Assessing liver fibrosis: Comparison of arterial enhancement fraction and diffusion-weighted imaging

David Bonekamp, Susanne Bonekamp, Hsin You Ou, Michael S. Torbenson, Celia Corona Villalobos, Esteban Mezey, Ihab R Kamel

Research output: Contribution to journalArticle

Abstract

Purpose: Noninvasive markers have been developed to reduce the need for liver biopsy. The aim of this study was to compare the strength of association of the arterial enhancement fraction (AEF), apparent diffusion coefficient (ADC), and serum biomarkers for staging hepatic fibrosis.

Materials and Methods: Eighty-five patients with chronic liver disease underwent triple-phase contrast-enhanced MRI, used to calculate AEF, and diffusion-weighted MRI (b=0,750 s/mm2), used to calculate ADC. Hepatic fibrosis was staged according METAVIR criteria. The overall association of the four biomarkers (AEF, ADC, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, and aspartate aminotransferase to platelet ratio index [APRI]) was compared using nonparametric tests and receiver operating characteristic (ROC) curve, using histopathologic analysis as the reference standard.

Results: AEF and ADC values differed significantly between histopathologic fibrosis stages. AEF values correlated with fibrosis stage, ADC values correlated negatively with fibrosis stage. Compared with ADC, AEF showed a trend toward an improved capability of discriminating fibrosis stages. A weighted composite score of AEF and ADC had significantly better diagnostic accuracy than ADC alone (P≤0.023). Imaging parameters had a significantly better diagnostic accuracy than AST/ALT ratio or APRI.

Conclusion: AEF may be able to detect the presence of mild, moderate, and advanced liver fibrosis, and its value is increased with concomitant use of ADC.

Original languageEnglish (US)
Pages (from-to)1137-1146
Number of pages10
JournalJournal of Magnetic Resonance Imaging
Volume40
Issue number5
DOIs
StatePublished - Nov 1 2014

Fingerprint

Liver Cirrhosis
Fibrosis
Aspartate Aminotransferases
Alanine Transaminase
Liver
Blood Platelets
Biomarkers
Diffusion Magnetic Resonance Imaging
Transaminases
ROC Curve
Liver Diseases
Chronic Disease
Biopsy
Serum

Keywords

  • Apparent diffusion coefficient
  • Arterial enhancement fraction
  • Diffuse liver disease
  • Hepatic fibrosis
  • Quantitative imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Assessing liver fibrosis : Comparison of arterial enhancement fraction and diffusion-weighted imaging. / Bonekamp, David; Bonekamp, Susanne; Ou, Hsin You; Torbenson, Michael S.; Corona Villalobos, Celia; Mezey, Esteban; Kamel, Ihab R.

In: Journal of Magnetic Resonance Imaging, Vol. 40, No. 5, 01.11.2014, p. 1137-1146.

Research output: Contribution to journalArticle

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