MR elastography‐based liver fibrosis correlates with liver events in nonalcoholic fatty liver patients: A multicenter study
Background & Aims Liver fibrosis assessed by liver biopsy is predictive of clinical liver events in patients with nonalcoholic fatty liver disease (NAFLD). Magnetic resonance elastography (MRE) correlates with liver biopsy in assessing liver fibrosis. However, data assessing the relationship bet...
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| Veröffentlicht in: | Liver international 2020-09, Vol.40 (9), p.2242-2251 |
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| creator | Han, Ma Ai Thanda Vipani, Aarshi Noureddin, Nabil Ramirez, Kim Gornbein, Jeffrey Saouaf, Rola Baniesh, Nader Cummings‐John, Oladuni Okubote, Toluwalase Setiawan, Veronica Wendy Rotman, Yaron Loomba, Rohit Alkhouri, Naim Noureddin, Mazen |
| description | Background & Aims
Liver fibrosis assessed by liver biopsy is predictive of clinical liver events in patients with nonalcoholic fatty liver disease (NAFLD). Magnetic resonance elastography (MRE) correlates with liver biopsy in assessing liver fibrosis. However, data assessing the relationship between MRE and clinical liver events are lacking. We investigated the association between MRE and clinical liver events/death and identified the cut‐off to predict clinical liver events in NAFLD patients.
Methods
We conducted a multicenter retrospective study of NAFLD patients who underwent MRE between 2016 and 2019. Clinical liver events were defined as decompensation events and death. We categorized patients into noncirrhosis, compensated cirrhosis and decompensated cirrhosis. Fisher's exact test was used to test association strength. Receiver operative curve methods were used to determine the optimal cut‐off of MRE liver stiffness and to maximize the accuracy for classifying noncirrhosis, compensated cirrhosis and decompensated cirrhosis. Logistic regression modelling was used to predict decompensation.
Results
The study included 320 NAFLD patients who underwent MRE. The best threshold for distinguishing cirrhosis from noncirrhosis was 4.39 kPa (AUROC 0.92) and from decompensated cirrhosis was 6.48 kPa (AUROC 0.71). Odds of decompensation increased as liver stiffness increased (OR 3.28) (P |
| doi_str_mv | 10.1111/liv.14593 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2423069447</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2432781441</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3303-1731be88f706af31d3b9547ee2f2f8c3dbd897443bf7eaddb6adf386a54232aa3</originalsourceid><addsrcrecordid>eNp10ctKAzEUANAgCtbqwj8IuNHFtJPHvNwV8VGoCKJuQ2YmsSnpZEwyLbMQ_AS_0S8xtcWFYDZ53JML914ATlE8QmGNtVqNEE0KsgcGiGZ5RDBB-79nTA7BkXOLOEZFkaABeL9_hEJz582r5e28__r4LLkTNQyJhIVSldY45WBlrA3OCwfXys93YbESjXdQNbAxDdeVmRutKii59_2OtNyrDbqEE7jstFdVuIV357u6PwYHkmsnTnb7EDzfXD9d3UWzh9vp1WQWVYTEJEIZQaXIc5nFKZcE1aQsEpoJgSWWeUXqss6LjFJSykzwui5TXkuSpzyhmGDOyRCcb_O21rx1wnm2VK4SWvNGmM4xHFycFpRmgZ79oQvT2VDcRhGc5YhSFNTFVlWhPc4KyVqrltz2DMVsMwgWqmc_gwh2vLVrpUX_P2Sz6cv2xzd5HY3D</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2432781441</pqid></control><display><type>article</type><title>MR elastography‐based liver fibrosis correlates with liver events in nonalcoholic fatty liver patients: A multicenter study</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Han, Ma Ai Thanda ; Vipani, Aarshi ; Noureddin, Nabil ; Ramirez, Kim ; Gornbein, Jeffrey ; Saouaf, Rola ; Baniesh, Nader ; Cummings‐John, Oladuni ; Okubote, Toluwalase ; Setiawan, Veronica Wendy ; Rotman, Yaron ; Loomba, Rohit ; Alkhouri, Naim ; Noureddin, Mazen</creator><creatorcontrib>Han, Ma Ai Thanda ; Vipani, Aarshi ; Noureddin, Nabil ; Ramirez, Kim ; Gornbein, Jeffrey ; Saouaf, Rola ; Baniesh, Nader ; Cummings‐John, Oladuni ; Okubote, Toluwalase ; Setiawan, Veronica Wendy ; Rotman, Yaron ; Loomba, Rohit ; Alkhouri, Naim ; Noureddin, Mazen</creatorcontrib><description>Background & Aims
Liver fibrosis assessed by liver biopsy is predictive of clinical liver events in patients with nonalcoholic fatty liver disease (NAFLD). Magnetic resonance elastography (MRE) correlates with liver biopsy in assessing liver fibrosis. However, data assessing the relationship between MRE and clinical liver events are lacking. We investigated the association between MRE and clinical liver events/death and identified the cut‐off to predict clinical liver events in NAFLD patients.
Methods
We conducted a multicenter retrospective study of NAFLD patients who underwent MRE between 2016 and 2019. Clinical liver events were defined as decompensation events and death. We categorized patients into noncirrhosis, compensated cirrhosis and decompensated cirrhosis. Fisher's exact test was used to test association strength. Receiver operative curve methods were used to determine the optimal cut‐off of MRE liver stiffness and to maximize the accuracy for classifying noncirrhosis, compensated cirrhosis and decompensated cirrhosis. Logistic regression modelling was used to predict decompensation.
Results
The study included 320 NAFLD patients who underwent MRE. The best threshold for distinguishing cirrhosis from noncirrhosis was 4.39 kPa (AUROC 0.92) and from decompensated cirrhosis was 6.48 kPa (AUROC 0.71). Odds of decompensation increased as liver stiffness increased (OR 3.28) (P < .001). Increased liver stiffness was associated with ascites, hepatic encephalopathy, oesophageal variceal bleeding and mortality (median 7.10, 10.15 and 10.15 kPa respectively).
Conclusion
In NAFLD patients, liver stiffness measured by MRE with a cut‐off of ≥6.48 kPa is associated with decompensation and mortality, and specific MRE cut‐offs are predictive of individual clinical liver events.</description><identifier>ISSN: 1478-3223</identifier><identifier>EISSN: 1478-3231</identifier><identifier>DOI: 10.1111/liv.14593</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc</publisher><subject>Ascites ; Biopsy ; Bleeding ; Cirrhosis ; decompensated cirrhosis ; Esophagus ; Fatty liver ; Fibrosis ; Hepatic encephalopathy ; Liver ; liver biopsy ; Liver cirrhosis ; Liver diseases ; liver fibrosis ; Magnetic resonance ; magnetic resonance elastography ; Mortality ; nonalcoholic fatty liver disease ; Stiffness ; transient elastography</subject><ispartof>Liver international, 2020-09, Vol.40 (9), p.2242-2251</ispartof><rights>2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2020 John Wiley & Sons A/S</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3303-1731be88f706af31d3b9547ee2f2f8c3dbd897443bf7eaddb6adf386a54232aa3</citedby><cites>FETCH-LOGICAL-c3303-1731be88f706af31d3b9547ee2f2f8c3dbd897443bf7eaddb6adf386a54232aa3</cites><orcidid>0000-0002-7549-8216 ; 0000-0002-2740-2486</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fliv.14593$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fliv.14593$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids></links><search><creatorcontrib>Han, Ma Ai Thanda</creatorcontrib><creatorcontrib>Vipani, Aarshi</creatorcontrib><creatorcontrib>Noureddin, Nabil</creatorcontrib><creatorcontrib>Ramirez, Kim</creatorcontrib><creatorcontrib>Gornbein, Jeffrey</creatorcontrib><creatorcontrib>Saouaf, Rola</creatorcontrib><creatorcontrib>Baniesh, Nader</creatorcontrib><creatorcontrib>Cummings‐John, Oladuni</creatorcontrib><creatorcontrib>Okubote, Toluwalase</creatorcontrib><creatorcontrib>Setiawan, Veronica Wendy</creatorcontrib><creatorcontrib>Rotman, Yaron</creatorcontrib><creatorcontrib>Loomba, Rohit</creatorcontrib><creatorcontrib>Alkhouri, Naim</creatorcontrib><creatorcontrib>Noureddin, Mazen</creatorcontrib><title>MR elastography‐based liver fibrosis correlates with liver events in nonalcoholic fatty liver patients: A multicenter study</title><title>Liver international</title><description>Background & Aims
Liver fibrosis assessed by liver biopsy is predictive of clinical liver events in patients with nonalcoholic fatty liver disease (NAFLD). Magnetic resonance elastography (MRE) correlates with liver biopsy in assessing liver fibrosis. However, data assessing the relationship between MRE and clinical liver events are lacking. We investigated the association between MRE and clinical liver events/death and identified the cut‐off to predict clinical liver events in NAFLD patients.
Methods
We conducted a multicenter retrospective study of NAFLD patients who underwent MRE between 2016 and 2019. Clinical liver events were defined as decompensation events and death. We categorized patients into noncirrhosis, compensated cirrhosis and decompensated cirrhosis. Fisher's exact test was used to test association strength. Receiver operative curve methods were used to determine the optimal cut‐off of MRE liver stiffness and to maximize the accuracy for classifying noncirrhosis, compensated cirrhosis and decompensated cirrhosis. Logistic regression modelling was used to predict decompensation.
Results
The study included 320 NAFLD patients who underwent MRE. The best threshold for distinguishing cirrhosis from noncirrhosis was 4.39 kPa (AUROC 0.92) and from decompensated cirrhosis was 6.48 kPa (AUROC 0.71). Odds of decompensation increased as liver stiffness increased (OR 3.28) (P < .001). Increased liver stiffness was associated with ascites, hepatic encephalopathy, oesophageal variceal bleeding and mortality (median 7.10, 10.15 and 10.15 kPa respectively).
Conclusion
In NAFLD patients, liver stiffness measured by MRE with a cut‐off of ≥6.48 kPa is associated with decompensation and mortality, and specific MRE cut‐offs are predictive of individual clinical liver events.</description><subject>Ascites</subject><subject>Biopsy</subject><subject>Bleeding</subject><subject>Cirrhosis</subject><subject>decompensated cirrhosis</subject><subject>Esophagus</subject><subject>Fatty liver</subject><subject>Fibrosis</subject><subject>Hepatic encephalopathy</subject><subject>Liver</subject><subject>liver biopsy</subject><subject>Liver cirrhosis</subject><subject>Liver diseases</subject><subject>liver fibrosis</subject><subject>Magnetic resonance</subject><subject>magnetic resonance elastography</subject><subject>Mortality</subject><subject>nonalcoholic fatty liver disease</subject><subject>Stiffness</subject><subject>transient elastography</subject><issn>1478-3223</issn><issn>1478-3231</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp10ctKAzEUANAgCtbqwj8IuNHFtJPHvNwV8VGoCKJuQ2YmsSnpZEwyLbMQ_AS_0S8xtcWFYDZ53JML914ATlE8QmGNtVqNEE0KsgcGiGZ5RDBB-79nTA7BkXOLOEZFkaABeL9_hEJz582r5e28__r4LLkTNQyJhIVSldY45WBlrA3OCwfXys93YbESjXdQNbAxDdeVmRutKii59_2OtNyrDbqEE7jstFdVuIV357u6PwYHkmsnTnb7EDzfXD9d3UWzh9vp1WQWVYTEJEIZQaXIc5nFKZcE1aQsEpoJgSWWeUXqss6LjFJSykzwui5TXkuSpzyhmGDOyRCcb_O21rx1wnm2VK4SWvNGmM4xHFycFpRmgZ79oQvT2VDcRhGc5YhSFNTFVlWhPc4KyVqrltz2DMVsMwgWqmc_gwh2vLVrpUX_P2Sz6cv2xzd5HY3D</recordid><startdate>202009</startdate><enddate>202009</enddate><creator>Han, Ma Ai Thanda</creator><creator>Vipani, Aarshi</creator><creator>Noureddin, Nabil</creator><creator>Ramirez, Kim</creator><creator>Gornbein, Jeffrey</creator><creator>Saouaf, Rola</creator><creator>Baniesh, Nader</creator><creator>Cummings‐John, Oladuni</creator><creator>Okubote, Toluwalase</creator><creator>Setiawan, Veronica Wendy</creator><creator>Rotman, Yaron</creator><creator>Loomba, Rohit</creator><creator>Alkhouri, Naim</creator><creator>Noureddin, Mazen</creator><general>Wiley Subscription Services, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7T5</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7549-8216</orcidid><orcidid>https://orcid.org/0000-0002-2740-2486</orcidid></search><sort><creationdate>202009</creationdate><title>MR elastography‐based liver fibrosis correlates with liver events in nonalcoholic fatty liver patients: A multicenter study</title><author>Han, Ma Ai Thanda ; Vipani, Aarshi ; Noureddin, Nabil ; Ramirez, Kim ; Gornbein, Jeffrey ; Saouaf, Rola ; Baniesh, Nader ; Cummings‐John, Oladuni ; Okubote, Toluwalase ; Setiawan, Veronica Wendy ; Rotman, Yaron ; Loomba, Rohit ; Alkhouri, Naim ; Noureddin, Mazen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3303-1731be88f706af31d3b9547ee2f2f8c3dbd897443bf7eaddb6adf386a54232aa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Ascites</topic><topic>Biopsy</topic><topic>Bleeding</topic><topic>Cirrhosis</topic><topic>decompensated cirrhosis</topic><topic>Esophagus</topic><topic>Fatty liver</topic><topic>Fibrosis</topic><topic>Hepatic encephalopathy</topic><topic>Liver</topic><topic>liver biopsy</topic><topic>Liver cirrhosis</topic><topic>Liver diseases</topic><topic>liver fibrosis</topic><topic>Magnetic resonance</topic><topic>magnetic resonance elastography</topic><topic>Mortality</topic><topic>nonalcoholic fatty liver disease</topic><topic>Stiffness</topic><topic>transient elastography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Han, Ma Ai Thanda</creatorcontrib><creatorcontrib>Vipani, Aarshi</creatorcontrib><creatorcontrib>Noureddin, Nabil</creatorcontrib><creatorcontrib>Ramirez, Kim</creatorcontrib><creatorcontrib>Gornbein, Jeffrey</creatorcontrib><creatorcontrib>Saouaf, Rola</creatorcontrib><creatorcontrib>Baniesh, Nader</creatorcontrib><creatorcontrib>Cummings‐John, Oladuni</creatorcontrib><creatorcontrib>Okubote, Toluwalase</creatorcontrib><creatorcontrib>Setiawan, Veronica Wendy</creatorcontrib><creatorcontrib>Rotman, Yaron</creatorcontrib><creatorcontrib>Loomba, Rohit</creatorcontrib><creatorcontrib>Alkhouri, Naim</creatorcontrib><creatorcontrib>Noureddin, Mazen</creatorcontrib><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Liver international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Han, Ma Ai Thanda</au><au>Vipani, Aarshi</au><au>Noureddin, Nabil</au><au>Ramirez, Kim</au><au>Gornbein, Jeffrey</au><au>Saouaf, Rola</au><au>Baniesh, Nader</au><au>Cummings‐John, Oladuni</au><au>Okubote, Toluwalase</au><au>Setiawan, Veronica Wendy</au><au>Rotman, Yaron</au><au>Loomba, Rohit</au><au>Alkhouri, Naim</au><au>Noureddin, Mazen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>MR elastography‐based liver fibrosis correlates with liver events in nonalcoholic fatty liver patients: A multicenter study</atitle><jtitle>Liver international</jtitle><date>2020-09</date><risdate>2020</risdate><volume>40</volume><issue>9</issue><spage>2242</spage><epage>2251</epage><pages>2242-2251</pages><issn>1478-3223</issn><eissn>1478-3231</eissn><abstract>Background & Aims
Liver fibrosis assessed by liver biopsy is predictive of clinical liver events in patients with nonalcoholic fatty liver disease (NAFLD). Magnetic resonance elastography (MRE) correlates with liver biopsy in assessing liver fibrosis. However, data assessing the relationship between MRE and clinical liver events are lacking. We investigated the association between MRE and clinical liver events/death and identified the cut‐off to predict clinical liver events in NAFLD patients.
Methods
We conducted a multicenter retrospective study of NAFLD patients who underwent MRE between 2016 and 2019. Clinical liver events were defined as decompensation events and death. We categorized patients into noncirrhosis, compensated cirrhosis and decompensated cirrhosis. Fisher's exact test was used to test association strength. Receiver operative curve methods were used to determine the optimal cut‐off of MRE liver stiffness and to maximize the accuracy for classifying noncirrhosis, compensated cirrhosis and decompensated cirrhosis. Logistic regression modelling was used to predict decompensation.
Results
The study included 320 NAFLD patients who underwent MRE. The best threshold for distinguishing cirrhosis from noncirrhosis was 4.39 kPa (AUROC 0.92) and from decompensated cirrhosis was 6.48 kPa (AUROC 0.71). Odds of decompensation increased as liver stiffness increased (OR 3.28) (P < .001). Increased liver stiffness was associated with ascites, hepatic encephalopathy, oesophageal variceal bleeding and mortality (median 7.10, 10.15 and 10.15 kPa respectively).
Conclusion
In NAFLD patients, liver stiffness measured by MRE with a cut‐off of ≥6.48 kPa is associated with decompensation and mortality, and specific MRE cut‐offs are predictive of individual clinical liver events.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1111/liv.14593</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-7549-8216</orcidid><orcidid>https://orcid.org/0000-0002-2740-2486</orcidid></addata></record> |
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| ispartof | Liver international, 2020-09, Vol.40 (9), p.2242-2251 |
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| language | eng |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Ascites Biopsy Bleeding Cirrhosis decompensated cirrhosis Esophagus Fatty liver Fibrosis Hepatic encephalopathy Liver liver biopsy Liver cirrhosis Liver diseases liver fibrosis Magnetic resonance magnetic resonance elastography Mortality nonalcoholic fatty liver disease Stiffness transient elastography |
| title | MR elastography‐based liver fibrosis correlates with liver events in nonalcoholic fatty liver patients: A multicenter study |
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