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Magnetic resonance elastography of the liver: preliminary results and estimation of inter-rater reliability

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Abstract

Purpose

The aim of this study was to estimate inter-rater reliability and validate magnetic resonance elastography (MRE) as a tool to measure liver elasticity.

Materials and methods

The study protocol was approved by the institutional review board at our institution. In all, 10 normal volunteers and 110 patients, who provided written informed consent, were enrolled. The pathological fibrosis score was applied as a standard reference of liver fibrosis in 21 patients. MRE was performed with a 1.5-T magnetic resonance imaging scanner with a cylindrical passive longitudinal shear wave driver placed over the right chest wall to deliver vibrations. A gradient-echo MRE sequence was used to acquire axial wave images, which were automatically converted to elastograms representing elasticity (in kilopascals, or kPa). The region of interest was placed in the right lobe of the liver on elastograms by two raters independently. To evaluate interrater reliability, the intraclass correlation coefficient was calculated. The elasticity measurements correlated with the pathological fibrosis score (F1–F4) in 21 patients.

Results

The intraclass correlation coefficient was almost perfect (0.993) between the elasticities measured by the two raters. The mean elasticity value for patients with F4 was 5.7 kPa; F3, 4.4 kPa; F2, 3.1 kPa; F1, 2.2 kPa; and F0, 2.1 kPa.

Conclusion

MRE is a reliable tool to measure liver elasticity.

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References

  1. Perrillo RP. The role of liver biopsy in hepatitis C. Hepatology 1997:26:57S–61S.

    Article  CAS  PubMed  Google Scholar 

  2. Yoshida H, Shiratori Y, Moriyama M, Arakawa Y, Ide T, Sata M, et al. Interferon therapy reduces the risk for hepatocellular carcinoma: national surveillance program of cirrhotic and noncirrhotic patients with chronic hepatitis C in Japan—IHIT Study Group: Inhibition of Hepatocarcinogenesis by Interferon Therapy. Ann Intern Med 1999;131:174–181.

    CAS  PubMed  Google Scholar 

  3. Tsukuma H, Hiyama T, Tanaka S, Nakao M, Yabuuchi T, Kitamura T, et al. Risk factors for hepatocellular carcinoma among patients with chronic liver disease. N Engl J Med 1993;328:1797–1801.

    Article  CAS  PubMed  Google Scholar 

  4. Glaser KJ, Felmlee JP, Manduca A, Ehman RL. Shear stiffness estimation using intravoxel phase dispersion in magnetic resonance elastography. Magn Reson Med 2003;50:1256–1265.

    Article  PubMed  Google Scholar 

  5. Rouviere O, Yin M, Dresner MA, Rossman PJ, Burgart LJ, Fidler JL, et al. MR elastography of the liver: preliminary results. Radiology 2006;240:440–448.

    Article  PubMed  Google Scholar 

  6. Talwalkar JA, Yin M, Fidler JL, Sanderson SO, Kamath PS, Ehman RL. Magnetic resonance imaging of hepatic fibrosis: emerging clinical applications. Hepatology 2008;47:332–342.

    Article  PubMed  Google Scholar 

  7. Huwart L, Sempoux C, Salameh N, Jamart J, Annet L, Sinkus R, et al. Liver fibrosis: noninvasive assessment with MR elastography versus aspartate aminotransferase-to-platelet ratio index. Radiology 2007;245:458–466.

    Article  PubMed  Google Scholar 

  8. Yin M, Talwalkar JA, Glaser KJ, Manduca A, Grimm RC, Rossman PJ, et al. Assessment of hepatic fibrosis with magnetic resonance elastography. Clin Gastroenterol Hepatol 2007;5:1207–1213.

    Article  PubMed  Google Scholar 

  9. Manduca A, Oliphant TE, Dresner MA, Mahowald JL, Kruse SA, Amromin E, et al. Magnetic resonance elastography: non-invasive mapping of tissue elasticity. Med Image Anal 2001;5:237–254.

    Article  CAS  PubMed  Google Scholar 

  10. Talwalkar JA, Yin M, Venkatesh S, Rossman PJ, Grimm RC, Manduca A, et al. Feasibility of in vivo MR elastographic splenic stiffness measurements in the assessment of portal hypertension. AJR Am J Roentgenol 2009;193:122–127.

    Article  PubMed  Google Scholar 

  11. Venkatesh SK, Yin M, Glockner JF, Takahashi N, Araoz PA, Talwalkar JA, et al. MR elastography of liver tumors: preliminary results. AJR Am J Roentgenol 2008;190:1534–1540.

    Article  PubMed  Google Scholar 

  12. Afdhal NH, Nunes D. Evaluation of liver fibrosis: a concise review. Am J Gastroenterol 2004;99:1160–1174.

    Article  PubMed  Google Scholar 

  13. Imbert-Bismut F, Ratziu V, Pieroni L, Charlotte F, Benhamou Y, Poynard T. Biochemical markers of liver fibrosis in patients with hepatitis C virus infection: a prospective study. Lancet 2001;357:1069–1075.

    Article  CAS  PubMed  Google Scholar 

  14. Castera L, Vergniol J, Foucher J, Le Bail B, Chanteloup E, Haaser M, et al. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology 2005;128:343–350.

    Article  PubMed  Google Scholar 

  15. Patel J, Sigmund EE, Rusinek H, Oei M, Babb JS, Taouli B. Diagnosis of cirrhosis with intravoxel incoherent motion diffusion MRI and dynamic contrast-enhanced MRI alone and in combination: preliminary experience. J Magn Reson Imaging 2010;31:589–600.

    Article  PubMed  Google Scholar 

  16. Luciani A, Vignaud A, Cavet M, Nhieu JT, Mallat A, Ruel L, et al. Liver cirrhosis: intravoxel incoherent motion MR imaging—pilot study. Radiology 2008;249:891–899.

    Article  PubMed  Google Scholar 

  17. Huwart L, Sempoux C, Vicaut E, Salameh N, Annet L, Danse E, et al. Magnetic resonance elastography for the noninvasive staging of liver fibrosis. Gastroenterology 2008;135:32–40.

    Article  PubMed  Google Scholar 

  18. Padhani AR, Liu G, Koh DM, Chenevert TL, Thoeny HC, Takahara T, et al. Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 2009;11:102–105.

    CAS  PubMed  Google Scholar 

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Correspondence to Utaroh Motosugi.

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Motosugi, U., Ichikawa, T., Sano, K. et al. Magnetic resonance elastography of the liver: preliminary results and estimation of inter-rater reliability. Jpn J Radiol 28, 623–627 (2010). https://doi.org/10.1007/s11604-010-0478-1

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  • DOI: https://doi.org/10.1007/s11604-010-0478-1

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