Clinical application of Magnetic resonance elastography in hepatocellular carcinoma: from diagnosis to prognosis

Liang, Jia-Xu; Ampuero, Javier; Castell, Javier; Zhang, Qiong; Zhang, Sijia; Chen, Yong; Romero–Gómez, Manuel

doi:10.1016/j.aohep.2022.100889

Cited by 7 publications

(4 citation statements)

References 62 publications

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“…While MRE is already a useful tool for assessing liver stiffness ( 27 ), post-acquisition motion correction of liver MRE may further enhance measurement accuracy. This increased accuracy would be useful in the probing of fibrotic heterogeneity ( 28 ) or the evaluation of hepatocellular carcinoma in which small tumors (less than 1 cm) are often unable to be measured ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Free-breathing motion corrected magnetic resonance elastography of the abdomen

van Schelt,

Wassenaar,

Runge

et al. 2024

Quant Imaging Med Surg

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Background Magnetic resonance elastography (MRE) is a non-invasive method to measure the viscoelastic properties of tissue and has been applied in multiple abdominal organs. However, abdominal MRE suffers from detrimental breathing motion causing misalignment of structures between repeated acquisitions for different MRE dimensions (e.g., motion encoding directions and wave phase offsets). This study investigated motion correction strategies to resolve all breathing motion on sagittal free-breathing MRE acquisitions in a phantom, in healthy volunteers and showed feasibility in patients. Methods First, in silico experiments were performed on a static phantom dataset with simulated motion. Second, eight healthy volunteers underwent two sagittal MRE acquisitions in the pancreas and right kidney. The multi-frequency free-breathing spin-echo echo-planar-imaging (SE-EPI) MRE consisted of four frequencies (30, 40, 50, 60 Hz), eight wave-phase offsets, with 3 mm 3 isotropic voxel size. Following data re-sorting in different number of motion states (4 till 12) based on respiratory waveform signal, three intensity-based registration methods (monomodal, multimodal, and phase correlation) and non-rigid local registration were compared. A ranking method was used to determine the best registration method, based on seven signal-to-noise and image quality measures. Repeatability was assessed for no motion correction (Original) and the best performing method (Best) using Bland-Altman analysis. Lastly, the best motion correction method was compared to no motion correction on patient MRE data [pancreatic ductal adenocarcinoma (PDAC, n=5) and metabolic dysfunction-associated steatotic liver disease (MASLD) (n=1)]. Results In silico experiments showed a deviation of shear wave speed (SWS) with simulated motion to the ground truth, which was (partially) resolved using motion correction. In healthy volunteers ranking resulted in the best motion correction method of monomodal registration using nine motion states, while no motion correction was ranked last. Limits of agreement were (−0.18, 0.14), and (−0.25, 0.18) m/s for Best and Original, respectively. Using motion correction in patients resulted in a significant increase in SWS in the pancreas (Original: 1.39±0.10 and Best: 1.50±0.17 m/s). After motion correction PDAC had a mean SWS of 1.56±0.27 m/s (Original: 1.42±0.25 m/s). The fibrotic liver mean SWS was 2.07±0.20 m/s (Original: 2.12±0.18 m/s). Conclusions Motion correction in sagittal free-breathing abdominal MRE results in improved data quality, inversion precision, repeatability, and is feasible in patients.

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Section: Discussionmentioning

confidence: 99%

Free-breathing motion corrected magnetic resonance elastography of the abdomen

van Schelt,

Wassenaar,

Runge

et al. 2024

Quant Imaging Med Surg

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“…Liver fibrosis is the most important factor associated with HCC development and prognosis in patients with chronic hepatitis B and other chronic hepatitis. 20 , 21 , 22 Therefore, accurate evaluation of liver fibrosis is crucial in clinical practice. Several noninvasive modalities for liver fibrosis assessment have been developed.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance elastography for the prediction of hepatocellular carcinoma in chronic hepatitis B

Tamaki,

Higuchi,

Keitoku

et al. 2024

JGH Open

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Background and AimMagnetic resonance elastography (MRE) is used for the evaluation of liver fibrosis; however, it remains unclear whether MRE‐based liver stiffness is associated with hepatocellular carcinoma (HCC) development, particularly in patients with chronic hepatitis B.MethodsA total of 504 patients with chronic hepatitis B receiving MRE were enrolled. The primary endpoint was the association between MRE‐based liver stiffness and HCC.ResultsIn a cross‐sectional analysis at the time of MRE measurement, the median (interquartile range) liver stiffness values in patients with presence or history of HCC and those without HCC were 3.68 (2.89–4.96) and 2.60 (2.22–3.45) kPa, respectively, and liver stiffness was significantly higher in patients with presence or history of HCC than in those without HCC (P < 0.001). In a longitudinal analysis of patients without HCC, the 1‐, 3‐, and 5‐year cumulative incidence of HCC in patients with liver stiffness ≥3.6 kPa and those with liver stiffness <3.6 kPa were 3.8%, 7.0%, and 22.9%, and 0%, 0.9%, and 1.5%, respectively (P < 0.001). In the multivariable analysis, MRE‐based liver stiffness (per 1 kPa) or liver stiffness ≥3.6 kPa was an independent factor for HCC development with an adjusted hazard ratio (aHR) of 1.61 (95% confidence interval [CI], 1.3–2.0) or aHR of 8.22 (95% CI, 2.1–31).ConclusionMRE‐based liver stiffness is associated with HCC risk in patients with chronic hepatitis B and may be used for the early prediction of HCC development and determination of indications for treatment.

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“…The disadvantages are represented by the fact that this method is not applicable in case of iron overload, requires an MRI facility, and the cost of this procedure. MRE seems to be a promising technique capable of differentiating benign and malignant focal lesions without the use of an intravenous contrast agent [ 43 ]. The study by Venkatesh et al [ 44 ] suggests that a cutoff value of 5.0 kPa may be very accurate (accuracy = 100%) for differentiating benign focal masses from malignant tumors.…”

Section: New Frontiers Of Non-invasive Evaluation Of Patients With He...mentioning

confidence: 99%

Liver Stiffness Values to Predict Occurrence and Recurrence of Hepatocellular Carcinoma

Stasi,

Brillanti

2024

Life

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Globally, liver cancer is the third most frequent etiology of cancer death, with the rates of occurrence of both new cases and mortality estimated to increase. Given the availability of multiple treatments, interdisciplinary management of the patient is crucial. Moreover, the diagnostic assessment of patients with severe liver fibrosis is essential for the staging of HCC and liver cirrhosis and early diagnosis of HCC. In this context, non-invasive evaluation plays a critical role in identifying prognostic factors of clinical application for the surveillance of the occurrence or recurrence of HCC. The new frontiers of transient elastography have become a useful tool to assess the risk of HCC occurrence and recurrence. There has been a major increase in studies investigating the cutoff liver stiffness value that best predicts the need for monitoring for the onset of HCC. Therefore, this review discusses the new advances that have occurred in the last four years on HCC, highlighting the new frontiers of non-invasive evaluation of HCC subjects, with particular attention regarding the clinical application of liver stiffness assessment for de novo HCC and predicting recurrence in patients with chronic HCV achieving sustained virological response after treatment with direct antiviral agents.

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Clinical application of Magnetic resonance elastography in hepatocellular carcinoma: from diagnosis to prognosis

Cited by 7 publications

References 62 publications

Free-breathing motion corrected magnetic resonance elastography of the abdomen

Free-breathing motion corrected magnetic resonance elastography of the abdomen

Magnetic resonance elastography for the prediction of hepatocellular carcinoma in chronic hepatitis B

Liver Stiffness Values to Predict Occurrence and Recurrence of Hepatocellular Carcinoma

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