Staging liver fibrosis in chronic hepatitis B with <i>T</i><sub>1</sub> relaxation time index on gadoxetic acid‐enhanced MRI: Comparison with aspartate aminotransferase‐to‐platelet ratio index and FIB‐4

Yang, Li; Ding, Ying; Rao, Sheng-Xiang; Chen, Caizhong; Wu, Lifang; Sheng, Ruofan; Fu, Caixia; Zeng, Mengsu

doi:10.1002/jmri.25440

Cited by 24 publications

(11 citation statements)

References 38 publications

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“…A total of 2831 studies were searched by the described search strategies, of which 2627 were excluded following title and abstract screening. Of those, 81 papers were included in the review following full-text screening (Text S5); 47 studies were related to the APRI[24-70], 11 to the ARFI[29,42,69-77], 32 to the FIB-4[24,25,27,30,35,36,39,40,43-46,48-55,57,58,60,62,63,65-69,78-79], 29 to the FibroScan[28,38,42,52,53,58,60,61,71,73,80-98], and 6 to the MRE[99-104].…”

Section: Resultsmentioning

confidence: 99%

Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

Xue¹,

Wang²,

Zhang³

et al. 2019

WJCC

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BACKGROUND Noninvasive biomarkers have been developed to predict hepatitis B virus (HBV) related fibrosis owing to the significant limitations of liver biopsy. Both serum biomarkers and imaging techniques have shown promising results and may improve the evaluation of liver fibrosis. However, most of the previous studies focused on the diagnostic effects of various imaging techniques on fibrosis in all chronic liver diseases. AIM To compare the performance of common imaging methods and serum biomarkers for prediction of significant fibrosis caused only by HBV infection. METHODS A systematic review was conducted on the records available in PubMed, EMBASE, and the Cochrane Library electronic databases until December 2018. We systematically assessed the effectiveness of two serum biomarkers and three imagine techniques in predicting significant fibrosis solely caused by HBV infection. The serum biomarkers included aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on the 4 factors (FIB-4). The three imaging techniques included acoustic radiation force impulse (ARFI), FibroScan, and magnetic resonance elastography (MRE). Three parameters, the area under the summary receiver operating characteristic curve (AUSROC), the summary diagnostic odds ratio, and the summary sensitivity and specificity, were used to examine the accuracy of all tests for liver fibrosis. RESULTS Out of 2831 articles evaluated for eligibility, 204 satisfied the predetermined inclusion criteria for this current meta-analysis. Eventually, our final data contained 81 studies. The AUSROCs of serum biomarkers of APRI and FIB-4 were both 0.75. For imaging techniques (ARFI, FibroScan, and MRE), the areas were 0.89, 0.83, and 0.97, respectively. The heterogeneities of ARFI and FibroScan were statistically significant ( I 2 > 50%). The publication bias was not observed in any of the serum biomarkers or imaging methods. CONCLUSION These five methods have attained an acceptable level of diagnostic accuracy. Imaging techniques, MRE in particular, demonstrate significant advantages in accurately predicting HBV-related significant fibrosis, while serum biomarkers are admissible methods.

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Section: Resultsmentioning

confidence: 99%

Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

Xue¹,

Wang²,

Zhang³

et al. 2019

WJCC

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“…Our HeF results were based on clinical patients, which have better reference values than animal experiments, and results for all the fibrosis stages were obtained. Yang et al[ 41 ] used 3D gradient-echo imaging on a 1.5-T MRI scanner to study volumetric interpolated breath-hold examination in liver fibrosis after CHB infection. They found that reduction in T1 relaxation time 20 min after gadoxetic acid injection (ΔT1, ΔR1%) compared with before injection and the contrast uptake rate (K Hep ) decreased significantly as the fibrosis score increased.…”

Section: Discussionmentioning

confidence: 99%

Quantitative assessment of hepatic fibrosis in chronic hepatitis B and C: T1 mapping on Gd-EOB-DTPA-enhanced liver magnetic resonance imaging

Pan¹,

Wang²,

Guo³

2018

WJG

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AIMTo assess the accuracy of Look-Locker on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for staging liver fibrosis in chronic hepatitis B/C (CHB/C).METHODSWe prospectively included 109 patients with CHB or CHC who underwent a 3.0-Tesla MRI examination, including T1-weighted and Look-Locker sequences for T1 mapping. Hepatocyte fractions (HeF) and relaxation time reduction rate (RE) were measured for staging liver fibrosis. A receiver operating characteristic analysis using the area under the receiver operating characteristic curve (AUC) was used to compare the diagnostic performance in predicting liver fibrosis between HeF and RE.RESULTSA total of 73 patients had both pathological results and MRI information. The number of patients in each fibrosis stage was evaluated semiquantitatively according to the METAVIR scoring system: F0, n = 23 (31.5%); F1, n = 19 (26.0%); F2, n = 13 (17.8%); F3, n = 6 (8.2%), and F4, n = 12 (16.4%). HeF by EOB enhancement imaging was significantly correlated with fibrosis stage (r = -0.808, P < 0.05). AUC values for diagnosis of any (≥ F1), significant (≥ F2) or advanced (≥ F3) fibrosis, and cirrhosis (F4) using HeF were 0.837 (0.733-0.913), 0.890 (0.795-0.951), 0.957 (0.881-0.990), and 0.957 (0.882-0.991), respectively. HeF measurement was more accurate than use of RE in establishing liver fibrosis staging, suggesting that calculation of HeF is a superior noninvasive liver fibrosis staging method.CONCLUSIONA T1 mapping-based HeF method is an efficient diagnostic tool for the staging of liver fibrosis.

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“…More recently published studies have suggested that the gadoxetic acid-enhanced T1 relaxation time index appears to be superior to APRI and FIB-4 for predicting hepatic fibrosis and the combined use of gadoxetic acid-enhanced T1 mapping, APRI, and FIB-4 may be more reliable for staging liver fibrosis in chronic hepatitis B and can be regarded as a useful imaging biomarker of hepatocyte transporter function [144,145]. …”

Section: Mri With Hepatobiliary Contrast Agentsmentioning

confidence: 99%

Evaluation of hepatic fibrosis: a review from the society of abdominal radiology disease focus panel

et al. 2017

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Hepatic fibrosis is potentially reversible, however early diagnosis is necessary for treatment in order to halt progression to cirrhosis and development of complications including portal hypertension and hepatocellular carcinoma. Morphologic signs of cirrhosis on ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) alone are unreliable and are seen with more advanced disease. Newer imaging techniques to diagnose liver fibrosis are reliable and accurate, and include magnetic resonance elastography and US elastography (1 dimensional transient elastography and point shear wave elastography or acoustic radiation force impulse imaging). Research is ongoing with multiple other techniques for the noninvasive diagnosis of hepatic fibrosis, including MRI with diffusion weighted imaging, hepatobiliary contrast enhancement, and perfusion; CT using perfusion, fractional extracellular space techniques, and dual energy, contrast-enhanced US, texture analysis in multiple modalities, quantitative mapping, and direct molecular imaging probes. Efforts to advance the noninvasive imaging assessment of hepatic fibrosis will facilitate earlier diagnosis and improved patient monitoring with the goal of preventing the progression to cirrhosis and its complications.

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Staging liver fibrosis in chronic hepatitis B with T₁ relaxation time index on gadoxetic acid‐enhanced MRI: Comparison with aspartate aminotransferase‐to‐platelet ratio index and FIB‐4

Abstract: 4 J. Magn. Reson. Imaging 2017;45:1186-1194.

Cited by 24 publications

References 38 publications

Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

Quantitative assessment of hepatic fibrosis in chronic hepatitis B and C: T1 mapping on Gd-EOB-DTPA-enhanced liver magnetic resonance imaging

Evaluation of hepatic fibrosis: a review from the society of abdominal radiology disease focus panel

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Staging liver fibrosis in chronic hepatitis B with T1 relaxation time index on gadoxetic acid‐enhanced MRI: Comparison with aspartate aminotransferase‐to‐platelet ratio index and FIB‐4

Abstract: 4 J. Magn. Reson. Imaging 2017;45:1186-1194.

Cited by 24 publications

References 38 publications

Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

Performance of common imaging techniques vs serum biomarkers in assessing fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

Quantitative assessment of hepatic fibrosis in chronic hepatitis B and C: T1 mapping on Gd-EOB-DTPA-enhanced liver magnetic resonance imaging

Evaluation of hepatic fibrosis: a review from the society of abdominal radiology disease focus panel

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Staging liver fibrosis in chronic hepatitis B with T₁ relaxation time index on gadoxetic acid‐enhanced MRI: Comparison with aspartate aminotransferase‐to‐platelet ratio index and FIB‐4