Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 4/2018

01-04-2018 | Magnetic Resonance

Comparison of gradient-recalled echo and spin-echo echo-planar imaging MR elastography in staging liver fibrosis: a meta-analysis

Authors: Yong Seek Kim, Yu Na Jang, Ji Soo Song

Published in: European Radiology | Issue 4/2018

Login to get access

Abstract

Objectives

To compare the diagnostic performance of gradient-recalled echo-based magnetic resonance elastography (GRE-MRE) and spin-echo echo-planar imaging-based MRE (SE-EPI-MRE) in liver fibrosis staging.

Methods

A systematic literature search was performed to identify studies involving the performance of MRE for the diagnosis of liver fibrosis. Pooled sensitivity, specificity, positive and negative likelihood ratios, the diagnostic odds ratio, and a summary receiver operating characteristic (ROC) curve were estimated by using a bivariate random effects model. Subgroup analyses were performed between different study characteristics.

Results

Twenty-six studies with a total of 3,200 patients were included in the meta-analysis. Pooled sensitivity and specificity of GRE-MRE and SE-EPI-MRE did not differ significantly. The area under the summary ROC curve for stage diagnosis of any (F ≥ 1), significant (F ≥ 2), advanced (F ≥ 3), and cirrhosis (F = 4) on GRE-MRE and SE-EPI-MRE were 0.93 versus 0.94, 0.95 versus 0.94, 0.94 versus 0.95, and 0.92 versus 0.93, respectively. Substantial heterogeneity was detected for both sequences.

Conclusion

Both GRE and SE-EPI-MRE show high sensitivity and specificity for detection of each stage of liver fibrosis, without significant differences. Magnetic resonance elastography (MRE) may be useful for noninvasive evaluation of liver fibrosis in chronic liver disease.

Key points

• Pooled sensitivity and specificity of GRE-MRE and SE-EPI-MRE did not differ significantly.
• GRE-MRE and SE-EPI-MRE were highly accurate for detecting all stages of fibrosis.
• Due to better agreement and repeatability, GRE-MRE should be used first.
• In case of failure on GRE-MRE, SE-EPI-MRE should be used.
Appendix
Available only for authorised users
Literature
1.
2.
D'Amico G, Garcia-Tsao G, Pagliaro L (2006) Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol 44:217–231CrossRefPubMed
3.
Martínez SM, Crespo G, Navasa M, Forns X (2011) Noninvasive assessment of liver fibrosis. Hepatology 53:325–335CrossRefPubMed
4.
Venkatesh SK, Yin M, Ehman RL (2013) Magnetic resonance elastography of liver: technique, analysis, and clinical applications. J Magn Reson Imaging 37:544–555CrossRefPubMedPubMedCentral
5.
Castera L (2012) Noninvasive methods to assess liver disease in patients with hepatitis B or C. Gastroenterology 142:1293-1302.e1294
6.
Hagiwara M, Rusinek H, Lee VS, Losada M, Bannan MA, Krinsky GA et al (2008) Advanced liver fibrosis: diagnosis with 3D whole-liver perfusion MR imaging--initial experience. Radiology 246:926–934CrossRefPubMed
7.
Friedrich-Rust M, Muller C, Winckler A, Kriener S, Herrmann E, Holtmeier J et al (2010) Assessment of liver fibrosis and steatosis in PBC with FibroScan, MRI, MR-spectroscopy, and serum markers. J Clin Gastroenterol 44:58–65CrossRefPubMed
8.
Loomba R, Wolfson T, Ang B, Hooker J, Behling C, Peterson M et al (2014) Magnetic resonance elastography predicts advanced fibrosis in patients with nonalcoholic fatty liver disease: a prospective study. Hepatology 60:1920–1928CrossRefPubMedPubMedCentral
9.
Yoon JH, Lee JM, Joo I, Lee ES, Sohn JY, Jang SK et al (2014) Hepatic fibrosis: prospective comparison of MR elastography and US shear-wave elastography for evaluation. Radiology 273:772–782CrossRefPubMed
10.
Batheja M, Vargas H, Silva AM, Walker F, Chang YH, De Petris G et al (2015) Magnetic resonance elastography (MRE) in assessing hepatic fibrosis: performance in a cohort of patients with histological data. Abdom Imaging 40:760-765
11.
12.
Yoshimitsu K, Mitsufuji T, Shinagawa Y, Fujimitsu R, Morita A, Urakawa H et al (2016) MR elastography of the liver at 3.0 T in diagnosing liver fibrosis grades; preliminary clinical experience. Eur Radiol 26:656–663CrossRefPubMed
13.
Wagner M, Besa C, Bou Ayache J, Yasar TK, Bane O, Fung M et al (2016) Magnetic resonance elastography of the liver: qualitative and quantitative comparison of gradient echo and spin echo echoplanar imaging sequences. Invest Radiol 51:575–581CrossRefPubMedPubMedCentral
14.
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
15.
Mariappan YK, Dzyubak B, Glaser KJ, Venkatesh SK, Sirlin CB, Hooker J 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
16.
Kim YS, Song JS, Kannengiesser S, Seo SY (2017) Comparison of spin-echo echoplanar imaging and gradient recalled echo-based MR elastography at 3 Tesla with and without gadoxetic acid administration. Eur Radiol 27:4120–4128CrossRefPubMed
17.
18.
Loomba R, Cui J, Wolfson T, Haufe W, Hooker J, Szeverenyi N 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
19.
Singh S, Venkatesh SK, Loomba R, Wang Z, Sirlin C, Chen J 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 26:1431–1440CrossRefPubMed
20.
Singh S, Venkatesh SK, Wang Z, Miller FH, Motosugi U, Low RN 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
21.
Su LN, Guo SL, Li BX, Yang P (2014) Diagnostic value of magnetic resonance elastography for detecting and staging of hepatic fibrosis: a meta-analysis. Clin Radiol 69:e545–e552CrossRefPubMed
22.
Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097CrossRefPubMedPubMedCentral
23.
Kim KW, Lee J, Choi SH, Huh J, Park SH (2015) Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: a practical review for clinical researchers-part I. General guidance and tips. Korean J Radiol 16:1175–1187CrossRefPubMedPubMedCentral
24.
Lee J, Kim KW, Choi SH, Huh J, Park SH (2015) Systematic review and meta-analysis of studies evaluating diagnostic test accuracy: a practical review for clinical researchers-part II. Statistical methods of meta-analysis. Korean J Radiol 16:1188–1196CrossRefPubMedPubMedCentral
25.
Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB et al (2011) QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 155:529–536CrossRefPubMed
26.
Reitsma JB, Glas AS, Rutjes AW, Scholten RJ, Bossuyt PM, Zwinderman AH (2005) Bivariate analysis of sensitivity and specificity produces informative summary measures in diagnostic reviews. J Clin Epidemiol 58:982–990CrossRefPubMed
27.
Higgins JP, Green S (2011) Cochrane handbook for systematic reviews of interventions. John Wiley & Sons
28.
Deville WL, Buntinx F, Bouter LM, Montori VM, de Vet HC, van der Windt DA et al (2002) Conducting systematic reviews of diagnostic studies: didactic guidelines. BMC Med Res Methodol 2:9CrossRefPubMedPubMedCentral
29.
Cook RD (2000) Detection of influential observation in linear regression. Technometrics 42:65–68CrossRef
30.
Deeks JJ, Macaskill P, Irwig L (2005) The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. J Clin Epidemiol 58:882–893CrossRefPubMed
31.
Yin M, Talwalkar JA, Glaser KJ, Manduca A, Grimm RC, Rossman PJ et al (2007) Assessment of hepatic fibrosis with magnetic resonance elastography. Clin Gastroenterol Hepatol 5:1207–1213.e1202CrossRefPubMedPubMedCentral
32.
Wang Y, Ganger DR, Levitsky J, Sternick LA, McCarthy RJ, Chen ZE et al (2011) Assessment of chronic hepatitis and fibrosis: comparison of MR elastography and diffusion-weighted imaging. AJR Am J Roentgenol 196:553–561CrossRefPubMedPubMedCentral
33.
Godfrey EM, Patterson AJ, Priest AN, Davies SE, Joubert I, Krishnan AS et al (2012) A comparison of MR elastography and 31P MR spectroscopy with histological staging of liver fibrosis. Eur Radiol 22:2790–2797CrossRefPubMed
34.
Rustogi R, Horowitz J, Harmath C, Wang Y, Chalian H, Ganger DR et al (2012) Accuracy of MR elastography and anatomic MR imaging features in the diagnosis of severe hepatic fibrosis and cirrhosis. J Magn Reson Imaging 35:1356–1364CrossRefPubMedPubMedCentral
35.
Choi YR, Lee JM, Yoon JH, Han JK, Choi BI (2013) Comparison of magnetic resonance elastography and gadoxetate disodium-enhanced magnetic resonance imaging for the evaluation of hepatic fibrosis. Invest Radiol 48:607–613CrossRefPubMed
36.
Kim D, Kim WR, Talwalkar JA, Kim HJ, Ehman RL (2013) Advanced fibrosis in nonalcoholic fatty liver disease: noninvasive assessment with MR elastography. Radiology 268:411–419CrossRefPubMedPubMedCentral
37.
Shi Y, Guo Q, Xia F, Dzyubak B, Glaser KJ, Li Q et al (2014) 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 273:88–98CrossRefPubMedPubMedCentral
38.
Venkatesh SK, Wang G, Lim SG, Wee A (2014) Magnetic resonance elastography for the detection and staging of liver fibrosis in chronic hepatitis B. Eur Radiol 24:70–78CrossRefPubMed
39.
Wu WP, Chou CT, Chen RC, Lee CW, Lee KW, Wu HK (2015) Non-invasive evaluation of hepatic fibrosis: the diagnostic performance of magnetic resonance elastography in patients with viral hepatitis B or C. PLoS One 10:e0140068CrossRefPubMedPubMedCentral
40.
Chang W, Lee JM, Yoon JH, Han JK, Choi BI, Yoon JH et al (2016) Liver fibrosis staging with MR elastography: comparison of diagnostic performance between patients with chronic hepatitis B and those with other etiologic causes. Radiology 280:88–97CrossRefPubMed
41.
Cui J, Heba E, Hernandez C, Haufe W, Hooker J, Andre MP 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
42.
Eaton JE, Dzyubak B, Venkatesh SK, Smyrk TC, Gores GJ, Ehman RL et al (2016) Performance of magnetic resonance elastography in primary sclerosing cholangitis. J Gastroenterol Hepatol 31:1184–1190CrossRefPubMedPubMedCentral
43.
Hennedige TP, Wang G, Leung FP, Alsaif HS, Teo LL, Lim SG et al (2016) Magnetic resonance elastography and diffusion weighted imaging in the evaluation of hepatic fibrosis in chronic hepatitis B. Gut Liver. https://​doi.​org/​10.​5009/​gnl16079
44.
45.
Park CC, Nguyen P, Hernandez C, Bettencourt R, Ramirez K, Fortney L et al (2017) Magnetic resonance elastography vs transient elastography in detection of fibrosis and noninvasive measurement of steatosis in patients with biopsy-proven nonalcoholic fatty liver disease. Gastroenterology 152:598–607 e592CrossRefPubMed
46.
Huwart L, Sempoux C, Vicaut E, Salameh N, Annet L, Danse E et al (2008) Magnetic resonance elastography for the noninvasive staging of liver fibrosis. Gastroenterology 135:32–40CrossRefPubMed
47.
Asbach P, Klatt D, Schlosser B, Biermer M, Muche M, Rieger A et al (2010) Viscoelasticity-based staging of hepatic fibrosis with multifrequency MR elastography. Radiology 257:80–86CrossRefPubMed
48.
Bohte AE, de Niet A, Jansen L, Bipat S, Nederveen AJ, Verheij J et al (2014) Non-invasive evaluation of liver fibrosis: a comparison of ultrasound-based transient elastography and MR elastography in patients with viral hepatitis B and C. Eur Radiol 24:638-648
49.
Imajo K, Kessoku T, Honda Y, Tomeno W, Ogawa Y, Mawatari H et al (2016) Magnetic resonance imaging more accurately classifies steatosis and fibrosis in patients with nonalcoholic fatty liver disease than transient elastography. Gastroenterology 150:626–637.e627CrossRefPubMed
50.
Loomba R, Cui J, Wolfson T, Haufe W, Hooker J, Szeverenyi N et al (2016) Novel 3D magnetic resonance elastography for the noninvasive diagnosis of advanced fibrosis in NAFLD: A prospective study. American Journal of Gastroenterology 111:986–994CrossRefPubMedPubMedCentral
51.
Sohrabpour AA, Mohamadnejad M, Malekzadeh R (2012) Review article: the reversibility of cirrhosis. Aliment Pharmacol Ther 36:824–832CrossRefPubMed
52.
Trout AT, Serai S, Mahley AD, Wang H, Zhang Y, Zhang B et al (2016) Liver stiffness measurements with mr elastography: agreement and repeatability across imaging systems, field strengths, and pulse sequences. Radiology 281:793–804CrossRefPubMed
Metadata
Title
Comparison of gradient-recalled echo and spin-echo echo-planar imaging MR elastography in staging liver fibrosis: a meta-analysis
Authors
Yong Seek Kim
Yu Na Jang
Ji Soo Song
Publication date
01-04-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 4/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5149-5

Other articles of this Issue 4/2018

European Radiology 4/2018 Go to the issue

Computer Applications

Detection of lung carcinoma with predominant ground-glass opacity on CT using temporal subtraction method

Breast

Breast compression parameters and mammographic density in the Norwegian Breast Cancer Screening Programme

Cardiac

Image quality and radiation dose of coronary CT angiography performed with whole-heart coverage CT scanner with intra-cycle motion correction algorithm in patients with atrial fibrillation

Magnetic Resonance

Sciatic neurosteatosis: Relationship with age, gender, obesity and height

Chest

Risk factors for haemoptysis after percutaneous transthoracic needle biopsies in 4,172 cases: Focusing on the effects of enlarged main pulmonary artery diameter

Paediatric

Early US findings of biliary atresia in infants younger than 30 days