MR elastography vs a combination of common non-invasive tests for estimation of severe liver fibrosis in patients with hepatobiliary tumors

Yujiro Nakazawa; Masahiro Okada; Kenichiro Tago; Naoki Kuwabara; Mariko Mizuno; Hayato Abe; Tokio Higaki; Yukiyasu Okamura; Tadatoshi Takayama

doi:10.1007/s00330-024-11086-8

MR elastography vs a combination of common non-invasive tests for estimation of severe liver fibrosis in patients with hepatobiliary tumors

Eur Radiol. 2024 Sep 30. doi: 10.1007/s00330-024-11086-8. Online ahead of print.

Authors

Yujiro Nakazawa¹, Masahiro Okada², Kenichiro Tago¹, Naoki Kuwabara¹, Mariko Mizuno¹, Hayato Abe³, Tokio Higaki³, Yukiyasu Okamura³, Tadatoshi Takayama³

Affiliations

¹ Departments of Radiology, Nihon University School of Medicine, Tokyo, Japan.
² Departments of Radiology, Nihon University School of Medicine, Tokyo, Japan. okada.masahiro@nihon-u.ac.jp.
³ Departments of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.

PMID: 39349724
DOI: 10.1007/s00330-024-11086-8

Abstract

Objectives: To evaluate the accuracy of combined imaging and blood test indices related to liver fibrosis (LF) compared to magnetic resonance elastography (MRE) for estimating severe LF (F3-4) in preoperative patients.

Methods: This retrospective study included patients who underwent MRE, gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI, and dynamic CT before liver resection. Liver stiffness measurement (LSM) using MRE, liver-to-spleen signal intensity ratio (LSR) using Gd-EOB-DTPA-enhanced MRI, and spleen volume normalized to body surface area (SV/BSA) using CT volumetry were measured. Laboratory parameters, including levels of type IV collagen 7S and hyaluronic acid, were also measured. Logistic regression and receiver operating characteristic analyses were performed to identify parameters that could estimate severe LF more accurately than LSM alone.

Results: A total of 81 patients (mean age, 67 years ± 9.9 [SD]; 58 men) were enrolled. Multivariable logistic regression analysis indicated that LSR (odds ratio [OR]: 0.14, 95% confidence interval [CI]: 0.05-0.37, p < 0.001), SV/BSA (OR: 1.25, 95% CI: 1.02-1.52, p = 0.03) and type IV collagen 7S (OR: 1.84, 95% CI: 1.12-3.00, p = 0.02) were associated with severe LF. Receiver operating characteristic analysis showed that for estimating severe LF, the area under the curve was significantly larger for the combination of LSR, SV/BSA, and type IV collagen 7S than for LSM alone (0.95 vs 0.85, p = 0.04).

Conclusion: The combined evaluation of LSR, SV/BSA, and type IV collagen 7S obtained by clinically common preoperative examinations was more accurate than MRE alone for estimating severe LF in preoperative patients.

Key points: Question What indicators among the imaging and blood tests commonly performed preoperatively can provide a more accurate estimate of severe LF compared to MRE? Findings The combination of LSR, SV/BSA, and type IV collagen 7S was more accurate than an LSM alone for estimating severe LF. Clinical relevance A combination of commonly performed non-invasive preoperative tests provides a more accurate estimation of severe LF than MR elastography, an examination with relatively limited.

Keywords: Elastography; Gd-EOB-DTPA; Liver fibrosis; Magnetic resonance imaging.