MR elastography of liver: current status and future perspectives

İdilman, İlkay S.; Li, Jiahui; Yin, Min-Jean; Venkatesh, Sudhakar K.

doi:10.1007/s00261-020-02656-7

Cited by 73 publications

(61 citation statements)

References 126 publications

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“…Quant Imaging Med Surg 2021;11 (8):3867-3881 | http://dx.doi.org/10.21037/qims-20-1328 than 20 mmHg is the best independent prognostic marker for acute variceal bleeding (17)(18)(19)(20) and thus indicates the presence of a much more severe status. The underlying mechanism of portal hypertension is the increased intrahepatic vascular resistance caused by hepatic fibrosis and/or the increased portal venous flow due to the elevated splanchnic blood flow (21)(22)(23)(24). Splenomegaly caused by portal hypertension also accounts for the elevation of portal venous flow.…”

Section: Introductionmentioning

confidence: 99%

Collaterals in portal hypertension: anatomy and clinical relevance

Maruyama¹,

Shiina²

2021

Quant Imaging Med Surg

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Portal hypertension is a key pathophysiology of chronic liver diseases typified with cirrhosis or noncirrhotic portal hypertension. The development of collateral vessels is a characteristic feature of impaired portal hemodynamics. The paraumbilical vein (PUV), left gastric vein (LGV), posterior gastric vein (PGV), short gastric vein (SGV), splenorenal shunt (SRS), and inferior mesenteric vein (IMV) are major collaterals, and there are some rare collaterals. The degree and hemodynamics of collateral may affect the portal venous circulation and may compensate for the balance between inflow and outflow volume of the liver. Additionally, the development of collateral shows a relation with the liver function reserve and clinical manifestations such as esophageal varices (EV), gastric varices, rectal varices and the other ectopic varices, hepatic encephalopathy, and prognosis. Furthermore, there may be an interrelationship in the development between different collaterals, showing additional influences on the clinical presentations. Thus, the assessment of collaterals may enhance the understanding of the underlying pathophysiology of the condition of patients with portal hypertension. This review article concluded that each collateral has a specific function depending on the anatomy and hemodynamics and is linked with the relative clinical presentation in patients with portal hypertension. Imaging modalities may be essential for the detection, grading and evaluation of the role of collaterals and may help to understand the pathophysiology of the patient condition. Further investigation in a large-scale study would elucidate the basic and clinical significance of collaterals in patients with portal hypertension and may provide information on how to manage them to improve the prognosis as well as quality of life.

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Section: Introductionmentioning

confidence: 99%

Collaterals in portal hypertension: anatomy and clinical relevance

Maruyama¹,

Shiina²

2021

Quant Imaging Med Surg

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“…Recently, magnetic resonance elastography has come under the spotlight, since it seems to be the most accurate non-invasive imaging method for evaluating liver fibrosis (49).…”

Section: The Best Practice Guideline and New Diagnostic Methodsmentioning

confidence: 99%

Non-invasive Diagnostic Tests in Cystic Fibrosis-Related Liver Disease: A Diagnostic Test Accuracy Network Meta-Analysis

et al. 2021

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Background and Aims: Cystic fibrosis-related liver disease (CFLD) is one of the leading causes of morbidity and mortality in cystic fibrosis (CF). Several non-invasive diagnostic methods have been proposed as screening tools for CFLD. Our aim was to rank all available non-invasive modalities for diagnostic performance.Methods: A systematic search was performed in five medical databases to find studies which reported on any single or composite non-invasive diagnostic test (as an index test) compared to the Debray, the EuroCare or the Colombo criteria (as a reference standard). Ranking was carried out with a Bayesian diagnostic test accuracy network meta-analysis based on superiority indices, calculated for pooled sensitivity (Se) and specificity (Sp) with a 95% confidence interval (CI). The study was registered under CRD42020155846 in PROSPERO.Results: Fifteen studies with 15 index tests and a combination of them were included. The New criteria proposed by Koh et al. – which represent a composite diagnostic definition for CFLD including liver biochemistry, ultrasonography, transient elastography and fibrosis markers—had the best performance for detecting CFLD (Se:94%[CI:58–100], Sp:72%[CI:52–84]); while transient elastography (Se:65%[CI:56–74], Sp:88%[CI:84–91]) and a combination of it with a tissue inhibitor of metalloproteinase-4 measurement (Se:78%[CI:30–100], Sp:64%[CI:18–95%]) proved to be the second and third best options, respectively. In the imaging techniques subgroup, transient elastography (Se:66%[CI:57–72], Sp:88%[CI:85–91%]), acoustic radiation force impulse in the right lobe (Se:54%[CI:33–74], Sp:88%[CI:66–96]) and that in the left lobe (Se:55%[CI:23–81], Sp:82%[CI:50–95]) were ranked the highest. Comparing biochemical markers/fibrosis indices, the measurement of the Forns index (Se:72%[CI:25–99], Sp:63%[CI:16–94]), the aspartate aminotransferase-to-platelet ratio (Se:55%[CI:41–68], Sp:83%[CI:66–89]) and alkaline phosphatase (Se:63%[CI:18–93], Sp:64%[CI:19–95]) were ranked the highest.Conclusion: The New criteria show the best diagnostic performance. In clinical practice, transient elastography seems to be a simple, cheap and non-invasive tool, outperforming imaging, biochemical and fibrosis tests for detecting CFLD. Further studies are needed to validate our findings.

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“…Several studies have explored a variety of serum biomarkers [for example, the aspartate aminotransferase (AST)-to-platelet ratio index (APRI) or the fibrosis-4 index (FIB-4)] and imaging techniques [for example, vibrationcontrolled transient elastography, magnetic resonance imaging (MRI) proton density fat fraction, magnetic resonance spectroscopy, magnetic resonance elastography or multiparametric MRI], for the assessment of hepatic steatosis and fibrosis, which have acceptable/good diagnostic performances as non-invasive alternatives to liver biopsy (8)(9)(10)(11)(12)(13)(14)(15). However, to date, there are no non-invasive biomarkers or imaging techniques that can accurately assess hepatic inflammation in NAFLD.…”

Section: Introductionmentioning

confidence: 99%

A novel radiomics signature based on T2-weighted imaging accurately predicts hepatic inflammation in individuals with biopsy-proven nonalcoholic fatty liver disease: a derivation and independent validation study

Chen¹,

Xiao²,

Ye³

et al. 2022

Hepatobiliary Surg Nutr

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Background: Currently, there are no effective methods for assessing hepatic inflammation without resorting to histological examination of liver tissue obtained by biopsy. T2-weighted images (T2WI) are routinely obtained from liver magnetic resonance imaging (MRI) scan sequences. We aimed to establish a radiomics signature based on T2WI (T2-RS) for assessment of hepatic inflammation in people with nonalcoholic fatty liver disease (NAFLD).Methods: A total of 203 individuals with biopsy-confirmed NAFLD from two independent Chinese cohorts with liver MRI examination were enrolled in this study. The hepatic inflammatory activity score (IAS) was calculated by the unweighted sum of the histologic scores for lobular inflammation and ballooning. One thousand and thirty-two radiomics features were extracted from the localized region of interest (ROI) in the right liver lobe of T2WI and, subsequently, selected by minimum redundancy maximum relevance and least absolute shrinkage and selection operator (LASSO) methods. The T2-RS was calculated by adding the selected features weighted by their coefficients.Results: Eighteen radiomics features from Laplacian of Gaussian, wavelet, and original images were selected for establishing T2-RS. The T2-RS value differed significantly between groups with increasing grades of hepatic inflammation (P<0.01). The T2-RS yielded an area under the receiver operating characteristic (ROC) curve (AUROC) of 0.80 [95% confidence interval (CI): 0.71-0.89] for predicting hepatic inflammation in the training cohort with excellent calibration. The AUROCs of T2-RS in the internal cohort and external 2 Chen et al. T2-RS predicts hepatic inflammation in NAFLD

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MR elastography of liver: current status and future perspectives

Cited by 73 publications

References 126 publications

Collaterals in portal hypertension: anatomy and clinical relevance

Collaterals in portal hypertension: anatomy and clinical relevance

Non-invasive Diagnostic Tests in Cystic Fibrosis-Related Liver Disease: A Diagnostic Test Accuracy Network Meta-Analysis

A novel radiomics signature based on T2-weighted imaging accurately predicts hepatic inflammation in individuals with biopsy-proven nonalcoholic fatty liver disease: a derivation and independent validation study

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