Native T1 mapping compared to ultrasound elastography for staging and monitoring liver fibrosis: an animal study of repeatability, reproducibility, and accuracy

Li, Jinning; Liu, Huanhuan; Zhang, Caiyuan; Yang, Shuyan; Wang, Yanshu; Chen, Weibo; Li, Xin; Wang, Dengbin

doi:10.1007/s00330-019-06335-0

Cited by 31 publications

(38 citation statements)

References 27 publications

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“…Of note, the values in our healthy control group agree well with normal values in literature [20,21]. Moreover, MR relaxometry has been compared to MR elastography in patients with liver brosis/cirrhosis and shown a good correlation between these techniques [18,19]. Of interest, in an animal model of liver congestion, changes in RA pressure have an immediate effect on the liver [7].…”

Section: Discussionsupporting

confidence: 85%

“…Whereas MR relaxometry of the liver has hardly been used in cardiac patients, use of this modality is more common in patients with 'primary' liver pathology such as to liver brosis in the setting of chronic hepatitis and cirrhosis, and hemochromatosis [18,19]. Of note, the values in our healthy control group agree well with normal values in literature [20,21].…”

Section: Discussionsupporting

confidence: 81%

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Detection of Passive Liver Congestion in Pericarditis Patients With Constrictive Physiology Using MR Relaxometry of the Liver.

Bogaert¹,

Dresselaers²,

Imazio³

et al. 2020

Preprint

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Constrictive pericarditis is a common cause of right heart failure, characterized by increased filling pressures and passive liver congestion. As magnetic resonance (MR) T1 and T2 mapping allow quantification of liver relaxation times, we hypothesized liver mapping may allow depiction of passive liver congestion. We studied 45 pericarditis patients, of whom 25 presented constrictive physiology (CP+) and 20 normal physiology (CP-), and 30 control subjects. Pericarditis patients were predominantly male, but CP+ patients were on average 13 years older than CP- patients (p=0.003). Native T1 and T2 values as well as extracellular volume (ECV) values of the liver were significantly higher in CP+ than in CP- patients and controls, i.e. native T1: 765±102ms vs 581±56ms and 537±30ms; T2: 63±13ms vs 50±4ms and 46±4ms; ECV: 42±7% vs 31±3% and 30±3% control (all p<0.001). Using a cut-off right atrial (RA) pressure of >5 mm Hg to discriminate between normal and increased RA pressure, native T1 liver yielded the highest AUC (0.926) at ROC analysis with a sensitivity of 79.3% and specificity of 95.6%. Moreover, liver mapping showed excellent intra- and inter-reader agreement. In conclusion, liver mapping as part of a comprehensive cardiovascular MR exam is valuable to depict liver congestion in pericarditis patients.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 81%

Detection of Passive Liver Congestion in Pericarditis Patients With Constrictive Physiology Using MR Relaxometry of the Liver.

Bogaert¹,

Dresselaers²,

Imazio³

et al. 2020

Preprint

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show abstract

“…Moreover, recently published studies have already shown positive correlations between hepatic T1, T2, and ECV with liver fibrosis in both animal and human models [15,[18][19][20]36]. There are also studies showing positive correlations between T1, T2 mapping parameters and MRE with liver fibrosis, however, without focusing on AIH patients [21,37].…”

Section: Discussionmentioning

confidence: 99%

Non-invasive assessment of liver fibrosis in autoimmune hepatitis: Diagnostic value of liver magnetic resonance parametric mapping including extracellular volume fraction

et al. 2020

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Purpose Autoimmune hepatitis (AIH) is an immune-mediated chronic liver disease that leads to severe fibrosis and cirrhosis. The aim of this study was to determine the diagnostic value of T1 and T2 mapping as well as extracellular volume fraction (ECV) for non-invasive assessment of liver fibrosis in AIH patients. Methods In this prospective study, 27 patients (age range: 19–77 years) with AIH underwent liver MRI. T1 and T2 relaxation times as well as ECV were quantified by mapping techniques. The presence of significant fibrosis (≥ F2) was defined as magnetic resonance elastography (MRE)-based liver stiffness ≥ 3.66 kPa. MRE was used as reference standard, against which the diagnostic performance of MRI-derived mapping parameters was tested. Diagnostic performance was compared by utilizing receiver-operating characteristic (ROC) analysis. Results MRE-based liver stiffness correlated with both, hepatic native T1 (r = 0.69; P < 0.001) as well as ECV (r = 0.80; P < 0.001). For the assessment of significant fibrosis, ECV yielded a sensitivity of 85.7% (95% confidence interval (CI): 60.1–96.0%) and a specificity of 84.6% (CI 60.1–96.0%); hepatic native T1 yielded a sensitivity of 85.7% (CI 60.1–96.0%); and a specificity of 76.9% (CI 49.7–91.8%). Diagnostic performance of hepatic ECV (area under the curve (AUC): 0.885), native hepatic T1 (AUC: 0.846) for assessment of significant fibrosis was similar compared to clinical fibrosis scores (APRI (AUC: 0.852), FIB-4 (AUC: 0.758), and AAR (0.654) (P > 0.05 for each comparison)). Conclusion Quantitative mapping parameters such as T1 and ECV can identify significant fibrosis in AIH patients. Future studies are needed to explore the value of parametric mapping for the evaluation of different disease stages.

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“…Further application areas have emerged with the use of T1 quantification to estimate liver function and the severity of liver fibrosis in humans [ 19 , 20 , 21 ] and animal models [ 22 ]. A recent study demonstrated superior diagnostic accuracy of T1 mapping over ultrasound elastography in early liver fibrosis [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Native T1 Mapping Magnetic Resonance Imaging as a Quantitative Biomarker for Characterization of the Extracellular Matrix in a Rabbit Hepatic Cancer Model

et al. 2020

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To characterize the tumor extracellular matrix (ECM) using native T1 mapping magnetic resonance imaging (MRI) in an experimental hepatic cancer model, a total of 27 female New Zealand white rabbits with hepatic VX2 tumors were examined by MRI at different time points following tumor implantation (day 14, 21, 28). A steady-state precession readout single-shot MOLLI sequence was acquired in a 3 T MRI scanner in prone position using a head-neck coil. The tumors were segmented into a central, marginal, and peritumoral region in anatomical images and color-coded T1 maps. In histopathological sections, stained with H&E and Picrosirius red, the regions corresponded to central tumor necrosis and accumulation of viable cells with fibrosis in the tumor periphery. Another region of interest (ROI) was placed in healthy liver tissue. T1 times were correlated with quantitative data of collagen area staining. A two-way repeated-measures ANOVA was used to compare cohorts and tumor regions. Hepatic tumors were successfully induced in all rabbits. T1 mapping demonstrated significant differences between the different tumor regions (F(1.43,34.26) = 106.93, p < 0.001) without interaction effects between time points and regions (F(2.86,34.26) = 0.74, p = 0.53). In vivo T1 times significantly correlated with ex vivo collagen stains (area %), (center: r = 0.78, p < 0.001; margin: r = 0.84, p < 0.001; peritumoral: r = 0.73, p < 0.001). Post hoc tests using Sidak’s correction revealed significant differences in T1 times between all three regions (p < 0.001). Native T1 mapping is feasible and allows the differentiation of tumor regions based on ECM composition in a longitudinal tumor study in an experimental small animal model, making it a potential quantitative biomarker of ECM remodeling and a promising technique for future treatment studies.

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Native T1 mapping compared to ultrasound elastography for staging and monitoring liver fibrosis: an animal study of repeatability, reproducibility, and accuracy

Cited by 31 publications

References 27 publications

Detection of Passive Liver Congestion in Pericarditis Patients With Constrictive Physiology Using MR Relaxometry of the Liver.

Detection of Passive Liver Congestion in Pericarditis Patients With Constrictive Physiology Using MR Relaxometry of the Liver.

Non-invasive assessment of liver fibrosis in autoimmune hepatitis: Diagnostic value of liver magnetic resonance parametric mapping including extracellular volume fraction

Native T1 Mapping Magnetic Resonance Imaging as a Quantitative Biomarker for Characterization of the Extracellular Matrix in a Rabbit Hepatic Cancer Model

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