Jorge Mario Fuentes MD, Presenter: Nothing to Disclose

Manuel Patino MD, Abstract Co-Author: Nothing to Disclose

Koichi Hayano MD, Abstract Co-Author: Nothing to Disclose

Yasir Andrabi MD, MPH, Abstract Co-Author: Nothing to Disclose

Mukta Dilipkumar Agrawal MBBS, MD, Abstract Co-Author: Nothing to Disclose

Dushyant V. Sahani MD, Abstract Co-Author: Research Grant, General Electric Company

To evaluate if the iodine quantification in the liver parenchyma from the DECT can serve as a marker for detection and stratification of liver fibrosis.

In this retrospective, IRB approved and HIPPA compliant study, 18 patients underwent dual phase (arterial and delayed phase) DECT scans for either chronic liver disease evaluation or liver lesion characterization. All patients had histopathological confirmation. Ten patients with chronic liver disease conformed the case group; whereas the remaining eight subjects comprised the control group. The normalized Iodine concentrations in the liver (NIL, mg/ml) parenchyma between both groups were compared using t test for both phase acquisitions and for the concentration difference (NIL delayed-arterial) respectively. Additionally, the t-test was also used to compare NIL values between various fibrosis subgroups. The correlation between NIL values and histologic fibrosis scores was evaluated using Spearman’s test. The receiver operating curve (ROC) analysis was applied to evaluate the diagnostic accuracy of the mean NIL to stratify liver fibrosis.

NIL values from the delayed phase were higher in the fibrosis group over the control group (Fibrosis: 0.56 ± 0.04 vs. control: 0.35 ± 0.05 mg/ml, p0.05). NIL values increased along with the Ishak scores, demonstrating a positive and strong correlation (r=0.772, p=0.0001). Mean NIL values from the control, moderate and severe fibrosis groups were statistically different (moderate: 0.55 ± 0.06 mg/ml, severe: 0.71 ± 0.13 mg/ml, p<0.05). NIL values enable discrimination between fibrotic and non-fibrotic liver parenchyma with a threshold of 0.461 mg/ml [sensitivity = 90%; specificity = 90%; area under the ROC (AUROC) = 92%]; and between the control and mild fibrosis groups with a threshold of 0.461 mg/ml [sensitivity and specificity = 75%; AUROC = 81%], between mild and moderate fibrosis with a threshold of 0.508 mg/ml [sensitivity = 100%, specificity = 50%; AUROC = 63%] and between moderate and severe fibrosis and 0.699 mg/ml [sensitivity and specificity = 75%; AUROC = 88%] respectively.

DECT by quantification of NIL values during the delayed phase enables detection and stratification of liver fibrosis.

DECT shows potential to perform liver fibrosis stratification in patients with chronic liver disease, enabling a more robust evaluation of liver disease.

Fuentes, J, Patino, M, Hayano, K, Andrabi, Y, Agrawal, M, Sahani, D, Detection and Stratification of Liver Fibrosis Using Dual Energy CT (DECT).  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015323.html