Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Staging of Hepatic Fibrosis: Comparison of Magnetic Resonance Elastography and Shear Wave Elastography in the Same Individuals

  • Yoon, Jeong Hee (Department of Radiology, Seoul National University College of Medicine) ;
  • Lee, Jeong Min (Department of Radiology, Seoul National University College of Medicine) ;
  • Woo, Hyun Sik (Department of Radiology, Seoul National University College of Medicine) ;
  • Yu, Mi Hye (Department of Radiology, Seoul National University College of Medicine) ;
  • Joo, Ijin (Department of Radiology, Seoul National University College of Medicine) ;
  • Lee, Eun Sun (Department of Radiology, Seoul National University College of Medicine) ;
  • Sohn, Ji Young (Department of Radiology, Seoul National University College of Medicine) ;
  • Lee, Kyung Boon (Department of Pathology, Seoul National University Hospital) ;
  • Han, Joon Koo (Department of Radiology, Seoul National University College of Medicine) ;
  • Choi, Byung Ihn (Department of Radiology, Seoul National University College of Medicine)
  • Published : 2013.04.01
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Abstract

Objective: To cross-validate liver stiffness (LS) measured on shear wave elastography (SWE) and on magnetic resonance elastography (MRE) in the same individuals. Materials and Methods: We included 94 liver transplantation (LT) recipients and 114 liver donors who underwent either MRE or SWE before surgery or biopsy. We determined the technical success rates and the incidence of unreliable LS measurements (LSM) of SWE and MRE. Among the 69 patients who underwent both MRE and SWE, the median and coefficient of variation (CV) of the LSM from each examination were compared and correlated. Areas under the receiver operating characteristic curve in both examinations were calculated in order to exclude the presence of hepatic fibrosis (HF). Results: The technical success rates of MRE and SWE were 96.4% and 92.2%, respectively (p = 0.17), and all of the technical failures occurred in LT recipients. SWE showed 13.1% unreliable LSM, whereas MRE showed no such case (p < 0.05). There was moderate correlation in the LSM in both examinations (r = 0.67). SWE showed a significantly larger median LSM and CV than MRE. Both examinations showed similar diagnostic performance for excluding HF (Az; 0.989, 1.000, respectively). Conclusion: MRE and SWE show moderate correlation in their LSMs, although SWE shows higher incidence of unreliable LSMs in cirrhotic liver.

Keywords

References

  1. Castera, L,Invasive and non-invasive methods for the assessment of fibrosis and disease progression in chronic liver disease, Best Pract Res Clin Gastroenterol, 25, 1, 291-303(2011)
  2. Taouli, B, Ehman, RL, Reeder, SB,Advanced MRI methods for assessment of chronic liver disease, AJR Am J Roentgenol, 193, 2, 14-27(2009) https://doi.org/10.2214/AJR.09.2601
  3. Tsochatzis, EA, Bosch, J, Burroughs, AK,New therapeutic paradigm for patients with cirrhosis, Hepatology, 56, 3, 1983-1992(2012) https://doi.org/10.1002/hep.25915
  4. Rockey, DC,Noninvasive assessment of liver fibrosis and portal hypertension with transient elastography, Gastroenterology, 134, 4, 8-14(2008) https://doi.org/10.1053/j.gastro.2007.11.053
  5. Han, KH, Yoon, KT,New diagnostic method for liver fibrosis and cirrhosis, Intervirology, 51, 5, 11-16(2008) https://doi.org/10.1159/000122594
  6. Castera, L,Noninvasive methods to assess liver disease in patients with hepatitis B or C, Gastroenterology, 142, 6, 1293-1302.e4(2012) https://doi.org/10.1053/j.gastro.2012.02.017
  7. Bravo, AA, Sheth, SG, Chopra, S,Liver biopsy, N Engl J Med, 344, 7, 495-500(2001) https://doi.org/10.1056/NEJM200102153440706
  8. McGill, DB, Rakela, J, Zinsmeister, AR, Ott, BJ,A 21-year experience with major hemorrhage after percutaneous liver biopsy, Gastroenterology, 99, 8, 1396-1400(1990) https://doi.org/10.1016/0016-5085(90)91167-5
  9. Van Thiel, DH, Gavaler, JS, Wright, H, Tzakis, A,Liver biopsy. Its safety and complications as seen at a liver transplant center, Transplantation, 55, 9, 1087-1090(1993) https://doi.org/10.1097/00007890-199305000-00029
  10. Friedman, SL,Liver fibrosis -- from bench to bedside, J Hepatol, 38, 10, S38-S53(2003)
  11. Kim, BH, Lee, JM, Lee, YJ, Lee, KB, Suh, KS, Han, JK,MR elastography for noninvasive assessment of hepatic fibrosis: experience from a tertiary center in Asia, J Magn Reson Imaging, 34, 11, 1110-1116(2011) https://doi.org/10.1002/jmri.22723
  12. Bonekamp, S, Torbenson, MS, Kamel, IR,Diffusion-weighted magnetic resonance imaging for the staging of liver fibrosis, J Clin Gastroenterol, 45, 12, 885-892(2011) https://doi.org/10.1097/MCG.0b013e318223bd2c
  13. Faria, SC, Ganesan, K, Mwangi, I, Shiehmorteza, M, Viamonte, B, Mazhar, S,MR imaging of liver fibrosis: current state of the art, Radiographics, 29, 13, 1615-1635(2009) https://doi.org/10.1148/rg.296095512
  14. Friedrich-Rust, M, Nierhoff, J, Lupsor, M, Sporea, I, Fierbinteanu-Braticevici, C, Strobel, D,Performance of Acoustic Radiation Force Impulse imaging for the staging of liver fibrosis: a pooled meta-analysis, J Viral Hepat, 19, 14, e212-e219(2012) https://doi.org/10.1111/j.1365-2893.2011.01537.x
  15. Tang, A, Kim, TK, Heathcote, J, Guindi, M, Jang, HJ, Karshafian, R,Does hepatic vein transit time performed with contrast-enhanced ultrasound predict the severity of hepatic fibrosis?, Ultrasound Med Biol, 37, 15, 1963-1969(2011) https://doi.org/10.1016/j.ultrasmedbio.2011.09.010
  16. Bavu, E, Gennisson, JL, Couade, M, Bercoff, J, Mallet, V, Fink, M,Noninvasive in vivo liver fibrosis evaluation using supersonic shear imaging: a clinical study on 113 hepatitis C virus patients, Ultrasound Med Biol, 37, 16, 1361-1373(2011) https://doi.org/10.1016/j.ultrasmedbio.2011.05.016
  17. Huwart, L, Sempoux, C, Salameh, N, Jamart, J, Annet, L, Sinkus, R,Liver fibrosis: noninvasive assessment with MR elastography versus aspartate aminotransferase-to-platelet ratio index, Radiology, 245, 17, 458-466(2007) https://doi.org/10.1148/radiol.2452061673
  18. Stebbing, J, Farouk, L, Panos, G, Anderson, M, Jiao, LR, Mandalia, S,A meta-analysis of transient elastography for the detection of hepatic fibrosis, J Clin Gastroenterol, 44, 18, 214-219(2010) https://doi.org/10.1097/MCG.0b013e3181b4af1f
  19. Tsochatzis, EA, Gurusamy, KS, Ntaoula, S, Cholongitas, E, Davidson, BR, Burroughs, AK,Elastography for the diagnosis of severity of fibrosis in chronic liver disease: a meta-analysis of diagnostic accuracy, J Hepatol, 54, 19, 650-659(2011) https://doi.org/10.1016/j.jhep.2010.07.033
  20. Castera, L, Foucher, J, Bernard, PH, Carvalho, F, Allaix, D, Merrouche, W,Pitfalls of liver stiffness measurement: a 5-year prospective study of 13,369 examinations, Hepatology, 51, 20, 828-835(2010)
  21. Lalitha, P, Reddy, MCh, Reddy, KJ,Musculoskeletal applications of elastography: a pictorial essay of our initial experience, Korean J Radiol, 12, 21, 365-375(2011) https://doi.org/10.3348/kjr.2011.12.3.365
  22. Cho, N, Moon, WK, Park, JS, Cha, JH, Jang, M, Seong, MH,Nonpalpable breast masses: evaluation by US elastography, Korean J Radiol, 9, 22, 111-118(2008) https://doi.org/10.3348/kjr.2008.9.2.111
  23. Lee, TH, Cha, SW, Cho, YD,EUS elastography: advances in diagnostic EUS of the pancreas, Korean J Radiol, 13, 23, S12-S16(2012) https://doi.org/10.3348/kjr.2012.13.S1.S12
  24. Rouviere, O, Yin, M, Dresner, MA, Rossman, PJ, Burgart, LJ, Fidler, JL,MR elastography of the liver: preliminary results, Radiology, 240, 24, 440-448(2006) https://doi.org/10.1148/radiol.2402050606
  25. Rustogi, R, Horowitz, J, Harmath, C, Wang, Y, Chalian, H, Ganger, DR,Accuracy of MR elastography and anatomic MR imaging features in the diagnosis of severe hepatic fibrosis and cirrhosis, J Magn Reson Imaging, 35, 25, 1356-1364(2012) https://doi.org/10.1002/jmri.23585
  26. Myers, RP, Pomier-Layrargues, G, Kirsch, R, Pollett, A, Beaton, M, Levstik, M,Discordance in fibrosis staging between liver biopsy and transient elastography using the FibroScan XL probe, J Hepatol, 56, 26, 564-570(2012) https://doi.org/10.1016/j.jhep.2011.10.007
  27. Bercoff, J, Tanter, M, Fink, M,Supersonic shear imaging: a new technique for soft tissue elasticity mapping, IEEE Trans Ultrason Ferroelectr Freq Control, 51, 27, 396-409(2004) https://doi.org/10.1109/TUFFC.2004.1295425
  28. Tanter, M, Bercoff, J, Athanasiou, A, Deffieux, T, Gennisson, JL, Montaldo, G,Quantitative assessment of breast lesion viscoelasticity: initial clinical results using supersonic shear imaging, Ultrasound Med Biol, 34, 28, 1373-1386(2008) https://doi.org/10.1016/j.ultrasmedbio.2008.02.002
  29. Myers, RP, Pomier-Layrargues, G, Kirsch, R, Pollett, A, Duarte-Rojo, A, Wong, D,Feasibility and diagnostic performance of the FibroScan XL probe for liver stiffness measurement in overweight and obese patients, Hepatology, 55, 29, 199-208(2012) https://doi.org/10.1002/hep.24624
  30. Venkatesh, SK, Yin, M, Glockner, JF, Takahashi, N, Araoz, PA, Talwalkar, JA,MR elastography of liver tumors: preliminary results, AJR Am J Roentgenol, 190, 30, 1534-1540(2008) https://doi.org/10.2214/AJR.07.3123
  31. Yin, M, Talwalkar, JA, Glaser, KJ, Manduca, A, Grimm, RC, Rossman, PJ,Assessment of hepatic fibrosis with magnetic resonance elastography, Clin Gastroenterol Hepatol, 5, 31, 1207-1213.e2(2007) https://doi.org/10.1016/j.cgh.2007.06.012
  32. Manduca, A, Oliphant, TE, Dresner, MA, Mahowald, JL, Kruse, SA, Amromin, E,Magnetic resonance elastography: non-invasive mapping of tissue elasticity, Med Image Anal, 5, 32, 237-254(2001) https://doi.org/10.1016/S1361-8415(00)00039-6
  33. Hines, CD, Bley, TA, Lindstrom, MJ, Reeder, SB,Repeatability of magnetic resonance elastography for quantification of hepatic stiffness, J Magn Reson Imaging, 31, 33, 725-731(2010) https://doi.org/10.1002/jmri.22066
  34. Bedossa, P, Poynard, T,An algorithm for the grading of activity in chronic hepatitis C, Hepatology, 24, 34, 289-293(1996) https://doi.org/10.1002/hep.510240201
  35. French METAVIR Cooperative Study Group, The,Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C, Hepatology, 20, 35, 15-20(1994) https://doi.org/10.1002/hep.1840200104
  36. De Groote, J, Desmet, VJ, Gedigk, P, Korb, G, Popper, H, Poulsen, H,A classification of chronic hepatitis, Lancet, 2, 36, 626-628(1968)
  37. Euser, AM, Dekker, FW, le Cessie, S,A practical approach to Bland-Altman plots and variation coefficients for log transformed variables, J Clin Epidemiol, 61, 37, 978-982(2008) https://doi.org/10.1016/j.jclinepi.2007.11.003
  38. Bland, JM, Altman, DG,Comparing methods of measurement: why plotting difference against standard method is misleading, Lancet, 346, 38, 1085-1087(1995) https://doi.org/10.1016/S0140-6736(95)91748-9
  39. Bland, JM, Altman, DG,Agreed statistics: measurement method comparison, Anesthesiology, 116, 39, 182-185(2012) https://doi.org/10.1097/ALN.0b013e31823d7784
  40. Motosugi, U, Ichikawa, T, Amemiya, F, Sou, H, Sano, K, Muhi, A,Cross-validation of MR elastography and ultrasound transient elastography in liver stiffness measurement: discrepancy in the results of cirrhotic liver, J Magn Reson Imaging, 35, 40, 607-610(2012) https://doi.org/10.1002/jmri.22845
  41. Oudry, J, Chen, J, Glaser, KJ, Miette, V, Sandrin, L, Ehman, RL,Cross-validation of magnetic resonance elastography and ultrasound-based transient elastography: a preliminary phantom study, J Magn Reson Imaging, 30, 41, 1145-1150(2009) https://doi.org/10.1002/jmri.21929
  42. Ferraioli, G, Tinelli, C, Dal Bello, B, Zicchetti, M, Filice, G, Filice, C,Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: A pilot study, Hepatology, 56, 42, 2125-2133(2012) https://doi.org/10.1002/hep.25936
  43. Ferraioli, G, Tinelli, C, Zicchetti, M, Above, E, Poma, G, Di Gregorio, M,Reproducibility of real-time shear wave elastography in the evaluation of liver elasticity, Eur J Radiol, 81, 43, 3102-3106(2012) https://doi.org/10.1016/j.ejrad.2012.05.030
  44. Rzymski, P, Skorzewska, A, Skibinska-Zielinska, M, Opala, T,Factors influencing breast elasticity measured by the ultrasound Shear Wave elastography - preliminary results, Arch Med Sci, 7, 44, 127-133(2011)
  45. Foucher, J, Chanteloup, E, Vergniol, J, Castera, L, Le Bail, B, Adhoute, X,Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective study, Gut, 55, 45, 403-408(2006) https://doi.org/10.1136/gut.2005.069153
  46. Asbach, P, Klatt, D, Schlosser, B, Biermer, M, Muche, M, Rieger, A,Viscoelasticity-based staging of hepatic fibrosis with multifrequency MR elastography, Radiology, 257, 46, 80-86(2010) https://doi.org/10.1148/radiol.10092489
  47. Huwart, L, Sempoux, C, Vicaut, E, Salameh, N, Annet, L, Danse, E,Magnetic resonance elastography for the noninvasive staging of liver fibrosis, Gastroenterology, 135, 47, 32-40(2008) https://doi.org/10.1053/j.gastro.2008.03.076
  48. Mariappan, YK, Glaser, KJ, Ehman, RL,Magnetic resonance elastography: a review, Clin Anat, 23, 48, 497-511(2010) https://doi.org/10.1002/ca.21006
  49. Bensamoun, SF, Wang, L, Robert, L, Charleux, F, Latrive, JP, Ho Ba Tho, MC,Measurement of liver stiffness with two imaging techniques: magnetic resonance elastography and ultrasound elastometry, J Magn Reson Imaging, 28, 49, 1287-1292(2008) https://doi.org/10.1002/jmri.21523
  50. Carrion, JA, Torres, F, Crespo, G, Miquel, R, García-Valdecasas, JC, Navasa, M,Liver stiffness identifies two different patterns of fibrosis progression in patients with hepatitis C virus recurrence after liver transplantation, Hepatology, 51, 50, 23-34(2010) https://doi.org/10.1002/hep.23240
  51. Huwart, L, Peeters, F, Sinkus, R, Annet, L, Salameh, N, ter Beek, LC,Liver fibrosis: non-invasive assessment with MR elastography, NMR Biomed, 19, 51, 173-179(2006) https://doi.org/10.1002/nbm.1030
  52. Lee, DH, Lee, JM, Han, JK, Choi, BI,MR elastography of healthy liver parenchyma: Normal value and reliability of the liver stiffness value measurement, J Magn Reson Imaging, , 52, (2012)
  53. Masuzaki, R, Tateishi, R, Yoshida, H, Goto, E, Sato, T, Ohki, T,Prospective risk assessment for hepatocellular carcinoma development in patients with chronic hepatitis C by transient elastography, Hepatology, 49, 53, 1954-1961(2009) https://doi.org/10.1002/hep.22870
  54. Robic, MA, Procopet, B, Metivier, S, Peron, JM, Selves, J, Vinel, JP,Liver stiffness accurately predicts portal hypertension related complications in patients with chronic liver disease: a prospective study, J Hepatol, 55, 54, 1017-1024(2011) https://doi.org/10.1016/j.jhep.2011.01.051
  55. Chon, YE, Jung, ES, Park, JY, Y Kim, do, Ahn, SH, Han, KH,The accuracy of noninvasive methods in predicting the development of hepatocellular carcinoma and hepatic decompensation in patients with chronic hepatitis B, J Clin Gastroenterol, 46, 55, 518-525(2012) https://doi.org/10.1097/MCG.0b013e31825079f1
  56. Fung, J, Lai, CL, Seto, WK, Wong, DK, Yuen, MF,Prognostic significance of liver stiffness for hepatocellular carcinoma and mortality in HBeAg-negative chronic hepatitis B, J Viral Hepat, 18, 56, 738-744(2011) https://doi.org/10.1111/j.1365-2893.2010.01355.x

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