Korean Journal of Radiology

  • 제18권3호
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  • Pages.444-451
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  • 2017
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Quantitative Measurement of Hepatic Fibrosis with Gadoxetic Acid-Enhanced Magnetic Resonance Imaging in Patients with Chronic Hepatitis B Infection: A Comparative Study on Aspartate Aminotransferase to Platelet Ratio Index and Fibrosis-4 Index

  • Lee, Guy Mok (Department of Radiology, Wonkwang University School of Medicine) ;
  • Kim, Youe Ree (Department of Radiology, Wonkwang University School of Medicine) ;
  • Ryu, Jong Hyun (Imaging Science Research Center, Wonkwang University) ;
  • Kim, Tae-Hoon (Imaging Science Research Center, Wonkwang University) ;
  • Cho, Eun Young (Department of Internal Medicine, Wonkwang University School of Medicine) ;
  • Lee, Young Hwan (Department of Radiology, Wonkwang University School of Medicine) ;
  • Yoon, Kwon-Ha (Department of Radiology, Wonkwang University School of Medicine)
  • 투고 : 2016.09.07
  • 심사 : 2016.12.19
  • 발행 : 2017.06.01
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: To quantitatively measure hepatic fibrosis on gadoxetic acid-enhanced magnetic resonance (MR) in chronic hepatitis B (CHB) patients and identify the correlations with aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 index (FIB-4) values. Materials and Methods: This study on gadoxetic acid-enhanced 3T MR imaging included 81 patients with CHB infection. To quantitatively measure hepatic fibrosis, MR images were analyzed with an aim to identify inhomogeneous signal intensities calculated from a coefficient of variation (CV) map in the liver parenchyma. We also carried out a comparative analysis between APRI and FIB-4 based on metaregression results. The diagnostic performance of the CV map was evaluated using a receiver-operating characteristic (ROC) curve. Results: In the MR images, the mean CV values in control, groups I, II, and III based on APRI were $4.08{\pm}0.92$, $4.24{\pm}0.80$, $5.64{\pm}1.11$, and $5.73{\pm}1.28$, respectively (p < 0.001). In CHB patients grouped by FIB-4, the mean CV values of groups A, B, and C were $4.22{\pm}0.95$, $5.40{\pm}1.19$, and $5.71{\pm}1.17$, respectively (p < 0.001). The mean CV values correlated well with APRI (r = 0.392, p < 0.001) and FIB-4 (r = 0.294, p < 0.001). In significant fibrosis group, ROC curve analysis yielded an area under the curve of 0.875 using APRI and 0.831 using FIB-4 in HB, respectively. Conclusion: Gadoxetic acid-enhanced MR imaging for calculating a CV map showed moderate correlation with APRI and FIB-4 values and could be employed to quantitatively measure hepatic fibrosis in patients with CHB.

키워드

과제정보

연구 과제 주관 기관 : Ministry of Health & Welfare

참고문헌

  1. Korean Liver Cancer Study Group (KLCSG); National Cancer Center, Korea (NCC). 2014 Korean Liver Cancer Study Group-National Cancer Center Korea practice guideline for the management of hepatocellular carcinoma. Korean J Radiol 2015;16:465-522 https://doi.org/10.3348/kjr.2015.16.3.465
  2. Ganem D, Prince AM. Hepatitis B virus infection--natural history and clinical consequences. N Engl J Med 2004;350:1118-1129 https://doi.org/10.1056/NEJMra031087
  3. Afdhal NH, Nunes D. Evaluation of liver fibrosis: a concise review. Am J Gastroenterol 2004;99:1160-1174 https://doi.org/10.1111/j.1572-0241.2004.30110.x
  4. Yoon JH, Park JW, Lee JM. Noninvasive diagnosis of hepatocellular carcinoma: elaboration on Korean Liver Cancer Study Group-National Cancer Center Korea Practice Guidelines compared with other guidelines and remaining issues. Korean J Radiol 2016;17:7-24 https://doi.org/10.3348/kjr.2016.17.1.7
  5. Bedossa P, Dargere D, Paradis V. Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology 2003;38:1449-1457 https://doi.org/10.1053/jhep.2003.09022
  6. Cadranel JF, Rufat P, Degos F. Practices of liver biopsy in France: results of a prospective nationwide survey. For the Group of Epidemiology of the French Association for the Study of the Liver (AFEF). Hepatology 2000;32:477-481 https://doi.org/10.1053/jhep.2000.16602
  7. Kim BK, Kim SA, Park YN, Cheong JY, Kim HS, Park JY, et al. Noninvasive models to predict liver cirrhosis in patients with chronic hepatitis B. Liver Int 2007;27:969-976 https://doi.org/10.1111/j.1478-3231.2007.01519.x
  8. Motosugi U, Ichikawa T, Sou H, Sano K, Tominaga L, Kitamura T, et al. Liver parenchymal enhancement of hepatocytephase images in Gd-EOB-DTPA-enhanced MR imaging: which biological markers of the liver function affect the enhancement? J Magn Reson Imaging 2009;30:1042-1046 https://doi.org/10.1002/jmri.21956
  9. Wai CT, Greenson JK, Fontana RJ, Kalbfleisch JD, Marrero JA, Conjeevaram HS, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology 2003;38:518-526
  10. Shin WG, Park SH, Jang MK, Hahn TH, Kim JB, Lee MS, et al. Aspartate aminotransferase to platelet ratio index (APRI) can predict liver fibrosis in chronic hepatitis B. Dig Liver Dis 2008;40:267-274 https://doi.org/10.1016/j.dld.2007.10.011
  11. Xiao G, Yang J, Yan L. Comparison of diagnostic accuracy of aspartate aminotransferase to platelet ratio index and fibrosis-4 index for detecting liver fibrosis in adult patients with chronic hepatitis B virus infection: a systemic review and meta-analysis. Hepatology 2015;61:292-302 https://doi.org/10.1002/hep.27382
  12. Geier A, Dietrich CG, Voigt S, Kim SK, Gerloff T, Kullak-Ublick GA, et al. Effects of proinflammatory cytokines on rat organic anion transporters during toxic liver injury and cholestasis. Hepatology 2003;38:345-354
  13. Kim SM, Heo SH, Kim JW, Lim HS, Shin SS, Jeong YY, et al. Hepatic arterial phase on gadoxetic acid-enhanced liver MR imaging: a randomized comparison of 0.5 mL/s and 1 mL/s injection rates. Korean J Radiol 2014;15:605-612 https://doi.org/10.3348/kjr.2014.15.5.605
  14. Tsuboyama T, Onishi H, Kim T, Akita H, Hori M, Tatsumi M, et al. Hepatocellular carcinoma: hepatocyte-selective enhancement at gadoxetic acid-enhanced MR imaging--correlation with expression of sinusoidal and canalicular transporters and bile accumulation. Radiology 2010;255:824-833 https://doi.org/10.1148/radiol.10091557
  15. Van Beers BE, Pastor CM, Hussain HK. Primovist, Eovist: what to expect? J Hepatol 2012;57:421-429 https://doi.org/10.1016/j.jhep.2012.01.031
  16. Kim H, Park SH, Kim EK, Kim MJ, Park YN, Park HJ, et al. Histogram analysis of gadoxetic acid-enhanced MRI for quantitative hepatic fibrosis measurement. PLoS One 2014;9:e114224 https://doi.org/10.1371/journal.pone.0114224
  17. Kanki A, Tamada T, Higaki A, Noda Y, Tanimoto D, Sato T, et al. Hepatic parenchymal enhancement at Gd-EOB-DTPAenhanced MR imaging: correlation with morphological grading of severity in cirrhosis and chronic hepatitis. Magn Reson Imaging 2012;30:356-360 https://doi.org/10.1016/j.mri.2011.11.002
  18. Tamada T, Ito K, Higaki A, Yoshida K, Kanki A, Sato T, et al. Gd-EOB-DTPA-enhanced MR imaging: evaluation of hepatic enhancement effects in normal and cirrhotic livers. Eur J Radiol 2011;80:e311-e316 https://doi.org/10.1016/j.ejrad.2011.01.020
  19. Sato Y, Matsushima S, Inaba Y, Sano T, Yamaura H, Kato M, et al. Preoperative estimation of future remnant liver function following portal vein embolization using relative enhancement on gadoxetic acid disodium-enhanced magnetic resonance imaging. Korean J Radiol 2015;16:523-530 https://doi.org/10.3348/kjr.2015.16.3.523
  20. Huh J, Kim SY, Yeh BM, Lee SS, Kim KW, Wu EH, et al. Troubleshooting arterial-phase MR images of gadoxetate disodium-enhanced liver. Korean J Radiol 2015;16:1207-1215 https://doi.org/10.3348/kjr.2015.16.6.1207
  21. Li C, Huang R, Ding Z, Gatenby JC, Metaxas DN, Gore JC. A level set method for image segmentation in the presence of intensity inhomogeneities with application to MRI. IEEE Trans Image Process 2011;20:2007-2016 https://doi.org/10.1109/TIP.2011.2146190
  22. Roth M, Obaidat A, Hagenbuch B. OATPs, OATs and OCTs: the organic anion and cation transporters of the SLCO and SLC22A gene superfamilies. Br J Pharmacol 2012;165:1260-1287 https://doi.org/10.1111/j.1476-5381.2011.01724.x
  23. Chen ZS, Tiwari AK. Multidrug resistance proteins (MRPs/ABCCs) in cancer chemotherapy and genetic diseases. FEBS J 2011;278:3226-3245 https://doi.org/10.1111/j.1742-4658.2011.08235.x
  24. Leonhardt M, Keiser M, Oswald S, Kuhn J, Jia J, Grube M, et al. Hepatic uptake of the magnetic resonance imaging contrast agent Gd-EOB-DTPA: role of human organic anion transporters. Drug Metab Dispos 2010;38:1024-1028 https://doi.org/10.1124/dmd.110.032862
  25. Schmitt M, Kubitz R, Wettstein M, vom Dahl S, Haussinger D. Retrieval of the MRP2 gene encoded conjugate export pump from the canalicular membrane contributes to cholestasis induced by tert-butyl hydroperoxide and chlorodinitrobenzene. Biol Chem 2000;381:487-495
  26. Beuers U, Bilzer M, Chittattu A, Kullak-Ublick GA, Keppler D, Paumgartner G, et al. Tauroursodeoxycholic acid inserts the apical conjugate export pump, MRP2, into canalicular membranes and stimulates organic anion secretion by protein kinase C-dependent mechanisms in cholestatic rat liver. Hepatology 2001;33:1206-1216 https://doi.org/10.1053/jhep.2001.24034
  27. Atzori L, Poli G, Perra A. Hepatic stellate cell: a star cell in the liver. Int J Biochem Cell Biol 2009;41:1639-1642 https://doi.org/10.1016/j.biocel.2009.03.001
  28. Chen BB, Hsu CY, Yu CW, Wei SY, Kao JH, Lee HS, et al. Dynamic contrast-enhanced magnetic resonance imaging with Gd-EOB-DTPA for the evaluation of liver fibrosis in chronic hepatitis patients. Eur Radiol 2012;22:171-180 https://doi.org/10.1007/s00330-011-2249-5
  29. Tsuda N, Matsui O. Cirrhotic rat liver: reference to transporter activity and morphologic changes in bile canaliculi--gadoxetic acid-enhanced MR imaging. Radiology 2010;256:767-773 https://doi.org/10.1148/radiol.10092065
  30. Chon YE, Choi EH, Song KJ, Park JY, Kim DY, Han KH, et al. Performance of transient elastography for the staging of liver fibrosis in patients with chronic hepatitis B: a meta-analysis. PLoS One 2012;7:e44930 https://doi.org/10.1371/journal.pone.0044930
  31. Shi Y, Guo Q, Xia F, Dzyubak B, Glaser KJ, Li Q, et al. MR elastography for the assessment of hepatic fibrosis in patients with chronic hepatitis B infection: does histologic necroinflammation influence the measurement of hepatic stiffness? Radiology 2014;273:88-98 https://doi.org/10.1148/radiol.14132592
  32. Liu J, Ji Y, Ai H, Ning B, Zhao J, Zhang Y, et al. Liver shearwave velocity and serum fibrosis markers to diagnose hepatic fibrosis in patients with chronic viral hepatitis B. Korean J Radiol 2016;17:396-404 https://doi.org/10.3348/kjr.2016.17.3.396
  33. Yoo H, Lee JM, Yoon JH, Lee DH, Chang W, Han JK. Prospective comparison of liver stiffness measurements between two point shear wave elastography methods: virtual touch quantification and elastography point quantification. Korean J Radiol 2016;17:750-757 https://doi.org/10.3348/kjr.2016.17.5.750

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  2. Assessment of Liver Fibrosis Stage Using Integrative Analysis of Hepatic Heterogeneity and Nodularity in Routine MRI with FIB-4 Index as Reference Standard vol.10, pp.8, 2017, https://doi.org/10.3390/jcm10081697