An individual patient data meta-analysis to determine cut-offs for and confounders of NAFLD-fibrosis staging with magnetic resonance elastography

Viscoelastic parameters derived from multifrequency MR elastography for depicting hepatic fibrosis and inflammation in chronic viral hepatitis

“…In our research, we found c to be a robust indicator for diagnosing fibrosis, exhibiting high sensitivity and specificity, although it failed to detect inflammation. And further subgroup analysis indicated that active necroinflammation (≥ G2) did not significantly influence c at matched fibrosis stages, meaning that stiffness might be barely influenced by active necroinflammation, contrasting with previous results that reported that higher inflammation activity was significantly associated with higher stiffness [ 9 , 11 , 14 , 15 , 21 ]. While previous studies have indicated that hepatic inflammation may stimulate hepatic stellate cells (HSCs), leading to increased collagen production and deposition in interstitial collagen fibrils and the extracellular matrix (ECM) [ 22 , 23 ], it is essential to note that the hepatic histological lesions associated with inflammation are typically linked to hepatocyte necrosis and apoptosis, including periportal and intralobular necrosis [ 20 , 24 ].…”

“…Previous research has indicated that MR elastography (MRE) is as accurate as liver biopsy and offers excellent performance in this regard [ 7 – 9 ]. However, earlier studies have noted that changes in liver shear stiffness (SS) derived from two-dimensional (2D) MRE can be challenging to distinguish between inflammatory activity and the degree of fibrosis [ 8 , 10 ].…”

“…Although previous results reported that higher inflammation activity was associated with higher liver stiffness by increasing local blood availability, inflammatory cell infiltration, and interstitial pressure [ 9 , 14 , 15 ], the intricate connection between fibrosis and inflammation may obscure the diagnostic accuracy. Therefore, the objective of this retrospective study is to assess the diagnostic utility of viscoelastic parameters derived from mMRE in characterizing hepatic fibrosis and inflammation in viral hepatitis patients and further explore the intrinsic of fibrosis and inflammation by viscoelastic parameters.…”

Validation of AGA clinical care pathway and AASLD practice guidance for nonalcoholic fatty liver disease in a prospective cohort of patients with type 2 diabetes

“…Magnetic resonance elastography (MRE) is the most accurate noninvasive biomarker of liver fibrosis with high specificity and positive predictive value (PPV) for advanced fibrosis liver fibrosis. [13][14][15] An additional consideration is that many primary care, endocrinology, and obesity clinics may not have access to VCTE before specialty referral; therefore, assessment of sequential testing with commercially available bloodbased noninvasive tests is also essential, and the ELF has demonstrated an association with progressive NAFLD per AASLD guidance. [16] Therefore, we aimed to examine the diagnostic accuracy of the AGA clinical pathway and sequential screening with FIB-4 and ELF per AASLD guidance in a prospectively recruited cohort of patients with T2DM with MRE as the reference.…”

Editorial: Let your muscles do the talking—what can muscle quality tell us about hepatic fibrosis?

“…In such studies, certain limitations are unavoidable. For example, the aforementioned group of interest had to be excluded, the distribution of fibrosis stages suggests a selection bias, the particular measure of muscle quality is debatable, MR‐based elastography could provide a more accurate definition of fibrosis progression, 8 and changes in the fibrosis‐4 index lend themselves sensitivity analyses. These limitations do not nullify the main conclusions of the paper, but imply that estimates of hazard ratios could be biased and confidence intervals broader than with alternative trial designs.…”