnostic accuracy in diagnosing NAFLD advanced fibrosis. Both 2D- and 3D-MRE at 60 Hz, the standard shear-wave frequency, are also highly accurate in diagnosing NAFLD advanced fibrosis.

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Novel 3D Magnetic Resonance Elastography for the Noninvasive Diagnosis of Advanced Fibrosis in NAFLD: A Prospective Study

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