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Pediatric Radiology
Published in: Pediatric Radiology 9/2018

01-08-2018 | Pediatric Body MRI

Putting it all together: established and emerging MRI techniques for detecting and measuring liver fibrosis

Authors: Suraj D. Serai, Andrew T. Trout, Alexander Miethke, Eric Diaz, Stavra A. Xanthakos, Jonathan R. Dillman

Published in: Pediatric Radiology | Issue 9/2018

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Abstract

Chronic injury to the liver leads to inflammation and hepatocyte necrosis, which when untreated can lead to myofibroblast activation and fibrogenesis with deposition of fibrous tissue. Over time, liver fibrosis can accumulate and lead to cirrhosis and end-stage liver disease with associated portal hypertension and liver failure. Detection and accurate measurement of the severity of liver fibrosis are important for assessing disease severity and progression, directing patient management, and establishing prognosis. Liver biopsy, generally considered the clinical standard of reference for detecting and measuring liver fibrosis, is invasive and has limitations, including sampling error, relatively high cost, and possible complications. For these reasons, liver biopsy is suboptimal for fibrosis screening, longitudinal monitoring, and assessing therapeutic efficacy. A variety of established and emerging qualitative and quantitative noninvasive MRI methods for detecting and staging liver fibrosis might ultimately serve these purposes. In this article, we review multiple MRI methods for detecting and measuring liver fibrosis and discuss the diagnostic performance and specific strengths and limitations of the various techniques.
Literature
1.
Cordova J, Jericho H, Azzam RK (2016) An overview of cirrhosis in children. Pediatr Ann 45:e427–e432CrossRefPubMed
2.
3.
4.
Arthur MJ (2002) Reversibility of liver fibrosis and cirrhosis following treatment for hepatitis C. Gastroenterology 122:1525–1528CrossRefPubMed
5.
6.
Regev A, Berho M, Jeffers LJ et al (2002) Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection. Am J Gastroenterol 97:2614–2618CrossRefPubMed
7.
Ratziu V, Charlotte F, Heurtier A et al (2005) Sampling variability of liver biopsy in nonalcoholic fatty liver disease. Gastroenterology 128:1898–1906CrossRefPubMed
8.
Serai SD, Towbin AJ, Podberesky DJ (2012) Pediatric liver MR elastography. Dig Dis Sci 57:2713–2719CrossRefPubMed
9.
Yin M, Talwalkar JA, Glaser KJ et al (2007) Assessment of hepatic fibrosis with magnetic resonance elastography. Clin Gastroenterol Hepatol 5:1207–1213 e1202CrossRefPubMedPubMedCentral
10.
Hu G, Zhang X, Liang W et al (2016) Assessment of liver fibrosis in rats by MRI with apparent diffusion coefficient and T1 relaxation time in the rotating frame. J Magn Reson Imaging 43:1082–1089CrossRefPubMed
11.
Rauscher I, Eiber M, Ganter C et al (2014) Evaluation of T1rho as a potential MR biomarker for liver cirrhosis: comparison of healthy control subjects and patients with liver cirrhosis. Eur J Radiol 83:900–904CrossRefPubMed
12.
13.
Zhang H, Yang Q, Yu T et al (2016) Comparison of T2, T1rho, and diffusion metrics in assessment of liver fibrosis in rats. J Magn Reson Imaging 45:741–750CrossRefPubMed
14.
Banerjee R, Pavlides M, Tunnicliffe EM et al (2014) Multiparametric magnetic resonance for the non-invasive diagnosis of liver disease. J Hepatol 60:69–77CrossRefPubMedPubMedCentral
15.
16.
Serai SD, Trout AT, Sirlin CB (2017) Elastography to assess the stage of liver fibrosis in children: concepts, opportunities, and challenges. Clin Liver Dis 9:5–10CrossRef
17.
Serai SD, Dillman JR, Trout AT (2017) Spin-echo echo-planar imaging MR elastography versus gradient-echo MR elastography for assessment of liver stiffness in children and young adults suspected of having liver disease. Radiology 282:761–770CrossRefPubMed
18.
Dodd GD 3rd, Baron RL, Oliver JH 3rd et al (1999) Spectrum of imaging findings of the liver in end-stage cirrhosis: part I, gross morphology and diffuse abnormalities. AJR Am J Roentgenol 173:1031–1036CrossRefPubMed
19.
Brancatelli G, Federle MP, Ambrosini R et al (2007) Cirrhosis: CT and MR imaging evaluation. Eur J Radiol 61:57–69CrossRefPubMed
20.
Ito K, Mitchell DG, Kim MJ et al (2003) Right posterior hepatic notch sign: a simple diagnostic MR finding of cirrhosis. J Magn Reson Imaging 18:561–566CrossRefPubMed
21.
22.
Ito K, Mitchell DG, Gabata T et al (1999) Expanded gallbladder fossa: simple MR imaging sign of cirrhosis. Radiology 211:723–726CrossRefPubMed
23.
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 280:771–781CrossRefPubMed
24.
Alhammad A, Kamath BM, Chami R et al (2016) Solitary hepatic nodule adjacent to the right portal vein: a common finding of Alagille syndrome? J Pediatr Gastroenterol Nutr 62:226–232CrossRefPubMed
25.
Venkatesh SK, Ehman RL (2014) Magnetic resonance elastography of liver. Magn Reson Imaging Clin N Am 22:433–446CrossRefPubMed
26.
Xanthakos SA, Podberesky DJ, Serai SD et al (2014) Use of magnetic resonance elastography to assess hepatic fibrosis in children with chronic liver disease. J Pediatr 164:186–188CrossRefPubMed
27.
Wagner M, Besa C, Bou Ayache J et al (2016) Magnetic resonance elastography of the liver: qualitative and quantitative comparison of gradient echo and spin echo echoplanar imaging sequences. Investig Radiol 51:575–581CrossRef
28.
Loomba R, Cui J, Wolfson T et al (2016) Novel 3D magnetic resonance elastography for the noninvasive diagnosis of advanced fibrosis in NAFLD: a prospective study. Am J Gastroenterol 111:986–994CrossRefPubMedPubMedCentral
29.
30.
Joshi M, Dillman JR, Towbin AJ et al (2017) MR elastography: high rate of technical success in pediatric and young adult patients. Pediatr Radiol 47:838–843CrossRefPubMed
31.
Venkatesh SK, Yin M, Ehman RL (2013) Magnetic resonance elastography of liver: technique, analysis, and clinical applications. J Magn Reson Imaging 37:544–555CrossRefPubMedPubMedCentral
32.
Trout AT, Dillman JR, Xanthakos S et al (2016) Prospective assessment of correlation between US acoustic radiation force impulse and MR elastography in a pediatric population: dispersion of US shear-wave speed measurement matters. Radiology 281:544–552CrossRefPubMed
33.
Singh S, Venkatesh SK, Wang Z et al (2015) Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant data. Clin Gastroenterol Hepatol 13:440–451 e446CrossRefPubMed
34.
Serai SD, Obuchowski NA, Venkatesh SK et al (2017) Repeatability of MR elastography of liver: a meta-analysis. Radiology 285:92–100CrossRefPubMed
35.
Cui J, Ang B, Haufe W et al (2015) Comparative diagnostic accuracy of magnetic resonance elastography vs. eight clinical prediction rules for non-invasive diagnosis of advanced fibrosis in biopsy-proven non-alcoholic fatty liver disease: a prospective study. Aliment Pharmacol Ther 41:1271–1280CrossRefPubMedPubMedCentral
36.
Shinagawa Y, Mitsufuji T, Morimoto S et al (2014) Optimization of scanning parameters for MR elastography at 3.0 T clinical unit: volunteer study. Jpn J Radiol 32:441–446CrossRefPubMed
37.
Trout AT, Serai S, Mahley AD et al (2016) Liver stiffness measurements with MR elastography: agreement and repeatability across imaging systems, field strengths, and pulse sequences. Radiology 281:793–804CrossRefPubMed
38.
Huwart L, Sempoux C, Salameh N et al (2007) Liver fibrosis: noninvasive assessment with MR elastography versus aspartate aminotransferase-to-platelet ratio index. Radiology 245:458–466CrossRefPubMed
39.
Cui J, Heba E, Hernandez C et al (2016) Magnetic resonance elastography is superior to acoustic radiation force impulse for the diagnosis of fibrosis in patients with biopsy-proven nonalcoholic fatty liver disease: a prospective study. Hepatology 63:453–461CrossRefPubMed
40.
Bonekamp S, Kamel I, Solga S et al (2009) Can imaging modalities diagnose and stage hepatic fibrosis and cirrhosis accurately? J Hepatol 50:17–35CrossRefPubMed
41.
Venkatesh SK, Yin M, Takahashi N et al (2015) Non-invasive detection of liver fibrosis: MR imaging features vs. MR elastography. Abdom Imaging 40:766–775CrossRefPubMedPubMedCentral
42.
Yin M, Glaser KJ, Talwalkar JA et al (2016) Hepatic MR elastography: clinical performance in a series of 1,377 consecutive examinations. Radiology 278:114–124CrossRefPubMed
43.
Shire NJ, Yin M, Chen J et al (2011) Test-retest repeatability of MR elastography for noninvasive liver fibrosis assessment in hepatitis C. J Magn Reson Imaging 34:947–955CrossRefPubMedPubMedCentral
44.
Dulai PS, Sirlin CB, Loomba R (2016) MRI and MRE for non-invasive quantitative assessment of hepatic steatosis and fibrosis in NAFLD and NASH: clinical trials to clinical practice. J Hepatol 65:1006–1016CrossRefPubMedPubMedCentral
45.
Deng M, Zhao F, Yuan J et al (2012) Liver T1rho MRI measurement in healthy human subjects at 3 T: a preliminary study with a two-dimensional fast-field echo sequence. Br J Radiol 85:e590–e595CrossRefPubMedPubMedCentral
46.
Serai SD, Wallihan DB, Venkatesh SK et al (2014) Magnetic resonance elastography of the liver in patients status-post fontan procedure: feasibility and preliminary results. Congenit Heart Dis 9:7–14CrossRefPubMed
47.
Wallihan DB, Podberesky DJ, Marino BS et al (2014) Relationship of MR elastography determined liver stiffness with cardiac function after Fontan palliation. J Magn Reson Imaging 40:1328–1335CrossRefPubMed
48.
Dillman JR, Trout AT, Costello EN et al (2017) Quantitative liver MRI-biopsy correlation in pediatric and young adult patients with nonalcoholic fatty liver disease: can one be used to predict the other? AJR Am J Roentgenol 18:1–9
49.
Yin M, Talwalkar JA, Glaser KJ et al (2011) Dynamic postprandial hepatic stiffness augmentation assessed with MR elastography in patients with chronic liver disease. AJR Am J Roentgenol 197:64–70CrossRefPubMedPubMedCentral
50.
Mariappan YK, Dzyubak B, Glaser KJ et al (2017) Application of modified spin-echo-based sequences for hepatic MR elastography: evaluation, comparison with the conventional gradient-echo sequence, and preliminary clinical experience. Radiology 282:390–398CrossRefPubMed
51.
Hazlewood CF, Yamanashi WS, Rangel RA et al (1982) In vivo NMR imaging and T1 measurements of water protons in the human brain. Magn Reson Imaging 1:3–10CrossRefPubMed
52.
Look DC, Locker DR (1970) Time saving in measurement of NMR and EPR relaxation times. Rev Sci Instrum 41:250–251CrossRef
53.
Messroghli DR, Radjenovic A, Kozerke S et al (2004) Modified look-locker inversion recovery (MOLLI) for high-resolution T1 mapping of the heart. Magn Reson Med 52:141–146CrossRefPubMed
54.
Serai SD, Fleck RJ, Quinn CT et al (2015) Retrospective comparison of gradient recalled echo R2* and spin-echo R2 magnetic resonance analysis methods for estimating liver iron content in children and adolescents. Pediatr Radiol 45:1629–1634CrossRefPubMed
55.
Towbin AJ, Serai SD, Podberesky DJ (2013) Magnetic resonance imaging of the pediatric liver. imaging of steatosis, iron deposition, and fibrosis Magn Reson Imaging Clin N Am 21:669–680CrossRefPubMed
56.
Tunnicliffe EM, Banerjee R, Pavlides M et al (2017) A model for hepatic fibrosis: the competing effects of cell loss and iron on shortened modified look-locker inversion recovery T1 (shMOLLI-T1 ) in the liver. J Magn Reson Imaging 45:450–462CrossRefPubMed
57.
Pavlides M, Banerjee R, Sellwood J et al (2016) Multiparametric magnetic resonance imaging predicts clinical outcomes in patients with chronic liver disease. J Hepatol 64:308–315CrossRefPubMedPubMedCentral
58.
Pavlides M, Banerjee R, Tunnicliffe EM et al (2017) Multiparametric magnetic resonance imaging for the assessment of non-alcoholic fatty liver disease severity. Liver Int 37:1065–1073CrossRefPubMedPubMedCentral
59.
Zhou ZP, Long LL, Qiu WJ et al (2017) Evaluating segmental liver function using T1 mapping on Gd-EOB-DTPA-enhanced MRI with a 3.0 tesla. BMC Med Imaging 17:20CrossRefPubMedPubMedCentral
60.
Haimerl M, Verloh N, Fellner C et al (2014) MRI-based estimation of liver function: Gd-EOB-DTPA-enhanced T1 relaxometry of 3T vs. the MELD score. Sci Rep 4:5621CrossRefPubMedPubMedCentral
61.
Kawel N, Nacif M, Zavodni A et al (2012) T1 mapping of the myocardium: intra-individual assessment of the effect of field strength, cardiac cycle and variation by myocardial region. J Cardiovasc Magn Reson 14:27CrossRefPubMedPubMedCentral
62.
Neumann D, Blaimer M, Jakob PM et al (2014) Simple recipe for accurate T(2) quantification with multi spin-echo acquisitions. MAGMA 27:567–577CrossRefPubMed
63.
64.
Filho HML, Chua-anusorn W, Oliveira CP et al (2017) Novel mapping of fibrosis and hepatic inflammation in NASH patients with dual R2 MRI relaxometry. J Hepatol 66:S243–S244CrossRef
65.
Sepponen RE, Pohjonen JA, Sipponen JT et al (1985) A method for T1 rho imaging. J Comput Assist Tomogr 9:1007–1011CrossRefPubMed
66.
Takayama Y, Nishie A, Asayama Y et al (2015) T1 rho relaxation of the liver: a potential biomarker of liver function. J Magn Reson Imaging 42:188–195CrossRefPubMed
67.
68.
Wang YX, Yuan J, Chu ES et al (2011) T1rho MR imaging is sensitive to evaluate liver fibrosis: an experimental study in a rat biliary duct ligation model. Radiology 259:712–719CrossRefPubMed
69.
Witschey WR 2nd, Borthakur A, Elliott MA et al (2007) Artifacts in T1 rho-weighted imaging: compensation for B(1) and B(0) field imperfections. J Magn Reson 186:75–85
70.
Chavhan GB, Alsabban Z, Babyn PS (2014) Diffusion-weighted imaging in pediatric body MR imaging: principles, technique, and emerging applications. Radiographics 34:E73–E88CrossRefPubMed
71.
Le Bihan D, Breton E, Lallemand D et al (1988) Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology 168:497–505CrossRefPubMed
72.
Taouli B, Tolia AJ, Losada M et al (2007) Diffusion-weighted MRI for quantification of liver fibrosis: preliminary experience. AJR Am J Roentgenol 189:799–806CrossRefPubMed
73.
Palmucci S, Cappello G, Attina G et al (2015) Diffusion-weighted MRI for the assessment of liver fibrosis: principles and applications. Biomed Res Int 2015:874201CrossRefPubMedPubMedCentral
74.
Papalavrentios L, Sinakos E, Chourmouzi D et al (2015) Value of 3 tesla diffusion-weighted magnetic resonance imaging for assessing liver fibrosis. Ann Gastroenterol 28:118–123PubMedPubMedCentral
75.
76.
Wang QB, Zhu H, Liu HL et al (2012) Performance of magnetic resonance elastography and diffusion-weighted imaging for the staging of hepatic fibrosis: a meta-analysis. Hepatology 56:239–247CrossRefPubMed
77.
Bakan AA, Inci E, Bakan S et al (2012) Utility of diffusion-weighted imaging in the evaluation of liver fibrosis. Eur Radiol 22:682–687CrossRefPubMed
78.
Lewin M, Poujol-Robert A, Boelle PY et al (2007) Diffusion-weighted magnetic resonance imaging for the assessment of fibrosis in chronic hepatitis C. Hepatology 46:658–665CrossRefPubMed
79.
Sandrasegaran K, Akisik FM, Lin C et al (2009) Value of diffusion-weighted MRI for assessing liver fibrosis and cirrhosis. AJR Am J Roentgenol 193:1556–1560CrossRefPubMed
80.
Soylu A, Kilickesmez O, Poturoglu S et al (2010) Utility of diffusion-weighted MRI for assessing liver fibrosis in patients with chronic active hepatitis. Diagn Interv Radiol 16:204–208PubMed
81.
Yang Y, Song B, Wu B et al (2009) Assessment of disease activity and liver fibrosis in chronic viral hepatitis by magnetic resonance diffusion-weighted imaging. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 31:155–159PubMed
82.
Luciani A, Vignaud A, Cavet M et al (2008) Liver cirrhosis: intravoxel incoherent motion MR imaging — pilot study. Radiology 249:891–899CrossRefPubMed
83.
Leitao HS, Doblas S, d’Assignies G et al (2013) Fat deposition decreases diffusion parameters at MRI: a study in phantoms and patients with liver steatosis. Eur Radiol 23:461–467CrossRefPubMed
Metadata
Title
Putting it all together: established and emerging MRI techniques for detecting and measuring liver fibrosis
Authors
Suraj D. Serai
Andrew T. Trout
Alexander Miethke
Eric Diaz
Stavra A. Xanthakos
Jonathan R. Dillman
Publication date
01-08-2018
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 9/2018
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-018-4083-2

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