Shintaro Ichikawa MD, Presenter: Nothing to Disclose

Utaroh Motosugi MD, Abstract Co-Author: Nothing to Disclose

Katsuhiro Sano MD, Abstract Co-Author: Nothing to Disclose

Hiroyuki Morisaka MD, Abstract Co-Author: Nothing to Disclose

Tomoaki Ichikawa MD, PhD, Abstract Co-Author: Consultant, DAIICHI SANKYO Group

MR elastography (MRE) and ultrasound transient elastography (UTE) are noninvasive techniques for assessing hepatic fibrosis. We directly compared the efficacy of them for the diagnosis of hepatic fibrosis.

This study included 113 patients who underwent liver biopsy or surgery, UTE, and MRE. The histological fibrosis score was F0 in 15 patients, F1 in 12, F2 in 19, F3 in 24, and F4 in 43. MR imaging was performed using a 1.5T or 3T (Signa EXCITE HD and Discovery 750; GE Healthcare). UTE was performed using Fibroscan® (EchoSens) by a gastroenterologist. Receiver operating characteristic curve analysis was performed to determine the optimal cutoff value and accuracy of MRE and UTE for staging of hepatic fibrosis.

The mean stiffness values of the liver increased with an increase in the fibrosis stage (MRE: F0, 2.03 ± 0.22 kPa; F1, 2.37 ± 0.33 kPa; F2, 2.92 ± 0.39 kPa; F3, 4.11 ± 0.76 kPa; and F4, 6.34 ± 1.68 kPa and UTE: F0, 5.95 ± 2.34 kPa; F1, 6.93 ± 2.02 kPa; F2, 7.47 ± 3.44 kPa; F3, 14.3 ± 5.99 kPa; F4, 27.1 ± 15.8 kPa). There was a significant correlation between histological fibrosis score and the liver stiffness determined using MRE (r = 0.9166, p < 0.0001) and UTE (r = 0.8100, p < 0.0001). The Az values for diagnosing each fibrosis score were as follows (MRE vs. UTE): ≥F1, 0.97 [0.92–0.99] (mean [95% confidence interval]) vs. 0.87 [0.76–0.93] (p = 0.0126); ≥F2, 0.98 [0.94–0.99] vs. 0.87 [0.79–0.92] (p = 0.0003); ≥F3, 0.99 [0.96–0.99] vs. 0.96 [0.91–0.98] (p = 0.0526); ≥F4, 0.97 [0.93–0.99] vs. 0.93 [0.87–0.96] (p = 0.0308). The optimal cutoff values were as follows: ≥F1, 2.5 kPa; ≥F2, 2.7 kPa; ≥F3, 3.5 kPa; ≥F4, 4.3 kPa with MRE and ≥F1, 6.9 kPa; ≥F2, 9.9 kPa; ≥F3, 10.1 kPa; F4, 13.9 kPa with UTE. The predicted sensitivity and specificity of differentiating fibrosis score with these cutoff values were as follows: ≥F1, 88/98 (89.8%) and 15/15 (100%); ≥F2, 81/86 (94.2%) and 26/27 (96.3%); ≥F3, 56/62 (90.3%) and 50/51 (98.0%); ≥F4, 40/43 (93.0%) and 61/70 (87.1%) with MRE and ≥F1, 78/98 (80.0%) and 13/15 (86.7%); ≥F2, 59/86 (68.6%) and 25/27 (92.6%); ≥F3, 56/62 (90.3%) and 47/51 (92.2%); ≥F4, 39/43 (90.7%) and 60/70 (85.7%) with UTE.

The efficacy of MRE is better than of UTE for diagnosing hepatic fibrosis.

There is only 1 previous report of a direct comparison of MRE and UTE. MRE in our study was performed using a different protocol, but our results were similar to those of the previous report.

Ichikawa, S, Motosugi, U, Sano, K, Morisaka, H, Ichikawa, T, Noninvasive Assessment of Hepatic Fibrosis by Liver Stiffness Measurement: Comparison of MR Elastography and Ultrasound Transient Elastography.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13044181.html