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Usefulness of iodine-blood material density images in estimating degree of liver fibrosis by calculating extracellular volume fraction obtained from routine dual-energy liver CT protocol equilibrium phase data: preliminary experience

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Abstract

Purpose

To assess whether extracellular volume fraction (ECV) calculated from iodine(-blood) density images (I-B) of dual-energy liver CT (DECT) equilibrium phase data (EqD) is useful in estimating the degree of liver fibrosis.

Materials and methods

Consecutive 52 patients with chronic liver disease who underwent fast kV switching DECT and liver MR elastography (MRE) were retrospectively enrolled. Iodine(-water) density images (I-W) and I-B generated from EqD and ECV were calculated. As blood pools, abdominal aorta (Ao) and suprahepatic inferior vena cava (IVC) were chosen, and, therefore, 4 types of ECV (ECVI-W Ao, ECVI-W IVC, ECVI-B Ao, ECVI-B IVC) were obtained. ECV was also calculated using conventional method (ECVconv Ao). The correlation coefficients (R2 or rho) of these five ECVs versus liver stiffness (MRE) or pathologically proven fibrosis grades were compared.

Results

As for correlation with liver stiffness, R2 for ECVconv.Ao, ECVI-W Ao, ECVI-B Ao, ECVI-W IVC, and ECVI-B IVC, were 0.26, 0.34, 0.44, 0.39, and 0.52, respectively (all p < 0.0001). Histopathological correlation was available in 28 patients, and rho values were 0.61, 0.60, 0.71, 0.68, and 0.76, respectively (all p < 0.001).

Conclusion

ECVI–B IVC calculated from EqD of DECT is useful in estimating the degree of liver fibrosis.

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Abbreviations

CT:

Computed tomography

MR:

Magnetic resonance

MRE:

Magnetic resonance elastography

ECV:

Extracellular volume fraction

ROI:

Region of interest

DECT:

Dual-energy CT

Ao:

Abdominal aorta

IVC:

Inferior vena cava

TR:

Repetition time

TE:

Echo time

SD:

Standard deviation

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Acknowledgements

We thank Professor Shotaro Sakisaka, Chair of the Department of Gastroenterology, Professor Suguru Hasegawa, Chair of the Department of Gastroenterological Surgery, and Professor Kazuki Nabeshima, Chair of the Department of Pathology, Faculty of Medicine, Fukuoka University, for providing clinical and pathological information.

Funding

This research received Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (Grant Number 16K10301). The funding source was used to purchase personal computers, software for analysis, other materials, etc., and also for travel expenses to attend scientific meetings to collect information or to present the data.

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Author notes

  1. Keisuke Sato and Ryotaro Yamamoto are equivalent first authors, contributing as equally as the first author Emi Ito.

Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-1080, Japan

    Emi Ito, Keisuke Sato, Keiko Sakamoto, Hiroshi Urakawa & Kengo Yoshimitsu

  2. Department of Radiology, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino, Fukuoka, 818-8502, Japan

    Ryotaro Yamamoto

Authors
  1. Emi Ito
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  2. Keisuke Sato
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  4. Keiko Sakamoto
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  5. Hiroshi Urakawa
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  6. Kengo Yoshimitsu
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Contributions

KY is the guarantor of integrity of entire study, and was involved in the conception, statistical analysis, and manuscript editing. KS was involved in literature search, and clinical study. EI was involved in literature search, clinical study, and manuscript preparation. KS and RY were involved in literature search, statistical analysis, and manuscript preparation. HU was involved in literature search, and clinical study. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kengo Yoshimitsu.

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Ito, E., Sato, K., Yamamoto, R. et al. Usefulness of iodine-blood material density images in estimating degree of liver fibrosis by calculating extracellular volume fraction obtained from routine dual-energy liver CT protocol equilibrium phase data: preliminary experience. Jpn J Radiol 38, 365–373 (2020). https://doi.org/10.1007/s11604-019-00918-z

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  • DOI: https://doi.org/10.1007/s11604-019-00918-z

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