European Radiology

, Volume 29, Issue 2, pp 1013–1021 | Cite as

Magnetic resonance elastography can predict development of hepatocellular carcinoma with longitudinally acquired two-point data

  • Shintaro Ichikawa
  • Utaroh MotosugiEmail author
  • Nobuyuki Enomoto
  • Hiroshi Onishi



To evaluate the usefulness of longitudinal observation of liver stiffness measured using magnetic resonance elastography (MRE) to stratify the risk of hepatocellular carcinoma (HCC) in patients with chronic liver disease.

Materials and methods

We retrospectively reviewed data for 161 patients with chronic liver disease using the following inclusion criteria: two MRE examinations separated by at least a 12-month interval, no history of HCC, no development of HCC between the two examinations and availability of laboratory results. Liver stiffness was classified as low (< 3 kPa), moderate (3–4.7 kPa) or high (> 4.7 kPa). The patients were divided into three groups according to sequential changes in liver stiffness as follows: high on the first MRE (group A, n = 60), low on both MRE examinations (group C, n = 36) and other combinations (group B, n = 65). Cox analyses and Kaplan-Meier methods were used to determine the risk of developing HCC.


Forty-seven patients (29.2%) developed HCC during follow-up (46.7% [28/60] in group A, 26.2% [17/65] in group B, and 5.6% [2/36] in group C). There was a significant difference in the rate of development of HCC between groups A (45.1%), B (26.1%) and C (12.4%) at 3 years (p = 0.0002). The independent risk factors for development of HCC were group A classification, age and a high alanine aminotransferase level (risk ratio 1.018–6.030; p = 0.0028–0.0268).


Longitudinal observation of liver stiffness using MRE can stratify the risk of HCC during follow-up of chronic liver disease.

Key Points

• The results of MRE can stratify the risk for development of HCC during follow-up in patients with chronic liver disease.

• Patients with chronic liver disease and high liver stiffness (> 4.7 kPa) on a previous MRE examination are at high risk for developing HCC, regardless of current liver stiffness.

• Management of patients with chronic liver disease becomes more appropriate using longitudinally acquired two-point MRE data.


Hepatocellular carcinoma Magnetic resonance elastography Risk assessment Observation 



Alanine aminotransferase


Direct-acting antiviral


Magnetic resonance elastography


Protein induced by vitamin K absence or antagonists-II


Sustained virological response



The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Hiroshi Onishi.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in an earlier report (Ichikawa S, et al. J Magn Reson Imaging 2017;46(2):375-382.). Data of magnetic resonance elastography (MRE) for 42 patients in this study were included in the paper; however, the results for two MRE examinations for these patients have not been reported previously.


• Retrospective

• Observational

• Performed at one institution

Supplementary material

330_2018_5640_MOESM1_ESM.docx (5.3 mb)
ESM 1 (DOCX 5467 kb)


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of RadiologyUniversity of YamanashiYamanashiJapan
  2. 2.First Department of Internal MedicineUniversity of YamanashiYamanashiJapan

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