B-mode ultrasound for the assessment of hepatic fibrosis: a quantitative multiparametric analysis for a radiomics approach

Abstract

Hepatic fibrosis and cirrhosis are a growing global health problem with increasing mortality rates. Early diagnosis and staging of hepatic fibrosis represent a major challenge. Currently liver biopsy is the gold standard for fibrosis assessment; however, biopsy requires an invasive procedure and is prone to sampling error and reader variability. In the current study we investigate using quantitative analysis of computer-extracted features of B-mode ultrasound as a non-invasive tool to characterize hepatic fibrosis. Twenty-two rats were administered diethylnitrosamine (DEN) orally for 12 weeks to induce hepatic fibrosis. Four control rats did not receive DEN. B-mode ultrasound scans sampling throughout the liver were acquired at baseline, 10, and 13 weeks. Computer extracted quantitative parameters representing brightness (echointensity, hepatorenal index) and variance (heterogeneity, anisotropy) of the liver were studied. DEN rats showed an increase in echointensity from 37.1 ± SD 7.8 to 53.5 ± 5.7 (10 w) to 57.5 ± 6.1 (13 w), while the control group remained unchanged at an average of 34.5 ± 4.5. The three other features studied increased similarly over time in the DEN group. Histologic analysis showed METAVIR fibrosis grades of F2-F4 in DEN rats and F0-F1 in controls. Increasing imaging parameters correlated with increasing METAVIR grades, and anisotropy showed the strongest correlation (ρ = 0.58). Sonographic parameters combined using multiparametric logistic regression were able to differentiate between clinically significant and insignificant fibrosis. Quantitative B-mode ultrasound imaging can be implemented in clinical settings as an accurate non-invasive tool for fibrosis assessment.

A radiomics-based model to classify the etiology of liver cirrhosis using gadoxetic acid-enhanced MRI

“…Approximately 1 million people die from complications of cirrhosis all over the world each year. In addition, cirrhosis accounts for 1.6% and 2.1% of the worldwide burden of disability-adjusted life years and years of life lost, respectively 1 , 6 .…”

“…1.2% and a mortality rate of 0.4%. Other limitations of liver biopsy include inter- and intraobserver variability and sampling error 6 – 8 . Such limitations emphasize the need for developing an alternative noninvasive method for identifying the etiology of liver cirrhosis especially in patients with indeterminate findings based on standard noninvasive diagnostic algorithms including physical examination, laboratory testing, biochemical markers, and imaging modalities 5 , 6 , 9 , 10 .…”

Photoacoustic Imaging for Assessing Tissue Oxygenation Changes in Rat Hepatic Fibrosis

“…As hepatic fibrosis developed, these later increases in echogenicity and coarseness could be related to an excessive accumulation of extracellular matrix components in the liver parenchyma [ 41 ]. Although increase in liver echogenicity is associated with steatosis as well as fibrosis [ 42 ], histological assessment of rat liver tissues in our previous study showed that DEN administration in rodents did not cause liver steatosis [ 5 ]. Hence, the accompanying changes in the liver texture features along with increased echogenicity of liver tissue induced by DEN ingestion are more likely due to fibrotic changes rather than steatosis.…”

Study Processes and Applications of Ultrasomics in Precision Medicine

“…An accurate assessment of liver status is essential for the prognosis, monitoring and management of CHB patients. D Souza et al studied the B-mode ultrasound features of the liver in a rat model to assess liver fibrosis (32). The computer algorithm extracted quantitative parameters representing brightness (echo intensity and liver and kidney index) and variance (heterogeneity) to study the anisotropy of the liver.…”