Imaging of Hepatic Fibrosis

  • Rishi Philip Mathew
  • Sudhakar Kundapur VenkateshEmail author
Liver (E Kallwitz and S Cotler, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Liver


Purpose of Review

The purpose of this review is to discuss the current imaging techniques for non-invasive assessment of liver fibrosis (LF).

Recent Findings

Elastography-based techniques are the most widely used imaging methods for the evaluation of LF. Currently, MR elastography (MRE) is the most accurate non-invasive method for detection and staging of LF. Ultrasound-based vibration-controlled transient elastography (VCTE) is the most widely used as it can be easily performed at the point of care but has technical limitations especially in the obese. Innovations and technical improvements continue to evolve in elastography for improving accuracy and avoiding misinterpretation from confounding factors. Other imaging methods including diffusion-weighted imaging (DWI), hepatocellular contrast-enhanced (HCE) MRI, T1 relaxometry, T1ρ imaging, textural analysis, liver surface nodularity, susceptibility-weighted imaging, and perfusion imaging are promising but need further evaluation and clinical validation.


MRE is the most accurate imaging technique for assessment of LF.


Liver fibrosis Functional imaging Magnetic resonance elastography 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Collaborators GMaCoD. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1459–544.CrossRefGoogle Scholar
  2. 2.
    Asrani SK, Larson JJ, Yawn B, Therneau TM, Kim WR. Underestimation of liver-related mortality in the United States. Gastroenterology. 2013;145(2):375–82.e1–2.PubMedPubMedCentralCrossRefGoogle Scholar
  3. 3.
    Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part III: liver, biliary tract, and pancreas. Gastroenterology. 2009;136(4):1134–44.PubMedCrossRefGoogle Scholar
  4. 4.
    Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease: meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73–84.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Martinez SM, Foucher J, Combis J-M, Metivier S, Brunetto M, Capron D, et al. Longitudinal liver stiffness assessment in patients with chronic hepatitis C undergoing antiviral therapy. PLoS One [Electronic Resource]. 2012;7(10):e47715.PubMedPubMedCentralCrossRefGoogle Scholar
  6. 6.
    Marcellin P, Gane E, Buti M, Afdhal N, Sievert W, Jacobson IM, et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study. Lancet. 2013;381(9865):468–75.PubMedCrossRefGoogle Scholar
  7. 7.
    Campana L, Iredale JP. Regression of liver fibrosis. Semin Liver Dis. 2017;37(1):1–10.PubMedCrossRefGoogle Scholar
  8. 8.
    Barr RG, Ferraioli G, Palmeri ML, Goodman ZD, Garcia-Tsao G, Rubin J, et al. Elastography assessment of liver fibrosis: Society of Radiologists in Ultrasound consensus conference statement. Radiology. 2015;276(3):845–61.PubMedCrossRefGoogle Scholar
  9. 9.
    Bravo AA, Sheth SG, Chopra S. Liver biopsy. N Engl J Med. 2001;344(7):495–500.PubMedCrossRefGoogle Scholar
  10. 10.
    Regev A, Berho M, Jeffers LJ, Milikowski C, Molina EG, Pyrsopoulos NT, et al. Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection. Am J Gastroenterol. 2002;97(10):2614–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Foucher J, Chanteloup E, Vergniol J, Castera L, Le Bail B, Adhoute X, et al. Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective study. Gut. 2006;55(3):403–8.PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Millonig G, Reimann FM, Friedrich S, Fonouni H, Mehrabi A, Buchler MW, et al. Extrahepatic cholestasis increases liver stiffness (FibroScan) irrespective of fibrosis. Hepatology. 2008;48(5):1718–23.PubMedCrossRefGoogle Scholar
  13. 13.
    Mederacke I, Wursthorn K, Kirschner J, Rifai K, Manns MP, Wedemeyer H, et al. Food intake increases liver stiffness in patients with chronic or resolved hepatitis C virus infection. Liver Int. 2009;29(10):1500–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Castera L, Foucher J, Bernard PH, Carvalho F, Allaix D, Merrouche W, et al. Pitfalls of liver stiffness measurement: a 5-year prospective study of 13,369 examinations. Hepatology. 2010;51(3):828–35.PubMedGoogle Scholar
  15. 15.
    Yoon KT, Lim SM, Park JY, do Kim Y, Ahn SH, Han KH, et al. Liver stiffness measurement using acoustic radiation force impulse (ARFI) elastography and effect of necroinflammation. Dig Dis Sci. 2012;57(6):1682–91.PubMedCrossRefGoogle Scholar
  16. 16.
    Cassinotto C, Lapuyade B, Aït-Ali A, Vergniol J, Gaye D, Foucher J, et al. Liver fibrosis: noninvasive assessment with acoustic radiation force impulse elastography—comparison with FibroScan M and XL probes and FibroTest in patients with chronic liver disease. Radiology. 2013;269(1):283–92.PubMedCrossRefGoogle Scholar
  17. 17.
    Bota S, Herkner H, Sporea I, Salzl P, Sirli R, Neghina AM, et al. Meta-analysis: ARFI elastography versus transient elastography for the evaluation of liver fibrosis. Liver Int. 2013;33(8):1138–47.PubMedCrossRefGoogle Scholar
  18. 18.
    Ferraioli G, Tinelli C, Zicchetti M, Above E, Poma G, Di Gregorio M, et al. Reproducibility of real-time shear wave elastography in the evaluation of liver elasticity. Eur J Radiol. 2012;81(11):3102–6.PubMedCrossRefGoogle Scholar
  19. 19.
    Cassinotto C, Lapuyade B, Mouries A, Hiriart JB, Vergniol J, Gaye D, et al. Non-invasive assessment of liver fibrosis with impulse elastography: comparison of supersonic shear imaging with ARFI and FibroScan. J Hepatol. 2014;61(3):550–7.PubMedCrossRefGoogle Scholar
  20. 20.
    Muller M, Gennisson JL, Deffieux T, Tanter M, Fink M. Quantitative viscoelasticity mapping of human liver using supersonic shear imaging: preliminary in vivo feasibility study. Ultrasound Med Biol. 2009;35(2):219–29.PubMedCrossRefGoogle Scholar
  21. 21.
    Cassinotto C, Boursier J, de Lédinghen V, Lebigot J, Lapuyade B, Cales P, et al. Liver stiffness in nonalcoholic fatty liver disease: a comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy. Hepatology. 2016;63(6):1817–27.PubMedCrossRefGoogle Scholar
  22. 22.
    Bavu E, Gennisson JL, Couade M, Bercoff J, Mallet V, Fink M, et al. Noninvasive in vivo liver fibrosis evaluation using supersonic shear imaging: a clinical study on 113 hepatitis C virus patients. Ultrasound Med Biol. 2011;37(9):1361–73.PubMedCrossRefGoogle Scholar
  23. 23.
    Woo H, Lee JY, Yoon JH, Kim W, Cho B, Choi BI. Comparison of the reliability of acoustic radiation force impulse imaging and supersonic shear imaging in measurement of liver stiffness. Radiology. 2015;277(3):881–6.PubMedCrossRefGoogle Scholar
  24. 24.
    Babu AS, Wells ML, Teytelboym OM, Mackey JE, Miller FH, Yeh BM, et al. Elastography in chronic liver disease: modalities, techniques, limitations, and future directions. Radiographics. 2016;36(7):1987–2006.CrossRefGoogle Scholar
  25. 25.
    •• Venkatesh SK, Yin M, Ehman RL. Magnetic resonance elastography of liver: technique, analysis, and clinical applications. J Magn Reson Imaging. 2013;37(3):544–55. This review article provides an extensive discussion on the principle, technique, and clinical application of magnetic resonance elastography. PubMedPubMedCentralCrossRefGoogle Scholar
  26. 26.
    • Venkatesh SK, Talwalkar JA. When and how to use magnetic resonance elastography for patients with liver disease in clinical practice. Am J Gastroenterol. 2018;113:923–6. This article provides practical guidelines for using magnetic resonance elastography in the clinical practice. PubMedCrossRefGoogle Scholar
  27. 27.
    Barr RG. Elastography in clinical practice. Radiol Clin N Am. 2014;52(6):1145–62.PubMedCrossRefGoogle Scholar
  28. 28.
    •• Tan CH, Venkatesh SK. Magnetic resonance elastography and other magnetic resonance imaging techniques in chronic liver disease: current status and future directions. Gut Liver. 2016;10(5):672–86. A descriptive review article that provides comparison and discussion of different magnetic resonance imaging techniques available for evaluation of chronic liver disease. PubMedPubMedCentralCrossRefGoogle Scholar
  29. 29.
    Wagner M, Corcuera-Solano I, Lo G, Esses S, Liao J, Besa C, et al. Technical failure of MR elastography examinations of the liver: experience from a large single-center study. Radiology. 2017;284(2):401–12.PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    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(10):1207–13.e2.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Singh S, Venkatesh SK, Wang Z, Miller FH, Motosugi U, Low RN, et al. Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant data. Clin Gastroenterol Hepatol. 2015;13(3):440–51.e6.PubMedCrossRefGoogle Scholar
  32. 32.
    Hines CD, Bley TA, Lindstrom MJ, Reeder SB. Repeatability of magnetic resonance elastography for quantification of hepatic stiffness. J Magn Reson Imaging. 2010;31(3):725–31.PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    Shire NJ, Yin M, Chen J, Railkar RA, Fox-Bosetti S, Johnson SM, et al. Test-retest repeatability of MR elastography for noninvasive liver fibrosis assessment in hepatitis C. J Magn Reson Imaging. 2011;34(4):947–55.PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Trout AT, Serai S, Mahley AD, Wang H, Zhang Y, Zhang B, et al. Liver stiffness measurements with MR elastography: agreement and repeatability across imaging systems, field strengths, and pulse sequences. Radiology. 2016;281(3):793–804.PubMedCrossRefGoogle Scholar
  35. 35.
    Yasar TK, Wagner M, Bane O, Besa C, Babb JS, Kannengiesser S, et al. Interplatform reproducibility of liver and spleen stiffness measured with MR elastography. J Magn Reson Imaging. 2016;43(5):1064–72.PubMedCrossRefGoogle Scholar
  36. 36.
    Joshi M, Dillman JR, Towbin AJ, Serai SD, Trout AT. MR elastography: high rate of technical success in pediatric and young adult patients. Pediatr Radiol. 2017;47(7):838–43.PubMedCrossRefGoogle Scholar
  37. 37.
    Lee VS, Miller FH, Omary RA, Wang Y, Ganger DR, Wang E, et al. Magnetic resonance elastography and biomarkers to assess fibrosis from recurrent hepatitis C in liver transplant recipients. Transplantation. 2011;92(5):581–6.PubMedCrossRefGoogle Scholar
  38. 38.
    Venkatesh SK, Wang G, Lim SG, Wee A. Magnetic resonance elastography for the detection and staging of liver fibrosis in chronic hepatitis B. Eur Radiol. 2014;24(1):70–8.PubMedCrossRefGoogle Scholar
  39. 39.
    Ichikawa S, Motosugi U, Morisaka H, Sano K, Ichikawa T, Enomoto N, et al. Validity and reliability of magnetic resonance elastography for staging hepatic fibrosis in patients with chronic hepatitis B. Magn Reson Med Sci. 2015;14(3):211–21.PubMedCrossRefGoogle Scholar
  40. 40.
    Ichikawa S, Motosugi U, Ichikawa T, Sano K, Morisaka H, Enomoto N, et al. Magnetic resonance elastography for staging liver fibrosis in chronic hepatitis C. Magn Reson Med Sci. 2012;11(4):291–7.PubMedCrossRefGoogle Scholar
  41. 41.
    Singh S, Venkatesh SK, Loomba R, Wang Z, Sirlin C, Chen J, et al. Magnetic resonance elastography for staging liver fibrosis in non-alcoholic fatty liver disease: a diagnostic accuracy systematic review and individual participant data pooled analysis. Eur Radiol. 2016;26(5):1431–40.PubMedCrossRefGoogle Scholar
  42. 42.
    Loomba R, Cui J, Wolfson T, Haufe W, Hooker J, Szeverenyi N, et al. Novel 3D magnetic resonance elastography for the noninvasive diagnosis of advanced fibrosis in NAFLD: a prospective study. Am J Gastroenterol. 2016;111(7):986–94.PubMedPubMedCentralCrossRefGoogle Scholar
  43. 43.
    Loomba R, Wolfson T, Ang B, Hooker J, Behling C, Peterson M, et al. Magnetic resonance elastography predicts advanced fibrosis in patients with nonalcoholic fatty liver disease: a prospective study. Hepatology. 2014;60(6):1920–8.PubMedPubMedCentralCrossRefGoogle Scholar
  44. 44.
    Singh S, Fujii LL, Murad MH, Wang Z, Asrani SK, Ehman RL, et al. Liver stiffness is associated with risk of decompensation, liver cancer, and death in patients with chronic liver diseases: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2013;11(12):1573–84.e1–2. quiz e88–9PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Wang QB, Zhu H, Liu HL, Zhang B. Performance of magnetic resonance elastography and diffusion-weighted imaging for the staging of hepatic fibrosis: a meta-analysis. Hepatology. 2012;56(1):239–47.PubMedCrossRefGoogle Scholar
  46. 46.
    Guo Y, Parthasarathy S, Goyal P, McCarthy RJ, Larson AC, Miller FH. Magnetic resonance elastography and acoustic radiation force impulse for staging hepatic fibrosis: a meta-analysis. Abdom Imaging. 2015;40(4):818–34.PubMedCrossRefGoogle Scholar
  47. 47.
    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(1):32–40.PubMedCrossRefGoogle Scholar
  48. 48.
    Dyvorne HA, Jajamovich GH, Bane O, Fiel MI, Chou H, Schiano TD, et al. Prospective comparison of magnetic resonance imaging to transient elastography and serum markers for liver fibrosis detection. Liver Int. 2016;36(5):659–66.PubMedPubMedCentralCrossRefGoogle Scholar
  49. 49.
    Chen J, Yin M, Talwalkar JA, Oudry J, Glaser KJ, Smyrk TC, et al. Diagnostic performance of MR elastography and vibration-controlled transient elastography in the detection of hepatic fibrosis in patients with severe to morbid obesity. Radiology. 2017;283(2):418–28.PubMedCrossRefGoogle Scholar
  50. 50.
    Bohte AE, de Niet A, Jansen L, Bipat S, Nederveen AJ, Verheij J, et al. Non-invasive evaluation of liver fibrosis: a comparison of ultrasound-based transient elastography and MR elastography in patients with viral hepatitis B and C. Eur Radiol. 2014;24(3):638–48.PubMedCrossRefGoogle Scholar
  51. 51.
    Imajo K, Kessoku T, Honda Y, Tomeno W, Ogawa Y, Mawatari H, et al. Magnetic resonance imaging more accurately classifies steatosis and fibrosis in patients with nonalcoholic fatty liver disease than transient elastography. Gastroenterology. 2016;150(3):626–37.e7.PubMedCrossRefGoogle Scholar
  52. 52.
    Ichikawa S, Motosugi U, Morisaka H, Sano K, Ichikawa T, Tatsumi A, et al. Comparison of the diagnostic accuracies of magnetic resonance elastography and transient elastography for hepatic fibrosis. Magn Reson Imaging. 2015;33(1):26–30.PubMedCrossRefGoogle Scholar
  53. 53.
    Sandrasegaran K. Functional MR imaging of the abdomen. Radiol Clin N Am. 2014;52(4):883–903.PubMedCrossRefGoogle Scholar
  54. 54.
    Sandrasegaran K, Akisik FM, Lin C, Tahir B, Rajan J, Saxena R, et al. Value of diffusion-weighted MRI for assessing liver fibrosis and cirrhosis. AJR Am J Roentgenol. 2009;193(6):1556–60.PubMedCrossRefGoogle Scholar
  55. 55.
    Bülow R, Mensel B, Meffert P, Hernando D, Evert M, Kühn JP. Diffusion-weighted magnetic resonance imaging for staging liver fibrosis is less reliable in the presence of fat and iron. Eur Radiol. 2013;23(5):1281–7.PubMedCrossRefGoogle Scholar
  56. 56.
    Leonhardt M, Keiser M, Oswald S, Kühn J, Jia J, Grube M, et al. Hepatic uptake of the magnetic resonance imaging contrast agent Gd-EOB-DTPA: role of human organic anion transporters. Drug Metab Dispos. 2010;38(7):1024–8.PubMedCrossRefGoogle Scholar
  57. 57.
    Kobayashi S, Matsui O, Gabata T, Koda W, Minami T, Ryu Y, et al. Relationship between signal intensity on hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MR imaging and prognosis of borderline lesions of hepatocellular carcinoma. Eur J Radiol. 2012;81(11):3002–9.PubMedCrossRefGoogle Scholar
  58. 58.
    Van Beers BE, Pastor CM, Hussain HK. Primovist, Eovist: what to expect? J Hepatol. 2012;57(2):421–9.PubMedCrossRefGoogle Scholar
  59. 59.
    Tamada T, Ito K, Higaki A, Yoshida K, Kanki A, Sato T, et al. Gd-EOB-DTPA-enhanced MR imaging: evaluation of hepatic enhancement effects in normal and cirrhotic livers. Eur J Radiol. 2011;80(3):e311–6.PubMedCrossRefGoogle Scholar
  60. 60.
    Verloh N, Haimerl M, Zeman F, Teufel A, Lang S, Stroszczynski C, et al. Multivariable analysis of clinical influence factors on liver enhancement of Gd-EOB-DTPA-enhanced 3T MRI. Rofo. 2015;187(1):29–35.PubMedGoogle Scholar
  61. 61.
    Verloh N, Haimerl M, Zeman F, Schlabeck M, Barreiros A, Loss M, et al. Assessing liver function by liver enhancement during the hepatobiliary phase with Gd-EOB-DTPA-enhanced MRI at 3 Tesla. Eur Radiol. 2014;24(5):1013–9.PubMedCrossRefGoogle Scholar
  62. 62.
    Verloh N, Utpatel K, Haimerl M, Zeman F, Beyer L, Fellner C, et al. Detecting liver fibrosis with Gd-EOB-DTPA-enhanced MRI: a confirmatory study. Sci Rep. 2018;8(1):6207.PubMedPubMedCentralCrossRefGoogle Scholar
  63. 63.
    Feier D, Balassy C, Bastati N, Stift J, Badea R, Ba-Ssalamah A. Liver fibrosis: histopathologic and biochemical influences on diagnostic efficacy of hepatobiliary contrast-enhanced MR imaging in staging. Radiology. 2013;269(2):460–8.PubMedCrossRefGoogle Scholar
  64. 64.
    Norén B, Forsgren MF, Dahlqvist Leinhard O, Dahlström N, Kihlberg J, Romu T, et al. Separation of advanced from mild hepatic fibrosis by quantification of the hepatobiliary uptake of Gd-EOB-DTPA. Eur Radiol. 2013;23(1):174–81.PubMedCrossRefGoogle Scholar
  65. 65.
    Choi YR, Lee JM, Yoon JH, Han JK, Choi BI. Comparison of magnetic resonance elastography and gadoxetate disodium-enhanced magnetic resonance imaging for the evaluation of hepatic fibrosis. Investig Radiol. 2013;48(8):607–13.CrossRefGoogle Scholar
  66. 66.
    Thomsen C, Christoffersen P, Henriksen O, Juhl E. Prolonged T1 in patients with liver cirrhosis: an in vivo MRI study. Magn Reson Imaging. 1990;8(5):599–604.PubMedCrossRefGoogle Scholar
  67. 67.
    Heye T, Yang SR, Bock M, Brost S, Weigand K, Longerich T, et al. MR relaxometry of the liver: significant elevation of T1 relaxation time in patients with liver cirrhosis. Eur Radiol. 2012;22(6):1224–32.PubMedCrossRefGoogle Scholar
  68. 68.
    Hoad CL, Palaniyappan N, Kaye P, Chernova Y, James MW, Costigan C, et al. A study of T1 relaxation time as a measure of liver fibrosis and the influence of confounding histological factors. NMR Biomed. 2015;28(6):706–14.PubMedCrossRefGoogle Scholar
  69. 69.
    Banerjee R, Pavlides M, Tunnicliffe EM, Piechnik SK, Sarania N, Philips R, et al. Multiparametric magnetic resonance for the non-invasive diagnosis of liver disease. J Hepatol. 2014;60(1):69–77.PubMedPubMedCentralCrossRefGoogle Scholar
  70. 70.
    Wang YX, Yuan J. Evaluation of liver fibrosis with T1ρ MR imaging. Quant Imaging Med Surg. 2014;4(3):152–5.PubMedPubMedCentralGoogle Scholar
  71. 71.
    Allkemper T, Sagmeister F, Cicinnati V, Beckebaum S, Kooijman H, Kanthak C, et al. Evaluation of fibrotic liver disease with whole-liver T1ρ MR imaging: a feasibility study at 1.5 T. Radiology. 2014;271(2):408–15.PubMedCrossRefGoogle Scholar
  72. 72.
    Singh A, Reddy D, Haris M, Cai K, Rajender Reddy K, Hariharan H, et al. T1ρ MRI of healthy and fibrotic human livers at 1.5 T. J Transl Med. 2015;13:292.PubMedPubMedCentralCrossRefGoogle Scholar
  73. 73.
    Takayama Y, Nishie A, Asayama Y, Ushijima Y, Okamoto D, Fujita N, et al. T1ρ relaxation of the liver: a potential biomarker of liver function. J Magn Reson Imaging. 2015;42(1):188–95.PubMedCrossRefGoogle Scholar
  74. 74.
    Deng M, Zhao F, Yuan J, Ahuja AT, Wang YX. Liver T1ρ MRI measurement in healthy human subjects at 3 T: a preliminary study with a two-dimensional fast-field echo sequence. Br J Radiol. 2012;85(1017):e590–5.PubMedPubMedCentralCrossRefGoogle Scholar
  75. 75.
    Yu H, Buch K, Li B, O'Brien M, Soto J, Jara H, et al. Utility of texture analysis for quantifying hepatic fibrosis on proton density MRI. J Magn Reson Imaging. 2015;42(5):1259–65.PubMedCrossRefGoogle Scholar
  76. 76.
    Yokoo T, Wolfson T, Iwaisako K, Peterson MR, Mani H, Goodman Z, et al. Evaluation of liver fibrosis using texture analysis on combined-contrast-enhanced magnetic resonance images at 3.0T. Biomed Res Int. 2015;2015:387653.PubMedPubMedCentralCrossRefGoogle Scholar
  77. 77.
    Bahl G, Cruite I, Wolfson T, Gamst AC, Collins JM, Chavez AD, et al. Noninvasive classification of hepatic fibrosis based on texture parameters from double contrast-enhanced magnetic resonance images. J Magn Reson Imaging. 2012;36(5):1154–61.PubMedPubMedCentralCrossRefGoogle Scholar
  78. 78.
    House MJ, Bangma SJ, Thomas M, Gan EK, Ayonrinde OT, Adams LA, et al. Texture-based classification of liver fibrosis using MRI. J Magn Reson Imaging. 2015;41(2):322–8.PubMedCrossRefGoogle Scholar
  79. 79.
    Li Z, Mao Y, Huang W, Li H, Zhu J, Li W, et al. Texture-based classification of different single liver lesion based on SPAIR T2W MRI images. BMC Med Imaging. 2017;17(1):42.PubMedPubMedCentralCrossRefGoogle Scholar
  80. 80.
    Thng CH, Koh TS, Collins DJ, Koh DM. Perfusion magnetic resonance imaging of the liver. World J Gastroenterol. 2010;16(13):1598–609.PubMedPubMedCentralCrossRefGoogle Scholar
  81. 81.
    Hagiwara M, Rusinek H, Lee VS, Losada M, Bannan MA, Krinsky GA, et al. Advanced liver fibrosis: diagnosis with 3D whole-liver perfusion MR imaging—initial experience. Radiology. 2008;246(3):926–34.PubMedCrossRefGoogle Scholar
  82. 82.
    Annet L, Materne R, Danse E, Jamart J, Horsmans Y, Van Beers BE. Hepatic flow parameters measured with MR imaging and Doppler US: correlations with degree of cirrhosis and portal hypertension. Radiology. 2003;229(2):409–14.PubMedCrossRefGoogle Scholar
  83. 83.
    Faria SC, Ganesan K, Mwangi I, Shiehmorteza M, Viamonte B, Mazhar S, et al. MR imaging of liver fibrosis: current state of the art. Radiographics. 2009;29(6):1615–35.PubMedCrossRefGoogle Scholar
  84. 84.
    Balassy C, Feier D, Peck-Radosavljevic M, Wrba F, Witoszynskyj S, Kiefer B, et al. Susceptibility-weighted MR imaging in the grading of liver fibrosis: a feasibility study. Radiology. 2014;270(1):149–58.PubMedCrossRefGoogle Scholar
  85. 85.
    Varenika V, Fu Y, Maher JJ, Gao D, Kakar S, Cabarrus MC, et al. Hepatic fibrosis: evaluation with semiquantitative contrast-enhanced CT. Radiology. 2013;266(1):151–8.PubMedPubMedCentralCrossRefGoogle Scholar
  86. 86.
    Zissen MH, Wang ZJ, Yee J, Aslam R, Monto A, Yeh BM. Contrast-enhanced CT quantification of the hepatic fractional extracellular space: correlation with diffuse liver disease severity. AJR Am J Roentgenol. 2013;201(6):1204–10.PubMedPubMedCentralCrossRefGoogle Scholar
  87. 87.
    Wells ML, Moynagh MR, Carter RE, Childs RA, Leitch CE, Fletcher JG, et al. Correlation of hepatic fractional extracellular space using gadolinium enhanced MRI with liver stiffness using magnetic resonance elastography. Abdom Radiol (NY). 2017;42(1):191–8.CrossRefGoogle Scholar
  88. 88.
    Smith AD, Branch CR, Zand K, Subramony C, Zhang H, Thaggard K, et al. Liver surface nodularity quantification from routine CT images as a biomarker for detection and evaluation of cirrhosis. Radiology. 2016;280(3):771–81.PubMedCrossRefGoogle Scholar
  89. 89.
    Smith AD, Zand KA, Florez E, Sirous R, Shlapak D, Souza F, et al. Liver surface nodularity score allows prediction of cirrhosis decompensation and death. Radiology. 2017;283(3):711–22.PubMedCrossRefGoogle Scholar
  90. 90.
    Pickhardt PJ, Malecki K, Kloke J, Lubner MG. Accuracy of liver surface nodularity quantification on MDCT as a noninvasive biomarker for staging hepatic fibrosis. AJR Am J Roentgenol. 2016;207(6):1194–9.PubMedCrossRefGoogle Scholar
  91. 91.
    Lubner MG, Jones D, Said A, Kloke J, Lee S, Pickhardt PJ. Accuracy of liver surface nodularity quantification on MDCT for staging hepatic fibrosis in patients with hepatitis C virus. Abdom Radiol (NY). 2018.Google Scholar
  92. 92.
    Lo GC, Besa C, King MJ, Kang M, Stueck A, Thung S, et al. Feasibility and reproducibility of liver surface nodularity quantification for the assessment of liver cirrhosis using CT and MRI. Eur J Radiol Open. 2017;4:95–100.PubMedPubMedCentralCrossRefGoogle Scholar
  93. 93.
    Besa C, Wagner M, Lo G, Gordic S, Chatterji M, Kennedy P, et al. Detection of liver fibrosis using qualitative and quantitative MR elastography compared to liver surface nodularity measurement, gadoxetic acid uptake, and serum markers. J Magn Reson Imaging. 2018;47(6):1552–61.PubMedCrossRefGoogle Scholar
  94. 94.
    Feier D, Balassy C, Bastati N, Fragner R, Wrba F, Ba-Ssalamah A. The diagnostic efficacy of quantitative liver MR imaging with diffusion-weighted, SWI, and hepato-specific contrast-enhanced sequences in staging liver fibrosis—a multiparametric approach. Eur Radiol. 2016;26(2):539–46.PubMedCrossRefGoogle Scholar
  95. 95.
    Pavlides M, Banerjee R, Sellwood J, Kelly CJ, Robson MD, Booth JC, et al. Multiparametric magnetic resonance imaging predicts clinical outcomes in patients with chronic liver disease. J Hepatol. 2016;64(2):308–15.PubMedPubMedCentralCrossRefGoogle Scholar
  96. 96.
    Angulo P, Kleiner DE, Dam-Larsen S, Adams LA, Bjornsson ES, Charatcharoenwitthaya P, et al. Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients with nonalcoholic fatty liver disease. Gastroenterology. 2015;149(2):389–97.e10.PubMedPubMedCentralCrossRefGoogle Scholar
  97. 97.
    Shen F, Zheng RD, Mi YQ, Wang XY, Pan Q, Chen GY, et al. Controlled attenuation parameter for non-invasive assessment of hepatic steatosis in Chinese patients. World J Gastroenterol. 2014;20(16):4702–11.PubMedPubMedCentralCrossRefGoogle Scholar
  98. 98.
    Kumar M, Rastogi A, Singh T, Behari C, Gupta E, Garg H, et al. Controlled attenuation parameter for non-invasive assessment of hepatic steatosis: does etiology affect performance? J Gastroenterol Hepatol. 2013;28(7):1194–201.PubMedCrossRefGoogle Scholar
  99. 99.
    Sasso M, Miette V, Sandrin L, Beaugrand M. The controlled attenuation parameter (CAP): a novel tool for the non-invasive evaluation of steatosis using Fibroscan. Clin Res Hepatol Gastroenterol. 2012;36(1):13–20.PubMedCrossRefGoogle Scholar
  100. 100.
    Sasso M, Beaugrand M, de Ledinghen V, Douvin C, Marcellin P, Poupon R, et al. Controlled attenuation parameter (CAP): a novel VCTETM guided ultrasonic attenuation measurement for the evaluation of hepatic steatosis: preliminary study and validation in a cohort of patients with chronic liver disease from various causes. Ultrasound Med Biol. 2010;36(11):1825–35.PubMedCrossRefPubMedCentralGoogle Scholar
  101. 101.
    Shi KQ, Tang JZ, Zhu XL, Ying L, Li DW, Gao J, et al. Controlled attenuation parameter for the detection of steatosis severity in chronic liver disease: a meta-analysis of diagnostic accuracy. J Gastroenterol Hepatol. 2014;29(6):1149–58.PubMedCrossRefGoogle Scholar
  102. 102.
    Chan WK, Nik Mustapha NR, Mahadeva S. Controlled attenuation parameter for the detection and quantification of hepatic steatosis in nonalcoholic fatty liver disease. J Gastroenterol Hepatol. 2014;29(7):1470–6.PubMedCrossRefGoogle Scholar
  103. 103.
    Mikolasevic I, Orlic L, Franjic N, Hauser G, Stimac D, Milic S. Transient elastography (FibroScan(®)) with controlled attenuation parameter in the assessment of liver steatosis and fibrosis in patients with nonalcoholic fatty liver disease—where do we stand? World J Gastroenterol. 2016;22(32):7236–51.PubMedPubMedCentralCrossRefGoogle Scholar
  104. 104.
    Raptis DA, Fischer MA, Graf R, Nanz D, Weber A, Moritz W, et al. MRI: the new reference standard in quantifying hepatic steatosis? Gut. 2012;61(1):117–27.PubMedCrossRefGoogle Scholar
  105. 105.
    Fischer MA, Raptis DA, Montani M, Graf R, Clavien PA, Nanz D, et al. Liver fat quantification by dual-echo MR imaging outperforms traditional histopathological analysis. Acad Radiol. 2012;19(10):1208–14.PubMedCrossRefGoogle Scholar
  106. 106.
    Cui J, Heba E, Hernandez C, Haufe W, Hooker J, Andre MP, et al. Magnetic resonance elastography is superior to acoustic radiation force impulse for the diagnosis of fibrosis in patients with biopsy-proven nonalcoholic fatty liver disease: a prospective study. Hepatology. 2016;63(2):453–61.PubMedCrossRefGoogle Scholar
  107. 107.
    Park CC, Nguyen P, Hernandez C, Bettencourt R, Ramirez K, Fortney L, et al. Magnetic resonance elastography vs transient elastography in detection of fibrosis and noninvasive measurement of steatosis in patients with biopsy-proven nonalcoholic fatty liver disease. Gastroenterology. 2017;152(3):598–607.e2.PubMedCrossRefGoogle Scholar
  108. 108.
    Taouli B, Serfaty L. Magnetic resonance imaging/elastography is superior to transient elastography for detection of liver fibrosis and fat in nonalcoholic fatty liver disease. Gastroenterology. 2016;150(3):553–6.PubMedCrossRefGoogle Scholar
  109. 109.
    Chen J, Talwalkar JA, Yin M, Glaser KJ, Sanderson SO, Ehman RL. Early detection of nonalcoholic steatohepatitis in patients with nonalcoholic fatty liver disease by using MR elastography. Radiology. 2011;259(3):749–56.PubMedPubMedCentralCrossRefGoogle Scholar
  110. 110.
    Kim D, Kim WR, Talwalkar JA, Kim HJ, Ehman RL. Advanced fibrosis in nonalcoholic fatty liver disease: noninvasive assessment with MR elastography. Radiology. 2013;268(2):411–9.PubMedPubMedCentralCrossRefGoogle Scholar
  111. 111.
    • Ajmera V, Loomba R. Can elastography differentiate isolated fatty liver from nonalcoholic steatohepatitis? Semin Liver Dis. 2018;38(1):14–20. Overview of imaging techniques and their use for differentiating isolated fatty liver from non-alcoholic steatohepatitis.PubMedCrossRefGoogle Scholar
  112. 112.
    • Singh S, Muir AJ, Dieterich DT, Falck-Ytter YT. American Gastroenterological Association Institute technical review on the role of elastography in chronic liver diseases. Gastroenterology. 2017;152(6):1544–77. Current guidelines by the american gastroenterological association for the use of elastography in the evaluation of chronic liver diseases.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Rishi Philip Mathew
    • 1
  • Sudhakar Kundapur Venkatesh
    • 1
    Email author
  1. 1.Department of Radiology, Mayo ClinicMayo Clinic College of MedicineRochesterUSA

Personalised recommendations