Liver surface nodularity on non-contrast MRI identifies advanced fibrosis in patients with NAFLD.
Fatty liver
Liver cirrhosis
Magnetic resonance imaging
Metabolic syndrome
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
received:
27
04
2021
accepted:
09
08
2021
revised:
29
07
2021
pubmed:
18
9
2021
medline:
15
2
2022
entrez:
17
9
2021
Statut:
ppublish
Résumé
To evaluate the diagnostic performance of liver surface nodularity (LSN) for the assessment of advanced fibrosis in patients with non-alcoholic fatty liver disease (NAFLD). We retrospectively analysed patients with pathologically proven NAFLD who underwent liver MRI. Demographic, clinical, and laboratory data (including FIB-4 scores) were gathered. The SAF score was used to assess NAFLD. MRI-proton density fat fraction (PDFF) and LSN were determined on pre-contrast MR sequences. ROC curve analysis was performed to evaluate the diagnostic performance of MRI-LSN for the diagnosis of advanced (F3-F4) liver fibrosis. The final population included 142 patients. Sixty-seven (47%) patients had non-alcoholic steatohepatitis (NASH), and 52 (37%) had advanced fibrosis. The median MRI-PDFF increased with the grades of steatosis: 8.1%, 18.1%, and 31% in S1, S2, and S3 patients, respectively (p < 0.001). The area under the ROC curve (AUC) of MRI-LSN ≥ 2.50 was 0.838 (95%CI 0.767-0.894, sensitivity 67.3%, specificity 88.9%, positive and negative predictive values 77.8% and 82.5%, respectively) for the diagnosis of advanced fibrosis. Combining FIB-4 and MRI-LSN correctly classified 103/142 (73%) patients. This was validated in an external cohort of 75 patients. MRI-LSN has good diagnostic performance in diagnosis of advanced fibrosis in NAFLD patients. A combination of FIB-4 and MRI-LSN derived from pre-contrast MRI could be helpful to detect advanced fibrosis. • MRI-LSN ≥ 2.5 was accurate for the diagnosis of advanced hepatic fibrosis in NAFLD patients. • The combination of FIB-4 and MRI-LSN improved the detection of advanced fibrosis. • MRI-LSN can be easily derived by unenhanced MRI sequences that are routinely acquired.
Identifiants
pubmed: 34533606
doi: 10.1007/s00330-021-08261-6
pii: 10.1007/s00330-021-08261-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1781-1791Informations de copyright
© 2021. European Society of Radiology.
Références
Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M (2016) Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology 64:73–84. https://doi.org/10.1002/hep.28431
doi: 10.1002/hep.28431
pubmed: 26707365
Bedossa P (2014) Utility and appropriateness of the fatty liver inhibition of progression (FLIP) algorithm and steatosis, activity, and fibrosis (SAF) score in the evaluation of biopsies of nonalcoholic fatty liver disease. Hepatology 60:565–575. https://doi.org/10.1002/hep.27173
doi: 10.1002/hep.27173
pubmed: 24753132
Sheka AC, Adeyi O, Thompson J, Hameed B, Crawford PA, Ikramuddin S (2020) Nonalcoholic steatohepatitis: a review. JAMA 323:1175–1183. https://doi.org/10.1001/jama.2020.2298
doi: 10.1001/jama.2020.2298
pubmed: 32207804
Schattenberg JM, Lazarus JV, Newsome PN et al (2021) Disease burden and economic impact of diagnosed non-alcoholic steatohepatitis in five European countries in 2018: a cost-of-illness analysis. Liver Int 41:1227–1242. https://doi.org/10.1111/liv.14825
doi: 10.1111/liv.14825
pubmed: 33590598
pmcid: 8252761
Caussy C, Reeder SB, Sirlin CB, Loomba R (2018) Noninvasive, quantitative assessment of liver fat by MRI-PDFF as an endpoint in NASH trials. Hepatology 68:763–772. https://doi.org/10.1002/hep.29797
doi: 10.1002/hep.29797
pubmed: 29356032
Berzigotti A, Tsochatzis E, Boursier J et al (2021) EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis – 2021 update. J Hepatol. https://doi.org/10.1016/j.jhep.2021.05.025
doi: 10.1016/j.jhep.2021.05.025
pubmed: 34333101
Allen AM, Shah VH, Therneau TM et al (2018) The role of three-dimensional magnetic resonance elastography in the diagnosis of nonalcoholic steatohepatitis in obese patients undergoing bariatric surgery. Hepatology. https://doi.org/10.1002/hep.30483
doi: 10.1002/hep.30483
pubmed: 29774589
van Werven JR, Schreuder TCMA, Aarts EO et al (2011) Hepatic steatosis in morbidly obese patients undergoing gastric bypass surgery: assessment with open-system 1H-MR spectroscopy. AJR Am J Roentgenol 196:W736-742. https://doi.org/10.2214/AJR.10.5215
doi: 10.2214/AJR.10.5215
pubmed: 21606262
Angulo P, Kleiner DE, Dam-Larsen S et al (2015) Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients with nonalcoholic fatty liver disease. Gastroenterology 149:389-397.e10. https://doi.org/10.1053/j.gastro.2015.04.043
doi: 10.1053/j.gastro.2015.04.043
pubmed: 25935633
Ekstedt M, Hagström H, Nasr P et al (2015) Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up. Hepatology 61:1547–1554. https://doi.org/10.1002/hep.27368
doi: 10.1002/hep.27368
pubmed: 25125077
Imajo K, Kessoku T, Honda Y 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.e7. https://doi.org/10.1053/j.gastro.2015.11.048
doi: 10.1053/j.gastro.2015.11.048
pubmed: 26677985
Akkaya HE, Erden A, Kuru Öz D, Ünal S, Erden İ (2018) Magnetic resonance elastography: basic principles, technique, and clinical applications in the liver. Diagn Interv Radiol 24:328–335. https://doi.org/10.5152/dir.2018.18186
doi: 10.5152/dir.2018.18186
pubmed: 30272563
pmcid: 6223825
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 280:771–781. https://doi.org/10.1148/radiol.2016151542
doi: 10.1148/radiol.2016151542
pubmed: 27089026
Sartoris R, Rautou P-E, Elkrief L et al (2018) Quantification of liver surface nodularity at CT: utility for detection of portal hypertension. Radiology 289:698–707. https://doi.org/10.1148/radiol.2018181131
doi: 10.1148/radiol.2018181131
pubmed: 30179109
De Vos N, Sartoris R, Cauchy F, Rautou PE, Vilgrain V, Ronot M (2020) Performance of liver surface nodularity quantification for the diagnosis of portal hypertension in patients with cirrhosis: comparison between MRI with hepatobiliary phase sequences and CT. Abdom Radiol (NY) 45:365–372. https://doi.org/10.1007/s00261-019-02355-y
doi: 10.1007/s00261-019-02355-y
Besa C, Wagner M, Lo G et al (2018) Detection of liver fibrosis using qualitative and quantitative MR elastography compared to liver surface nodularity measurement, gadoxetic acid uptake, and serum markers. J Magn Reson Imaging 47:1552–1561. https://doi.org/10.1002/jmri.25911
doi: 10.1002/jmri.25911
pubmed: 29193508
EASL-EASD-EASO (2016) Clinical practice guidelines for the management of non-alcoholic fatty liver disease. J Hepatol 64:1388–402. https://doi.org/10.1016/j.jhep.2015.11.004
doi: 10.1016/j.jhep.2015.11.004
Kim WR, Berg T, Asselah T et al (2016) Evaluation of APRI and FIB-4 scoring systems for non-invasive assessment of hepatic fibrosis in chronic hepatitis B patients. J Hepatol 64:773–780. https://doi.org/10.1016/j.jhep.2015.11.012
doi: 10.1016/j.jhep.2015.11.012
pubmed: 26626497
Brunt EM, Kleiner DE, Wilson LA et al (2011) The NAS and the histopathologic diagnosis in NAFLD: distinct clinicopathologic meanings. Hepatology 53:810–820. https://doi.org/10.1002/hep.24127
doi: 10.1002/hep.24127
pubmed: 21319198
Kleiner DE, Brunt EM, Natta MV et al (2005) Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 41:1313–1321. https://doi.org/10.1002/hep.20701
doi: 10.1002/hep.20701
pubmed: 15915461
Smith AD, Zand KA, Florez E et al (2016) Liver surface nodularity score allows prediction of cirrhosis decompensation and death. Radiology 283:711–722. https://doi.org/10.1148/radiol.2016160799
doi: 10.1148/radiol.2016160799
pubmed: 27809664
Sartoris R, Lazareth M, Nivolli A, Burgio MD, Vilgrain V, Ronot M (2020) CT-based liver surface nodularity for the detection of clinically significant portal hypertension: defining measurement quality criteria. Abdom Radiol (NY). https://doi.org/10.1007/s00261-020-02519-1
doi: 10.1007/s00261-020-02519-1
Mózes FE, Lee JA, Selvaraj EA et al (2021) Diagnostic accuracy of non-invasive tests for advanced fibrosis in patients with NAFLD: an individual patient data meta-analysis. Gut. https://doi.org/10.1136/gutjnl-2021-324243
doi: 10.1136/gutjnl-2021-324243
pubmed: 34706868
Castera L, Friedrich-Rust M, Loomba R (2019) Noninvasive assessment of liver disease in patients with nonalcoholic fatty liver disease. Gastroenterology 156:1264-1281.e4. https://doi.org/10.1053/j.gastro.2018.12.036
doi: 10.1053/j.gastro.2018.12.036
pubmed: 30660725
Costa-Silva L, Ferolla SM, Lima AS, Vidigal PVT, de Abreu Ferrari TC (2018) MR elastography is effective for the non-invasive evaluation of fibrosis and necroinflammatory activity in patients with nonalcoholic fatty liver disease. Eur J Radiol 98:82–89. https://doi.org/10.1016/j.ejrad.2017.11.003
doi: 10.1016/j.ejrad.2017.11.003
pubmed: 29279175
Yin M, Talwalkar JA, Glaser KJ et al (2007) Assessment of hepatic fibrosis with magnetic resonance elastography. Clin Gastroenterol Hepatol 5:1207-1213.e2. https://doi.org/10.1016/j.cgh.2007.06.012
doi: 10.1016/j.cgh.2007.06.012
pubmed: 17916548
pmcid: 2276978
Kim DW, Kim SY, Yoon HM, Kim KW, Byun JH (2020) Comparison of technical failure of MR elastography for measuring liver stiffness between gradient-recalled echo and spin-echo echo-planar imaging: a systematic review and meta-analysis. J Magn Reson Imaging 51:1086–1102. https://doi.org/10.1002/jmri.26918
doi: 10.1002/jmri.26918
pubmed: 31456328
Wagner M, Corcuera-Solano I, Lo G et al (2017) Technical failure of MR elastography examinations of the liver: experience from a large single-center study. Radiology 284:401–412. https://doi.org/10.1148/radiol.2016160863
doi: 10.1148/radiol.2016160863
pubmed: 28045604
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 9:9994. https://doi.org/10.1038/s41598-019-46442-y
doi: 10.1038/s41598-019-46442-y
pubmed: 31292497
pmcid: 6620281
Catania R, Furlan A, Smith AD, Behari J, Tublin ME, Borhani AA (2020) Diagnostic value of MRI-derived liver surface nodularity score for the non-invasive quantification of hepatic fibrosis in non-alcoholic fatty liver disease. Eur Radiol. https://doi.org/10.1007/s00330-020-07114-y
doi: 10.1007/s00330-020-07114-y
pubmed: 32757050