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Non-invasive assessment of hepatic fibrosis: comparison of MR elastography to transient elastography and intravoxel incoherent motion diffusion-weighted MRI

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Abstract

Objective

To compare the ability of MR elastography (MRE) with transient elastography (TE) and intravoxel incoherent motion (IVIM) diffusion-weighted MRI in staging hepatic fibrosis (HF).

Materials and methods

100 patients with chronic liver disease and 25 healthy volunteers underwent preoperative MRE, IVIM on a 3T MRI unit, and ultrasound-based TE. Liver stiffness measurement from MRE (LSM-MRE) and liver stiffness measurement from TE (LSM-TE) were measured; four diffusion parameters including the true diffusion coefficient (Dt), pseudo-diffusion coefficient, perfusion fraction (f), and apparent diffusion coefficient (ADC) were calculated. Receiver operating characteristic (ROC) curves were performed for significant parameters to compare the diagnosis performance for detecting HF.

Results

LSM-MRE and LSM-TE values showed positive correlation with the fibrosis stage (r = 0.910 and 0.813, P < 0.001). Dt, f, and ADC values showed negative correlation with the fibrosis stage (r = − 0.727, − 0.503, and − 0.601, all P < 0.001). The area under the ROC curve (AUC) of LSM-MRE (AUC = 0.965, 0.957, 0.983) was significantly higher than that of LSM-TE (AUC = 0.906, 0.913, 0.931) and Dt (AUC = 0.875, 0.879, 0.861) in discriminating significant HF (≥ F2), advanced HF (≥ F3), or cirrhosis (F4) (all P < 0.05). Although LSM-TE showed higher AUCs than Dt in detecting fibrosis stages, there were no significant differences between LSM-TE and Dt (P > 0.05) except for detecting F4 (P < 0.05).

Conclusion

MRE shows excellent diagnostic performance for predicting significant fibrosis, advanced fibrosis compared with TE and IVIM, while TE and IVIM have comparable diagnostic performance.

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Acknowledgements

This work was supported by the National Key R&D Program of China (2017YFE0103600), National Natural Science Foundation of China (81720108021, 81772009, 81601466, 81641168, 31470047), and Scientific and Technological Research Project of Henan Province (182102310162).

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Author notes

  1. Fangfang Fu and Xiaodong Li have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Henan Provincial People’s Hospital, No. 7 Weiwu Road, Zhengzhou, Henan, 450003, China

    Fangfang Fu, Xiaodong Li, Cuiyun Chen, Yan Bai, Dapeng Shi & Meiyun Wang

  2. Department of Pathology, Henan Provincial People’s Hospital, Zhengzhou, Henan, 450003, China

    Qiuyu Liu

  3. Department of Infectious Diseases, Henan Provincial People’s Hospital, Zhengzhou, Henan, 450003, China

    Jia Sang

  4. Department of MR Research China, GE Healthcare, Beijing, 100000, China

    Kaiyu Wang

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  1. Fangfang Fu
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Fu, F., Li, X., Chen, C. et al. Non-invasive assessment of hepatic fibrosis: comparison of MR elastography to transient elastography and intravoxel incoherent motion diffusion-weighted MRI. Abdom Radiol 45, 73–82 (2020). https://doi.org/10.1007/s00261-019-02140-x

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