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European Radiology

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01-01-2021 | Fatty Liver | Hepatobiliary-Pancreas

Diagnostic value of MRI-derived liver surface nodularity score for the non-invasive quantification of hepatic fibrosis in non-alcoholic fatty liver disease

Authors: Roberta Catania, Alessandro Furlan, Andrew D. Smith, Jaideep Behari, Mitchell E. Tublin, Amir A. Borhani

Published in: European Radiology | Issue 1/2021

Abstract

Objectives

To assess the accuracy of MRI-derived liver surface nodularity (LSN) score for staging of hepatic fibrosis in patients with non-alcoholic fatty liver disease (NAFLD).

Methods

Forty-seven patients with clinicopathological diagnosis of NAFLD who underwent 1.5-T liver MRI within 12 months of liver biopsy were included. Axial non-contrast T1-weighted 3D GRE was used for image analysis. LSN of the left lobe was measured using a custom semiautomated software. Histopathologic analysis (F0–F4) served as the reference standard for staging of fibrosis. Mann-Whitney test and Spearman’s correlation coefficient were used to compare LSN scores between different stages of fibrosis and to assess the correlation. Diagnostic performance of LSN score for detection of significant (F2–F4) and advanced (F3–F4) fibrosis was assessed by receiver operating characteristics (ROC) curve. p value of less than 0.05 was considered statistically significant different.

Results

Twenty-one subjects had advanced fibrosis. The LSN scores among different stages of fibrosis were significantly different (p < 0.001). The correlation between LSN score and stage of fibrosis was also strong (ρ = 0.71; p < 0.001). The areas under ROC curves for detection of significant and advanced fibrosis were 0.80 (95% CI 0.66–0.95) and 0.86 (95% CI 0.75–0.97), using a threshold of 2.23 and 2.44, respectively. This method showed 81% sensitivity and 88% specificity for detection of advanced fibrosis.

Conclusion

MR-based LSN score is a promising non-invasive objective tool for detection of advanced fibrosis in patients with NAFLD.

Key Points

• Liver surface nodularity (LSN) score is a fast retrospective method for precise quantification of nodularity of liver surface.

• MR-based LSN score is a promising non-invasive objective tool to accurately detect different stages of fibrosis in patients with non-alcoholic fatty liver disease (NAFLD).

Younossi ZM (2019) Non-alcoholic fatty liver disease - a global public health perspective. J Hepatol 70(3):531–544. https://doi.org/10.1016/j.jhep.2018.10.033CrossRefPubMed

Li Q, Dhyani M, Grajo JR, Sirlin C, Samir AE (2018) Current status of imaging in nonalcoholic fatty liver disease. World J Hepatol 10(8):530–542. https://doi.org/10.4254/wjh.v10.i8.530CrossRefPubMedPubMedCentral

Chalasani N, Younossi Z, Lavine JE et al (2018) The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 67(1):328–357. https://doi.org/10.1002/hep.29367CrossRefPubMed

European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), European Association for the Study of Obesity (EASO) (2016) EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease. J Hepatol 64(6):1388–1402. https://doi.org/10.1016/j.jhep.2015.11.004CrossRef

Shiha G, Ibrahim A, Helmy A et al (2017) Asian-Pacific Association for the Study of the Liver (APASL) consensus guidelines on invasive and non-invasive assessment of hepatic fibrosis: a 2016 update. Hepatol Int 11(1):1–30. https://doi.org/10.1007/s12072-016-9760-3CrossRefPubMed

Ito K, Mitchell DG, Siegelman ES (2002) Cirrhosis: MR imaging features. Magn Reson Imaging Clin N Am 10(1):75–92, vi. https://doi.org/10.1016/s1064-9689(03)00050-3CrossRefPubMed

Venkatesh SK, Yin M, Takahashi N, Glockner JF, Talwalkar JA, Ehman RL (2015) Non-invasive detection of liver fibrosis: MR imaging features vs. MR elastography. Abdom Imaging 40(4):766–775. https://doi.org/10.1007/s00261-015-0347-6CrossRefPubMedPubMedCentral

Lubner MG, Pickhardt PJ (2018) Multidetector computed tomography for retrospective, noninvasive staging of liver fibrosis. Gastroenterol Clin North Am 47(3):569–584. https://doi.org/10.1016/j.gtc.2018.04.012CrossRefPubMed

Dodd GD, Baron RL, Oliver JH, Federle MP (1999) Spectrum of imaging findings of the liver in end-stage cirrhosis: part I, gross morphology and diffuse abnormalities. AJR Am J Roentgenol 173(4):1031–1036. https://doi.org/10.2214/ajr.173.4.10511173CrossRefPubMed

10.

Smith AD, Branch CR, Zand K et al (2016) Liver surface nodularity quantification from routine CT images as a biomarker for detection and evaluation of cirrhosis. Radiology 280(3):771–781. https://doi.org/10.1148/radiol.2016151542CrossRefPubMed

11.

Smith A, Varney E, Zand K et al (2018) Precision analysis of a quantitative CT liver surface nodularity score. Abdom Radiol (NY) 43(12):3307–3316. https://doi.org/10.1007/s00261-018-1617-xCrossRef

12.

Smith AD, Zand KA, Florez E et al (2017) Liver surface nodularity score allows prediction of cirrhosis decompensation and death. Radiology 283(3):711–722. https://doi.org/10.1148/radiol.2016160799CrossRef

13.

Lubner MG, Jones D, Said A, Kloke J, Lee S, Pickhardt PJ (2018) Accuracy of liver surface nodularity quantification on MDCT for staging hepatic fibrosis in patients with hepatitis C virus. Abdom Radiol (NY) 43(11):2980–2986. https://doi.org/10.1007/s00261-018-1572-6CrossRef

14.

Furlan A, Tublin ME, Yu L, Chopra KB, Lippello A, Behari J (2020) Comparison of 2D shear wave elastography, transient elastography, and MR elastography for the diagnosis of fibrosis in patients with nonalcoholic fatty liver disease. AJR Am J Roentgenol 214(1):W20–W26. https://doi.org/10.2214/AJR.19.21267CrossRefPubMed

15.

Kleiner DE, Brunt EM, Van Natta M et al (2005) Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 41(6):1313–1321. https://doi.org/10.1002/hep.20701CrossRefPubMed

16.

Kim T-H, Kim JE, Ryu J-H, Jeong C-W (2019) Development of liver surface nodularity quantification program and its clinical application in nonalcoholic fatty liver disease. Sci Rep 9(1):9994. https://doi.org/10.1038/s41598-019-46442-yCrossRefPubMedPubMedCentral

17.

Singh S, Venkatesh SK, Loomba R et al (2016) Magnetic resonance elastography for staging liver fibrosis in non-alcoholic fatty liver disease: a diagnostic accuracy systematic review and individual participant data pooled analysis. Eur Radiol 26(5):1431–1440. https://doi.org/10.1007/s00330-015-3949-zCrossRefPubMed

18.

Tang A, Cloutier G, Szeverenyi NM, Sirlin CB (2015) Ultrasound elastography and MR elastography for assessing liver fibrosis: part 2, diagnostic performance, confounders, and future directions. AJR Am J Roentgenol 205(1):33–40. https://doi.org/10.2214/AJR.15.14553CrossRefPubMedPubMedCentral

Title: Diagnostic value of MRI-derived liver surface nodularity score for the non-invasive quantification of hepatic fibrosis in non-alcoholic fatty liver disease
Authors: Roberta Catania
Alessandro Furlan
Andrew D. Smith
Jaideep Behari
Mitchell E. Tublin
Amir A. Borhani
Publication date: 01-01-2021
Publisher: Springer Berlin Heidelberg
Keyword: Fatty Liver
Published in: European Radiology / Issue 1/2021
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-07114-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Diagnostic value of MRI-derived liver surface nodularity score for the non-invasive quantification of hepatic fibrosis in non-alcoholic fatty liver disease

Abstract

Objectives

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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