Prospective study of quantitative liver MRI in cystic fibrosis: feasibility and comparison to PUSH cohort ultrasound
Authors:
Alexander J. Towbin, Wen Ye, Suiyuan Huang, Boaz W. Karmazyn, Jean P. Molleston, Prakash Masand, Daniel H. Leung, Samuel Chang, Michael R. Narkewicz, Adina L. Alazraki, A. Jay Freeman, Randolph K. Otto, Nicole Green, Ihab R. Kamel, Wikrom W. Karnsakul, John C. Magee, Jean Tkach, Joseph J. Palermo
Pediatric radiologists can identify a liver ultrasound (US) pattern predictive of progression to advanced liver disease. However, reliably discriminating these US patterns remains difficult. Quantitative magnetic resonance imaging (MRI) may provide an objective measure of liver disease in cystic fibrosis (CF).
Objective
The purpose of this study was to determine if quantitative MRI, including MR elastography, is feasible in children with CF and to determine how quantitative MRI-derived metrics compared to a research US.
Materials and methods
A prospective, multi-institutional trial was performed evaluating CF participants who underwent a standardized MRI. At central review, liver stiffness, fat fraction, liver volume, and spleen volume were obtained. Participants whose MRI was performed within 1 year of US were classified by US pattern as normal, homogeneous hyperechoic, heterogeneous, or nodular. Each MRI measure was compared among US grade groups using the Kruskal–Wallis test.
Results
Ninety-three participants (51 females [54.8%]; mean 15.6 years [range 8.1–21.7 years]) underwent MRI. MR elastography was feasible in 87 participants (93.5%). Fifty-eight participants had an US within 1 year of MRI. In these participants, a nodular liver had significantly higher stiffness (P<0.01) than normal or homogeneous hyperechoic livers. Participants with a homogeneous hyperechoic liver had a higher fat fraction (P<0.005) than others.
Conclusion
MR elastography is feasible in children with CF. Participants with a nodular pattern had higher liver stiffness supporting the US determination of advanced liver disease. Participants with a homogeneous hyperechoic pattern had higher fat fractions supporting the diagnosis of steatosis.
Prospective study of quantitative liver MRI in cystic fibrosis: feasibility and comparison to PUSH cohort ultrasound
Authors
Alexander J. Towbin Wen Ye Suiyuan Huang Boaz W. Karmazyn Jean P. Molleston Prakash Masand Daniel H. Leung Samuel Chang Michael R. Narkewicz Adina L. Alazraki A. Jay Freeman Randolph K. Otto Nicole Green Ihab R. Kamel Wikrom W. Karnsakul John C. Magee Jean Tkach Joseph J. Palermo