Assessment of liver cirrhosis for patients with Child's A classification before hepatectomy using dynamic contrast-enhanced MRI
To determine the feasibility of semi-quantitative haemodynamic parameters derived from dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) to assess liver fibrosis. Seventy-five patients with Child's A classification (males/females=24/51; average age, 58 years; range, 30–80 years)...
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| Veröffentlicht in: | Clinical radiology 2019-05, Vol.74 (5), p.407.e11-407.e17 |
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| container_title | Clinical radiology |
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| creator | Liao, Y.-S. Lee, L.-W. Yang, P.-H. Kuo, L.-M. Kuan, L.-Y. Tseng, W.-Y.I. Hwang, D.W. |
| description | To determine the feasibility of semi-quantitative haemodynamic parameters derived from dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) to assess liver fibrosis.
Seventy-five patients with Child's A classification (males/females=24/51; average age, 58 years; range, 30–80 years) received DCE-MRI 3 days prior to hepatectomy. Semi-quantitative haemodynamic parameters, including the wash-in slope, wash-out slope, and time-to-peak, were calculated from DCE-MRI data. Liver fibrosis of the resected non-tumour liver was graded pathologically from F0 (no fibrosis) to F6 (cirrhosis) in the regions corresponding to those assessed by DCE-MRI.
The wash-out slope showed higher interobserver and intra-observer reliabilities than the wash-in slope and time-to-peak. There was a significant positive correlation between the wash-out slope and pathological grade of fibrosis (Spearman's correlation coefficient: r=0.5331, p |
| doi_str_mv | 10.1016/j.crad.2019.01.017 |
| format | Article |
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Seventy-five patients with Child's A classification (males/females=24/51; average age, 58 years; range, 30–80 years) received DCE-MRI 3 days prior to hepatectomy. Semi-quantitative haemodynamic parameters, including the wash-in slope, wash-out slope, and time-to-peak, were calculated from DCE-MRI data. Liver fibrosis of the resected non-tumour liver was graded pathologically from F0 (no fibrosis) to F6 (cirrhosis) in the regions corresponding to those assessed by DCE-MRI.
The wash-out slope showed higher interobserver and intra-observer reliabilities than the wash-in slope and time-to-peak. There was a significant positive correlation between the wash-out slope and pathological grade of fibrosis (Spearman's correlation coefficient: r=0.5331, p<0.0001). The area under the receiver operating characteristic curve was 0.8066 when using the wash-out slope to differentiate cirrhosis (grade F6) from non-cirrhosis (grades F0–5). Using the cut-off point that maximised specificity, the sensitivity was 62.07%, specificity was 91.30%, positive predictive value was 81.81%, negative predictive value was 79.25%, and accuracy was 80%.
The wash-out slope derived from DCE-MRI might be potentially useful in assessing liver cirrhosis in patients with Child's A classification before hepatectomy.
•Wash-out slope of DCE-MRI may be useful for assessing cirrhotic patients with Child's A classification before hepatectomy.•Wash-out slope showed better inter-observer and intra-observer reliabilities than wash-in slope and time-to-peak.•There was a significant positive correlation between the wash-out slope and pathological grading of liver fibrosis.•The area under the ROC curve was 0.8066 when using the wash-out slope to differentiate cirrhosis from non-cirrhosis.</description><identifier>ISSN: 0009-9260</identifier><identifier>EISSN: 1365-229X</identifier><identifier>DOI: 10.1016/j.crad.2019.01.017</identifier><identifier>PMID: 30799098</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Contrast Media ; Feasibility Studies ; Female ; Hepatectomy ; Humans ; Liver Cirrhosis - pathology ; Liver Cirrhosis - surgery ; Magnetic Resonance Imaging - methods ; Male ; Middle Aged ; Observer Variation ; Preoperative Care - methods</subject><ispartof>Clinical radiology, 2019-05, Vol.74 (5), p.407.e11-407.e17</ispartof><rights>2019</rights><rights>Copyright © 2019. Published by Elsevier Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-8ea940447bab36d1a131a91b5e477fa79cba76be2094968c6f7063fa23fdc3343</citedby><cites>FETCH-LOGICAL-c356t-8ea940447bab36d1a131a91b5e477fa79cba76be2094968c6f7063fa23fdc3343</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0009926019300790$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30799098$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liao, Y.-S.</creatorcontrib><creatorcontrib>Lee, L.-W.</creatorcontrib><creatorcontrib>Yang, P.-H.</creatorcontrib><creatorcontrib>Kuo, L.-M.</creatorcontrib><creatorcontrib>Kuan, L.-Y.</creatorcontrib><creatorcontrib>Tseng, W.-Y.I.</creatorcontrib><creatorcontrib>Hwang, D.W.</creatorcontrib><title>Assessment of liver cirrhosis for patients with Child's A classification before hepatectomy using dynamic contrast-enhanced MRI</title><title>Clinical radiology</title><addtitle>Clin Radiol</addtitle><description>To determine the feasibility of semi-quantitative haemodynamic parameters derived from dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) to assess liver fibrosis.
Seventy-five patients with Child's A classification (males/females=24/51; average age, 58 years; range, 30–80 years) received DCE-MRI 3 days prior to hepatectomy. Semi-quantitative haemodynamic parameters, including the wash-in slope, wash-out slope, and time-to-peak, were calculated from DCE-MRI data. Liver fibrosis of the resected non-tumour liver was graded pathologically from F0 (no fibrosis) to F6 (cirrhosis) in the regions corresponding to those assessed by DCE-MRI.
The wash-out slope showed higher interobserver and intra-observer reliabilities than the wash-in slope and time-to-peak. There was a significant positive correlation between the wash-out slope and pathological grade of fibrosis (Spearman's correlation coefficient: r=0.5331, p<0.0001). The area under the receiver operating characteristic curve was 0.8066 when using the wash-out slope to differentiate cirrhosis (grade F6) from non-cirrhosis (grades F0–5). Using the cut-off point that maximised specificity, the sensitivity was 62.07%, specificity was 91.30%, positive predictive value was 81.81%, negative predictive value was 79.25%, and accuracy was 80%.
The wash-out slope derived from DCE-MRI might be potentially useful in assessing liver cirrhosis in patients with Child's A classification before hepatectomy.
•Wash-out slope of DCE-MRI may be useful for assessing cirrhotic patients with Child's A classification before hepatectomy.•Wash-out slope showed better inter-observer and intra-observer reliabilities than wash-in slope and time-to-peak.•There was a significant positive correlation between the wash-out slope and pathological grading of liver fibrosis.•The area under the ROC curve was 0.8066 when using the wash-out slope to differentiate cirrhosis from non-cirrhosis.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Area Under Curve</subject><subject>Contrast Media</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Hepatectomy</subject><subject>Humans</subject><subject>Liver Cirrhosis - pathology</subject><subject>Liver Cirrhosis - surgery</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Observer Variation</subject><subject>Preoperative Care - methods</subject><issn>0009-9260</issn><issn>1365-229X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1rGzEQhkVoSNw0f6CHolt7WUcfa2kFvRiTpoGUQmkhN6HVjroyuytXs07xqX89Mk57LAwMwzzzwjyEvOVsyRlXN9ulz65bCsbNkvFS-owsuFSrSgjz-IosGGOmMkKxS_IacXsca1FfkEvJtDHMNAvyZ40IiCNMM02BDvEJMvUx5z5hRBpSpjs3x7JG-jvOPd30cejeI11TPzjEGKIv-zTRFgoMtIfCg5_TeKB7jNNP2h0mN0ZPfZrm7HCuYOrd5KGjX77dvyHnwQ0I1y_9ivz4dPt987l6-Hp3v1k_VF6u1Fw14EzN6lq3rpWq445L7gxvV1BrHZw2vnVatSDKh0Y1XgXNlAxOyNB5KWt5RT6ccnc5_doDznaM6GEY3ARpj1bwZtVooRUrqDihPifEDMHuchxdPljO7FG83dqjeHsUbxkvpcvRu5f8fTtC9-_kr-kCfDwBUL58ipAt-qK1aIi56LJdiv_LfwZdAZaV</recordid><startdate>201905</startdate><enddate>201905</enddate><creator>Liao, Y.-S.</creator><creator>Lee, L.-W.</creator><creator>Yang, P.-H.</creator><creator>Kuo, L.-M.</creator><creator>Kuan, L.-Y.</creator><creator>Tseng, W.-Y.I.</creator><creator>Hwang, D.W.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201905</creationdate><title>Assessment of liver cirrhosis for patients with Child's A classification before hepatectomy using dynamic contrast-enhanced MRI</title><author>Liao, Y.-S. ; Lee, L.-W. ; Yang, P.-H. ; Kuo, L.-M. ; Kuan, L.-Y. ; Tseng, W.-Y.I. ; Hwang, D.W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-8ea940447bab36d1a131a91b5e477fa79cba76be2094968c6f7063fa23fdc3343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Area Under Curve</topic><topic>Contrast Media</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Hepatectomy</topic><topic>Humans</topic><topic>Liver Cirrhosis - pathology</topic><topic>Liver Cirrhosis - surgery</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Observer Variation</topic><topic>Preoperative Care - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liao, Y.-S.</creatorcontrib><creatorcontrib>Lee, L.-W.</creatorcontrib><creatorcontrib>Yang, P.-H.</creatorcontrib><creatorcontrib>Kuo, L.-M.</creatorcontrib><creatorcontrib>Kuan, L.-Y.</creatorcontrib><creatorcontrib>Tseng, W.-Y.I.</creatorcontrib><creatorcontrib>Hwang, D.W.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liao, Y.-S.</au><au>Lee, L.-W.</au><au>Yang, P.-H.</au><au>Kuo, L.-M.</au><au>Kuan, L.-Y.</au><au>Tseng, W.-Y.I.</au><au>Hwang, D.W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of liver cirrhosis for patients with Child's A classification before hepatectomy using dynamic contrast-enhanced MRI</atitle><jtitle>Clinical radiology</jtitle><addtitle>Clin Radiol</addtitle><date>2019-05</date><risdate>2019</risdate><volume>74</volume><issue>5</issue><spage>407.e11</spage><epage>407.e17</epage><pages>407.e11-407.e17</pages><issn>0009-9260</issn><eissn>1365-229X</eissn><abstract>To determine the feasibility of semi-quantitative haemodynamic parameters derived from dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) to assess liver fibrosis.
Seventy-five patients with Child's A classification (males/females=24/51; average age, 58 years; range, 30–80 years) received DCE-MRI 3 days prior to hepatectomy. Semi-quantitative haemodynamic parameters, including the wash-in slope, wash-out slope, and time-to-peak, were calculated from DCE-MRI data. Liver fibrosis of the resected non-tumour liver was graded pathologically from F0 (no fibrosis) to F6 (cirrhosis) in the regions corresponding to those assessed by DCE-MRI.
The wash-out slope showed higher interobserver and intra-observer reliabilities than the wash-in slope and time-to-peak. There was a significant positive correlation between the wash-out slope and pathological grade of fibrosis (Spearman's correlation coefficient: r=0.5331, p<0.0001). The area under the receiver operating characteristic curve was 0.8066 when using the wash-out slope to differentiate cirrhosis (grade F6) from non-cirrhosis (grades F0–5). Using the cut-off point that maximised specificity, the sensitivity was 62.07%, specificity was 91.30%, positive predictive value was 81.81%, negative predictive value was 79.25%, and accuracy was 80%.
The wash-out slope derived from DCE-MRI might be potentially useful in assessing liver cirrhosis in patients with Child's A classification before hepatectomy.
•Wash-out slope of DCE-MRI may be useful for assessing cirrhotic patients with Child's A classification before hepatectomy.•Wash-out slope showed better inter-observer and intra-observer reliabilities than wash-in slope and time-to-peak.•There was a significant positive correlation between the wash-out slope and pathological grading of liver fibrosis.•The area under the ROC curve was 0.8066 when using the wash-out slope to differentiate cirrhosis from non-cirrhosis.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>30799098</pmid><doi>10.1016/j.crad.2019.01.017</doi></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Area Under Curve Contrast Media Feasibility Studies Female Hepatectomy Humans Liver Cirrhosis - pathology Liver Cirrhosis - surgery Magnetic Resonance Imaging - methods Male Middle Aged Observer Variation Preoperative Care - methods |
| title | Assessment of liver cirrhosis for patients with Child's A classification before hepatectomy using dynamic contrast-enhanced MRI |
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