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05.07.2019 | Gastrointestinal

Prospective comparison of transient, point shear wave, and magnetic resonance elastography for staging liver fibrosis

verfasst von: Thierry Lefebvre, Claire Wartelle-Bladou, Philip Wong, Giada Sebastiani, Jeanne-Marie Giard, Hélène Castel, Jessica Murphy-Lavallée, Damien Olivié, André Ilinca, Marie-Pierre Sylvestre, Guillaume Gilbert, Zu-Hua Gao, Bich N. Nguyen, Guy Cloutier, An Tang

Erschienen in: European Radiology | Ausgabe 12/2019

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Abstract

Objectives

To perform head-to-head comparisons of the feasibility and diagnostic performance of transient elastography (TE), point shear-wave elastography (pSWE), and magnetic resonance elastography (MRE).

Methods

This prospective, cross-sectional, dual-center imaging study included 100 patients with known or suspected chronic liver disease caused by hepatitis B or C virus, nonalcoholic fatty liver disease, or autoimmune hepatitis identified between 2014 and 2018. Liver stiffness measured with the three elastographic techniques was obtained within 6 weeks of a liver biopsy. Confounding effects of inflammation and steatosis on association between fibrosis and liver stiffness were assessed. Obuchowski scores and AUCs for staging fibrosis were evaluated and the latter were compared using the DeLong method.

Results

TE, pSWE, and MRE were technically feasible and reliable in 92%, 79%, and 91% subjects, respectively. At univariate analysis, liver stiffness measured by all techniques increased with fibrosis stages and inflammation and decreased with steatosis. For classification of dichotomized fibrosis stages, the AUCs were significantly higher for distinguishing stages F0 vs. ≥ F1 with MRE than with TE (0.88 vs. 0.71; p < 0.05) or pSWE (0.88 vs. 0.73; p < 0.05), and for distinguishing stages ≤ F1 vs. ≥ F2 with MRE than with TE (0.85 vs. 0.75; p < 0.05). TE, pSWE, and MRE Obuchowski scores for staging fibrosis stages were respectively 0.89 (95% CI 0.85–0.93), 0.90 (95% CI 0.85–0.94), and 0.94 (95% CI 0.91–0.96).

Conclusion

MRE provided a higher diagnostic performance than TE and pSWE for staging early stages of liver fibrosis.

Trial registration

NCT02044523

Key Points

• The technical failure rate was similar between MRE and US-based elastography techniques.

• Liver stiffness measured by MRE and US-based elastography techniques increased with fibrosis stages and inflammation and decreased with steatosis.

• MRE provided a diagnostic accuracy higher than US-based elastography techniques for staging of early stages of histology-determined liver fibrosis.

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Titel: Prospective comparison of transient, point shear wave, and magnetic resonance elastography for staging liver fibrosis
verfasst von: Thierry Lefebvre
Claire Wartelle-Bladou
Philip Wong
Giada Sebastiani
Jeanne-Marie Giard
Hélène Castel
Jessica Murphy-Lavallée
Damien Olivié
André Ilinca
Marie-Pierre Sylvestre
Guillaume Gilbert
Zu-Hua Gao
Bich N. Nguyen
Guy Cloutier
An Tang
Publikationsdatum: 05.07.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 12/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-019-06331-4

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Prospective comparison of transient, point shear wave, and magnetic resonance elastography for staging liver fibrosis