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Comparison of interobserver agreement of magnetic resonance elastography with histopathological staging of liver fibrosis

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Abstract

Purpose

MR elastography (MRE) can serve as an accurate surrogate marker of liver fibrosis. For any diagnostic test that is to replace the current reference standard, interobserver agreement should be at least as good and preferably better. The objective of this study was to perform a head-to-head comparison of the interobserver agreements of MRE and liver fibrosis staging on biopsy in a single cohort of hepatitis patients.

Methods

One hundred and three patients with viral hepatitis B or C who had a liver biopsy underwent MRE. Two readers independently selected a region-of-interest (ROI) in the liver to derive elasticity values. Two pathologists first independently staged fibrosis on biopsies using the METAVIR classification and subsequently held a consensus meeting. Interobserver agreements of elasticity values and fibrosis stages were assessed with intraclass correlation coefficients (ICC).

Results

MRE and biopsy data were available for 85/103 patients. ICC of pathologists staging fibrosis was almost perfect at 0.91 (95% CI 0.86–0.94). ICC for MRE readers was significantly (P < 0.0001) higher at 0.99 (95% CI 0.98–1.00).

Conclusions

Interobserver agreement for liver fibrosis staging was almost perfect for both histopathology and MRE, with a significant higher agreement for MRE. Its high interobserver agreement and reliable accuracy support the use of MRE as a non-invasive screening tool for liver fibrosis.

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Abbreviations

TE:

Transient elastography

MRE:

Magnetic resonance elastography

ICC:

Intraclass correlation coefficient

ROI:

Region-of-interest

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Acknowledgements

This study was presented at the European Society of Gastrointestinal and Abdominal Radiology annual meeting 2013 and was funded by the NutsOhra Foundation, The Netherlands. NutsOhra was not involved in designing and conducting this study, did not have access to the data, and was not involved in data analysis or preparation of this manuscript.

Conflict of interest

None of the authors have potential relevant conflicts of interests to disclose.

Author information

Authors and Affiliations

  1. Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Jurgen H. Runge, Anneloes E. Bohte, Aart J. Nederveen & Jaap Stoker

  2. Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Joanne Verheij

  3. Department of Pathology, Bronovo Hospital, The Hague, The Netherlands

    Valeska Terpstra

  4. Department of Gastroenterology, VU Medical Center, Amsterdam, The Netherlands

    Karin M. J. van Nieuwkerk

  5. Department of Gastroenterology, Erasmus MC University Medical Center, Rotterdam, The Netherlands

    Rob J. de Knegt

  6. Department of Gastroenterology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands

    Bert C. Baak

  7. Department of Gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Peter L. M. Jansen

  8. Department of Radiology and IPMA, INSERM UMR 773, Beaujon University Hospital, University of Paris Diderot, Clichy, France

    Ralph Sinkus

Authors
  1. Jurgen H. Runge
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  2. Anneloes E. Bohte
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Corresponding author

Correspondence to Jurgen H. Runge.

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Runge, J.H., Bohte, A.E., Verheij, J. et al. Comparison of interobserver agreement of magnetic resonance elastography with histopathological staging of liver fibrosis. Abdom Imaging 39, 283–290 (2014). https://doi.org/10.1007/s00261-013-0063-z

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  • DOI: https://doi.org/10.1007/s00261-013-0063-z

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