Multiparametric magnetic resonance imaging for the assessment of non‐alcoholic fatty liver disease severity
Background & Aims The diagnosis of non‐alcoholic steatohepatitis and fibrosis staging are central to non‐alcoholic fatty liver disease assessment. We evaluated multiparametric magnetic resonance in the assessment of non‐alcoholic steatohepatitis and fibrosis using histology as standard in non‐al...
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| Veröffentlicht in: | Liver international 2017-07, Vol.37 (7), p.1065-1073 |
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| creator | Pavlides, Michael Banerjee, Rajarshi Tunnicliffe, Elizabeth M. Kelly, Catherine Collier, Jane Wang, Lai Mun Fleming, Kenneth A. Cobbold, Jeremy F. Robson, Matthew D. Neubauer, Stefan Barnes, Eleanor |
| description | Background & Aims
The diagnosis of non‐alcoholic steatohepatitis and fibrosis staging are central to non‐alcoholic fatty liver disease assessment. We evaluated multiparametric magnetic resonance in the assessment of non‐alcoholic steatohepatitis and fibrosis using histology as standard in non‐alcoholic fatty liver disease.
Methods
Seventy‐one patients with suspected non‐alcoholic fatty liver disease were recruited within 1 month of liver biopsy. Magnetic resonance data were used to define the liver inflammation and fibrosis score (LIF 0‐4). Biopsies were assessed for steatosis, lobular inflammation, ballooning and fibrosis and classified as non‐alcoholic steatohepatitis or simple steatosis, and mild or significant (Activity ≥2 and/or Fibrosis ≥2 as defined by the Fatty Liver Inhibition of Progression consortium) non‐alcoholic fatty liver disease. Transient elastography was also performed.
Results
Magnetic resonance success rate was 95% vs 59% for transient elastography (P |
| doi_str_mv | 10.1111/liv.13284 |
| format | Article |
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The diagnosis of non‐alcoholic steatohepatitis and fibrosis staging are central to non‐alcoholic fatty liver disease assessment. We evaluated multiparametric magnetic resonance in the assessment of non‐alcoholic steatohepatitis and fibrosis using histology as standard in non‐alcoholic fatty liver disease.
Methods
Seventy‐one patients with suspected non‐alcoholic fatty liver disease were recruited within 1 month of liver biopsy. Magnetic resonance data were used to define the liver inflammation and fibrosis score (LIF 0‐4). Biopsies were assessed for steatosis, lobular inflammation, ballooning and fibrosis and classified as non‐alcoholic steatohepatitis or simple steatosis, and mild or significant (Activity ≥2 and/or Fibrosis ≥2 as defined by the Fatty Liver Inhibition of Progression consortium) non‐alcoholic fatty liver disease. Transient elastography was also performed.
Results
Magnetic resonance success rate was 95% vs 59% for transient elastography (P<.0001). Fibrosis stage on biopsy correlated with liver inflammation and fibrosis (rs=.51, P<.0001). The area under the receiver operating curve using liver inflammation and fibrosis for the diagnosis of cirrhosis was 0.85. Liver inflammation and fibrosis score for ballooning grades 0, 1 and 2 was 1.2, 2.7 and 3.5 respectively (P<.05) with an area under the receiver operating characteristic curve of 0.83 for the diagnosis of ballooning. Patients with steatosis had lower liver inflammation and fibrosis (1.3) compared to patients with non‐alcoholic steatohepatitis (3.0) (P<.0001); area under the receiver operating characteristic curve for the diagnosis of non‐alcoholic steatohepatitis was 0.80. Liver inflammation and fibrosis scores for patients with mild and significant non‐alcoholic fatty liver disease were 1.2 and 2.9 respectively (P<.0001). The area under the receiver operating characteristic curve of liver inflammation and fibrosis for the diagnosis of significant non‐alcoholic fatty liver disease was 0.89.
Conclusions
Multiparametric magnetic resonance is a promising technique with good diagnostic accuracy for non‐alcoholic fatty liver disease histological parameters, and can potentially identify patients with non‐alcoholic steatohepatitis and cirrhosis.]]></description><identifier>ISSN: 1478-3223</identifier><identifier>EISSN: 1478-3231</identifier><identifier>DOI: 10.1111/liv.13284</identifier><identifier>PMID: 27778429</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aged ; Alcohol use ; Algorithms ; Area Under Curve ; Balloon treatment ; Biopsy ; Cirrhosis ; Consortia ; Diagnosis ; diagnostic accuracy ; Diagnostic systems ; Elasticity Imaging Techniques ; Fatty liver ; Female ; Fibrosis ; Histology ; Humans ; Inflammation ; Liver ; Liver - diagnostic imaging ; Liver - pathology ; Liver cirrhosis ; Liver Cirrhosis - diagnostic imaging ; Liver Cirrhosis - pathology ; Liver diseases ; Magnetic Resonance Imaging ; Male ; Metabolic Liver Disease ; Middle Aged ; Non-alcoholic Fatty Liver Disease - diagnostic imaging ; Non-alcoholic Fatty Liver Disease - pathology ; non‐alcoholic steatohepatitis ; non‐invasive test ; Parameter identification ; Patients ; Pilot Projects ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Reproducibility of Results ; Resonance ; ROC Curve ; sensitivity and specificity ; Severity of Illness Index ; Steatosis</subject><ispartof>Liver international, 2017-07, Vol.37 (7), p.1065-1073</ispartof><rights>2017 The Authors Liver International Published by John Wiley & Sons Ltd</rights><rights>2017 The Authors Liver International Published by John Wiley & Sons Ltd.</rights><rights>2017 John Wiley & Sons A/S</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5094-1eb5af2d5bc365e8c87285774966c0a95dcb097f8ab3a2a1db35f99be1f515d03</citedby><cites>FETCH-LOGICAL-c5094-1eb5af2d5bc365e8c87285774966c0a95dcb097f8ab3a2a1db35f99be1f515d03</cites></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.13284$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fliv.13284$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27778429$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pavlides, Michael</creatorcontrib><creatorcontrib>Banerjee, Rajarshi</creatorcontrib><creatorcontrib>Tunnicliffe, Elizabeth M.</creatorcontrib><creatorcontrib>Kelly, Catherine</creatorcontrib><creatorcontrib>Collier, Jane</creatorcontrib><creatorcontrib>Wang, Lai Mun</creatorcontrib><creatorcontrib>Fleming, Kenneth A.</creatorcontrib><creatorcontrib>Cobbold, Jeremy F.</creatorcontrib><creatorcontrib>Robson, Matthew D.</creatorcontrib><creatorcontrib>Neubauer, Stefan</creatorcontrib><creatorcontrib>Barnes, Eleanor</creatorcontrib><title>Multiparametric magnetic resonance imaging for the assessment of non‐alcoholic fatty liver disease severity</title><title>Liver international</title><addtitle>Liver Int</addtitle><description><![CDATA[Background & Aims
The diagnosis of non‐alcoholic steatohepatitis and fibrosis staging are central to non‐alcoholic fatty liver disease assessment. We evaluated multiparametric magnetic resonance in the assessment of non‐alcoholic steatohepatitis and fibrosis using histology as standard in non‐alcoholic fatty liver disease.
Methods
Seventy‐one patients with suspected non‐alcoholic fatty liver disease were recruited within 1 month of liver biopsy. Magnetic resonance data were used to define the liver inflammation and fibrosis score (LIF 0‐4). Biopsies were assessed for steatosis, lobular inflammation, ballooning and fibrosis and classified as non‐alcoholic steatohepatitis or simple steatosis, and mild or significant (Activity ≥2 and/or Fibrosis ≥2 as defined by the Fatty Liver Inhibition of Progression consortium) non‐alcoholic fatty liver disease. Transient elastography was also performed.
Results
Magnetic resonance success rate was 95% vs 59% for transient elastography (P<.0001). Fibrosis stage on biopsy correlated with liver inflammation and fibrosis (rs=.51, P<.0001). The area under the receiver operating curve using liver inflammation and fibrosis for the diagnosis of cirrhosis was 0.85. Liver inflammation and fibrosis score for ballooning grades 0, 1 and 2 was 1.2, 2.7 and 3.5 respectively (P<.05) with an area under the receiver operating characteristic curve of 0.83 for the diagnosis of ballooning. Patients with steatosis had lower liver inflammation and fibrosis (1.3) compared to patients with non‐alcoholic steatohepatitis (3.0) (P<.0001); area under the receiver operating characteristic curve for the diagnosis of non‐alcoholic steatohepatitis was 0.80. Liver inflammation and fibrosis scores for patients with mild and significant non‐alcoholic fatty liver disease were 1.2 and 2.9 respectively (P<.0001). The area under the receiver operating characteristic curve of liver inflammation and fibrosis for the diagnosis of significant non‐alcoholic fatty liver disease was 0.89.
Conclusions
Multiparametric magnetic resonance is a promising technique with good diagnostic accuracy for non‐alcoholic fatty liver disease histological parameters, and can potentially identify patients with non‐alcoholic steatohepatitis and cirrhosis.]]></description><subject>Adult</subject><subject>Aged</subject><subject>Alcohol use</subject><subject>Algorithms</subject><subject>Area Under Curve</subject><subject>Balloon treatment</subject><subject>Biopsy</subject><subject>Cirrhosis</subject><subject>Consortia</subject><subject>Diagnosis</subject><subject>diagnostic accuracy</subject><subject>Diagnostic systems</subject><subject>Elasticity Imaging Techniques</subject><subject>Fatty liver</subject><subject>Female</subject><subject>Fibrosis</subject><subject>Histology</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Liver</subject><subject>Liver - diagnostic imaging</subject><subject>Liver - pathology</subject><subject>Liver cirrhosis</subject><subject>Liver Cirrhosis - diagnostic imaging</subject><subject>Liver Cirrhosis - pathology</subject><subject>Liver diseases</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Metabolic Liver Disease</subject><subject>Middle Aged</subject><subject>Non-alcoholic Fatty Liver Disease - diagnostic imaging</subject><subject>Non-alcoholic Fatty Liver Disease - pathology</subject><subject>non‐alcoholic steatohepatitis</subject><subject>non‐invasive test</subject><subject>Parameter identification</subject><subject>Patients</subject><subject>Pilot Projects</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Reproducibility of Results</subject><subject>Resonance</subject><subject>ROC Curve</subject><subject>sensitivity and specificity</subject><subject>Severity of Illness Index</subject><subject>Steatosis</subject><issn>1478-3223</issn><issn>1478-3231</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp1kc1uGyEUhVHVqHaSLvoCFVJXWTgGZvDAJlIUNT-So27abBHDXGysGXABp_Iuj5BnzJOExomVLsqGC3z3cOAg9IWSU1rGtHf3p7Riov6AxrRuxKRiFf24r1k1QocprQihUnL6CY1Y0zSiZnKMhttNn91aRz1Ajs7gQS885FJESMFrbwC7suf8AtsQcV4C1ilBSgP4jIPFPvinh0fdm7AMfemzOuctLpYg4s4l0AlwgrJyeXuMDqzuE3x-nY_Qr8vvPy-uJ_MfVzcX5_OJ4UTWEwot15Z1vDXVjIMwomGCN00tZzNDtOSdaYlsrNBtpZmmXVtxK2UL1HLKO1IdobOd7nrTDtCZYjXqXq1jeUrcqqCd-vfEu6VahHvFORVMyCLw7VUght8bSFmtwib64llRyQgvDJsV6mRHmRhSimD3N1Ci_iajyjeol2QK-_W9pT35FkUBpjvgj-th-38lNb-520k-A9vYnMY</recordid><startdate>201707</startdate><enddate>201707</enddate><creator>Pavlides, Michael</creator><creator>Banerjee, Rajarshi</creator><creator>Tunnicliffe, Elizabeth M.</creator><creator>Kelly, Catherine</creator><creator>Collier, Jane</creator><creator>Wang, Lai Mun</creator><creator>Fleming, Kenneth A.</creator><creator>Cobbold, Jeremy F.</creator><creator>Robson, Matthew D.</creator><creator>Neubauer, Stefan</creator><creator>Barnes, Eleanor</creator><general>Wiley Subscription Services, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><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>7QO</scope><scope>7T5</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>RC3</scope><scope>5PM</scope></search><sort><creationdate>201707</creationdate><title>Multiparametric magnetic resonance imaging for the assessment of non‐alcoholic fatty liver disease severity</title><author>Pavlides, Michael ; Banerjee, Rajarshi ; Tunnicliffe, Elizabeth M. ; Kelly, Catherine ; Collier, Jane ; Wang, Lai Mun ; Fleming, Kenneth A. ; Cobbold, Jeremy F. ; Robson, Matthew D. ; Neubauer, Stefan ; Barnes, Eleanor</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5094-1eb5af2d5bc365e8c87285774966c0a95dcb097f8ab3a2a1db35f99be1f515d03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Alcohol use</topic><topic>Algorithms</topic><topic>Area Under Curve</topic><topic>Balloon treatment</topic><topic>Biopsy</topic><topic>Cirrhosis</topic><topic>Consortia</topic><topic>Diagnosis</topic><topic>diagnostic accuracy</topic><topic>Diagnostic systems</topic><topic>Elasticity Imaging Techniques</topic><topic>Fatty liver</topic><topic>Female</topic><topic>Fibrosis</topic><topic>Histology</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Liver</topic><topic>Liver - diagnostic imaging</topic><topic>Liver - pathology</topic><topic>Liver cirrhosis</topic><topic>Liver Cirrhosis - diagnostic imaging</topic><topic>Liver Cirrhosis - pathology</topic><topic>Liver diseases</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Metabolic Liver Disease</topic><topic>Middle Aged</topic><topic>Non-alcoholic Fatty Liver Disease - diagnostic imaging</topic><topic>Non-alcoholic Fatty Liver Disease - pathology</topic><topic>non‐alcoholic steatohepatitis</topic><topic>non‐invasive test</topic><topic>Parameter identification</topic><topic>Patients</topic><topic>Pilot Projects</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Reproducibility of Results</topic><topic>Resonance</topic><topic>ROC Curve</topic><topic>sensitivity and specificity</topic><topic>Severity of Illness Index</topic><topic>Steatosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pavlides, Michael</creatorcontrib><creatorcontrib>Banerjee, Rajarshi</creatorcontrib><creatorcontrib>Tunnicliffe, Elizabeth M.</creatorcontrib><creatorcontrib>Kelly, Catherine</creatorcontrib><creatorcontrib>Collier, Jane</creatorcontrib><creatorcontrib>Wang, Lai Mun</creatorcontrib><creatorcontrib>Fleming, Kenneth A.</creatorcontrib><creatorcontrib>Cobbold, Jeremy F.</creatorcontrib><creatorcontrib>Robson, Matthew D.</creatorcontrib><creatorcontrib>Neubauer, Stefan</creatorcontrib><creatorcontrib>Barnes, Eleanor</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><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>PubMed Central (Full Participant titles)</collection><jtitle>Liver international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pavlides, Michael</au><au>Banerjee, Rajarshi</au><au>Tunnicliffe, Elizabeth M.</au><au>Kelly, Catherine</au><au>Collier, Jane</au><au>Wang, Lai Mun</au><au>Fleming, Kenneth A.</au><au>Cobbold, Jeremy F.</au><au>Robson, Matthew D.</au><au>Neubauer, Stefan</au><au>Barnes, Eleanor</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multiparametric magnetic resonance imaging for the assessment of non‐alcoholic fatty liver disease severity</atitle><jtitle>Liver international</jtitle><addtitle>Liver Int</addtitle><date>2017-07</date><risdate>2017</risdate><volume>37</volume><issue>7</issue><spage>1065</spage><epage>1073</epage><pages>1065-1073</pages><issn>1478-3223</issn><eissn>1478-3231</eissn><abstract><![CDATA[Background & Aims
The diagnosis of non‐alcoholic steatohepatitis and fibrosis staging are central to non‐alcoholic fatty liver disease assessment. We evaluated multiparametric magnetic resonance in the assessment of non‐alcoholic steatohepatitis and fibrosis using histology as standard in non‐alcoholic fatty liver disease.
Methods
Seventy‐one patients with suspected non‐alcoholic fatty liver disease were recruited within 1 month of liver biopsy. Magnetic resonance data were used to define the liver inflammation and fibrosis score (LIF 0‐4). Biopsies were assessed for steatosis, lobular inflammation, ballooning and fibrosis and classified as non‐alcoholic steatohepatitis or simple steatosis, and mild or significant (Activity ≥2 and/or Fibrosis ≥2 as defined by the Fatty Liver Inhibition of Progression consortium) non‐alcoholic fatty liver disease. Transient elastography was also performed.
Results
Magnetic resonance success rate was 95% vs 59% for transient elastography (P<.0001). Fibrosis stage on biopsy correlated with liver inflammation and fibrosis (rs=.51, P<.0001). The area under the receiver operating curve using liver inflammation and fibrosis for the diagnosis of cirrhosis was 0.85. Liver inflammation and fibrosis score for ballooning grades 0, 1 and 2 was 1.2, 2.7 and 3.5 respectively (P<.05) with an area under the receiver operating characteristic curve of 0.83 for the diagnosis of ballooning. Patients with steatosis had lower liver inflammation and fibrosis (1.3) compared to patients with non‐alcoholic steatohepatitis (3.0) (P<.0001); area under the receiver operating characteristic curve for the diagnosis of non‐alcoholic steatohepatitis was 0.80. Liver inflammation and fibrosis scores for patients with mild and significant non‐alcoholic fatty liver disease were 1.2 and 2.9 respectively (P<.0001). The area under the receiver operating characteristic curve of liver inflammation and fibrosis for the diagnosis of significant non‐alcoholic fatty liver disease was 0.89.
Conclusions
Multiparametric magnetic resonance is a promising technique with good diagnostic accuracy for non‐alcoholic fatty liver disease histological parameters, and can potentially identify patients with non‐alcoholic steatohepatitis and cirrhosis.]]></abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>27778429</pmid><doi>10.1111/liv.13284</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Liver international, 2017-07, Vol.37 (7), p.1065-1073 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Aged Alcohol use Algorithms Area Under Curve Balloon treatment Biopsy Cirrhosis Consortia Diagnosis diagnostic accuracy Diagnostic systems Elasticity Imaging Techniques Fatty liver Female Fibrosis Histology Humans Inflammation Liver Liver - diagnostic imaging Liver - pathology Liver cirrhosis Liver Cirrhosis - diagnostic imaging Liver Cirrhosis - pathology Liver diseases Magnetic Resonance Imaging Male Metabolic Liver Disease Middle Aged Non-alcoholic Fatty Liver Disease - diagnostic imaging Non-alcoholic Fatty Liver Disease - pathology non‐alcoholic steatohepatitis non‐invasive test Parameter identification Patients Pilot Projects Predictive Value of Tests Prognosis Prospective Studies Reproducibility of Results Resonance ROC Curve sensitivity and specificity Severity of Illness Index Steatosis |
| title | Multiparametric magnetic resonance imaging for the assessment of non‐alcoholic fatty liver disease severity |
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