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Combining hepatic surface nodularity and serum tests better predicts hepatic fibrosis stages in chronic liver disease

  • Hepatobiliary
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

Hepatic surface nodularity quantified on CT images has shown promising results in staging hepatic fibrosis in chronic hepatitis C. The aim of this study was to evaluate hepatic surface nodularity, serum fibrosis indices, and a linear combination of them for staging fibrosis in chronic liver disease, mainly chronic hepatitis B.

Methods

We developed a semiautomated software quantifying hepatic surface nodularity on CT images. Hepatic surface nodularity and serum fibrosis indices were assessed in the development group of 125 patients to generate 3 linear models combining hepatic surface nodularity with the aspartate aminotransferase to platelet ratio index, fibrosis-4 index, or platelet count in reference to the METAVIR scoring system. The models were validated in 183 patients.

Results

Hepatic surface nodularity and serum fibrosis indices all significantly correlated with fibrosis stages. For binary classifications into cirrhosis (F4), advanced fibrosis (≥ F3), and significant fibrosis (≥ F2), hepatic surface nodularity was significantly different across categories. The areas under the curve (AUCs) of the best model were 0.901, 0.872, and 0.794 for cirrhosis, advanced fibrosis, and significant fibrosis, respectively, higher than serum fibrosis indices alone (0.797–0.802, 0.799–0.818, and 0.761–0.773). In the validation group, the same model likewise showed higher AUCs (0.872, 0.831, and 0.850) compared to serum fibrosis indices (0.722–0.776, 0.692–0.768, and 0.695–0.769; p < 0.001 for F4).

Conclusion

Hepatic surface nodularity combined with serum blood test could be a practical method to predict cirrhosis, advanced fibrosis, and significant fibrosis in chronic liver disease patients, providing higher accuracy than using serum fibrosis indices alone.

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Funding

This study was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2017R1C1B5076568). The receiver of the fund is Bohyun Kim.

Author information

Author notes

  1. Hyo Jung Cho and Jaewon Choi contributed equally to this work as co-first authors.

Authors and Affiliations

  1. Department of Gastroenterology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Republic of Korea

    Hyo Jung Cho

  2. School of Integrated Technology, College of Engineering, Yonsei University, Incheon, Republic of Korea

    Jaewon Choi & JeongGil Ko

  3. Department of Radiology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Republic of Korea

    Bohyun Kim, Jimi Huh, Jei Hee Lee & Jai Keun Kim

  4. Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Bohyun Kim & Joon-Il Choi

Authors
  1. Hyo Jung Cho
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Correspondence to Bohyun Kim.

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Informed consent was waived by the institutional IRB due to retrospective analysis.

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Cho, H.J., Choi, J., Kim, B. et al. Combining hepatic surface nodularity and serum tests better predicts hepatic fibrosis stages in chronic liver disease. Abdom Radiol 46, 4189–4199 (2021). https://doi.org/10.1007/s00261-021-03113-9

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  • DOI: https://doi.org/10.1007/s00261-021-03113-9

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