Multiparametric MR mapping in clinical decision-making for diffuse liver disease

Thomaides-Brears, Helena; Lepe, Rita; Banerjee, Rajarshi; Duncker, Carlos Martínez

doi:10.1007/s00261-020-02684-3

Cited by 37 publications

(35 citation statements)

References 171 publications

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“…Iron-corrected liver T 1 is a histologically validated imaging biomarker of hepatic fibro-inflammation, [19] which has subsequently been developed in Liver MultiScan where it is increasingly being used to monitor the response of hepatitis to novel therapies. [20] By contrast, no statistically significant differences were seen in liver fat ( p =0·18), iron ( p =0·60) and extracellular volume fraction (a marker of diffuse fibrosis, p =0·60) between both groups. Iron-corrected liver T 1 correlated moderately with systemic markers of inflammation (white cell count, neutrophil, monocyte count and CRP) in patients (appendix Table 4, p21), but also in controls.…”

Section: Resultsmentioning

confidence: 79%

Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge

et al. 2021

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Section: Resultsmentioning

confidence: 79%

Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge

et al. 2021

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“…Iron-corrected liver T 1 is a histologically validated imaging biomarker of hepatic fibro-inflammation, 15 which has subsequently been developed in Liver MultiScan where it is increasingly being used to monitor the response of hepatitis to novel therapies. 16 By contrast, liver fat, iron and extracellular volume fraction (a marker of diffuse fibrosis) did not differ between groups. Iron-corrected liver T 1 correlated moderately with systemic markers of inflammation (white cell count, neutrophil, monocyte count and CRP) in patients ( appendix Table 4, p21 ), but also in controls.…”

Section: Resultsmentioning

confidence: 88%

Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge

Raman

Cassar

Tunnicliffe

et al. 2020

Preprint

166

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Background The medium-term effects of Coronavirus disease (COVID-19) on multiple organ health, exercise capacity, cognition, quality of life and mental health are poorly understood. Methods Fifty-eight COVID-19 patients post-hospital discharge and 30 comorbidity-matched controls were prospectively enrolled for multiorgan (brain, lungs, heart, liver and kidneys) magnetic resonance imaging (MRI), spirometry, six-minute walk test, cardiopulmonary exercise test (CPET), quality of life, cognitive and mental health assessments. Findings At 2-3 months from disease-onset, 64% of patients experienced persistent breathlessness and 55% complained of significant fatigue. On MRI, tissue signal abnormalities were seen in the lungs (60%), heart (26%), liver (10%) and kidneys (29%) of patients. COVID-19 patients also exhibited tissue changes in the thalamus, posterior thalamic radiations and sagittal stratum on brain MRI and demonstrated impaired cognitive performance, specifically in the executive and visuospatial domain relative to controls. Exercise tolerance (maximal oxygen consumption and ventilatory efficiency on CPET) and six-minute walk distance (405±118m vs 517±106m in controls, p<0.0001) were significantly reduced in patients. The extent of extra-pulmonary MRI abnormalities and exercise tolerance correlated with serum markers of ongoing inflammation and severity of acute illness. Patients were more likely to report symptoms of moderate to severe anxiety (35% versus 10%, p=0.012) and depression (39% versus 17%, p=0.036) and significant impairment in all domains of quality of life compared to controls. Interpretation A significant proportion of COVID-19 patients discharged from hospital experience ongoing symptoms of breathlessness, fatigue, anxiety, depression and exercise limitation at 2-3 months from disease-onset. Persistent lung and extra-pulmonary organ MRI findings are common. In COVID-19 survivors, chronic inflammation may underlie multiorgan abnormalities and contribute to impaired quality of life.

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“…This could then impact decisions for their own health regarding suitability for other clinical interventions or their suitability as a liver donor. MRI has been shown to provide a more accurate and comprehensive measure of liver health with techniques such as Liver MultiScan, which provide measures of liver iron, fibro-inflammation and liver fat [24,25,46]. Importantly, these measures are standardised across different MRI scanners and field strengths and have a very high technical success rate [47].…”

Section: Plos Onementioning

confidence: 99%

Comparison between magnetic resonance and ultrasound-derived indicators of hepatic steatosis in a pooled NAFLD cohort

Beyer¹,

Hutton²,

Andersson³

et al. 2021

PLoS ONE

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Background & aims MRI-based proton density fat fraction (PDFF) and the ultrasound-derived controlled attenuation parameter (CAP) are non-invasive techniques for quantifying liver fat, which can be used to assess steatosis in patients with non-alcoholic fatty liver disease (NAFLD). This study compared both of these techniques to histopathological graded steatosis for the assessment of fat levels in a large pooled NAFLD cohort. Methods This retrospective study pooled N = 581 participants from two suspected NAFLD cohorts (mean age (SD) 56 (12.7), 60% females). Steatosis was graded according to NASH-CRN criteria. Liver fat was measured non-invasively using PDFF (with Liver MultiScan’s Iterative Decomposition of water and fat with Echo Asymmetry and Least-squares estimation method, LMS-IDEAL, Perspectum, Oxford) and CAP (FibroScan, Echosens, France), and their diagnostic performances were compared. Results LMS-IDEAL and CAP detected steatosis grade ≥ 1 with AUROCs of 1.00 (95% CI, 0.99–1.0) and 0.95 (95% CI, 0.91–0.99), respectively. LMS-IDEAL was superior to CAP for detecting steatosis grade ≥ 2 with AUROCs of 0.77 (95% CI, 0.73–0.82] and 0.60 (95% CI, 0.55–0.65), respectively. Similarly, LMS-IDEAL outperformed CAP for detecting steatosis grade ≥ 3 with AUROCs of 0.81 (95% CI, 0.76–0.87) and 0.63 (95% CI, 0.56–0.70), respectively. Conclusion LMS-IDEAL was able to diagnose individuals accurately across the spectrum of histological steatosis grades. CAP performed well in identifying individuals with lower levels of fat (steatosis grade ≥1); however, its diagnostic performance was inferior to LMS-IDEAL for higher levels of fat (steatosis grades ≥2 and ≥3). Trial registration ClinicalTrials.gov (NCT03551522); https://clinicaltrials.gov/ct2/show/NCT03551522. UMIN Clinical Trials Registry (UMIN000026145); https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000026145.

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Multiparametric MR mapping in clinical decision-making for diffuse liver disease

Cited by 37 publications

References 171 publications

Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge

Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge

Medium-term effects of SARS-CoV-2 infection on multiple vital organs, exercise capacity, cognition, quality of life and mental health, post-hospital discharge

Comparison between magnetic resonance and ultrasound-derived indicators of hepatic steatosis in a pooled NAFLD cohort

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