Technical success rates and reliability of spin-echo echo-planar imaging (SE-EPI) MR elastography in patients with chronic liver disease or liver cirrhosis

Choi, Sang Lim; Lee, Eun Sun; Ko, Ara; Park, Hyun Jeong; Park, Sung Bin; Choi, Byung Ihn; Cho, Young Youn; Kannengießer, Stephan

doi:10.1007/s00330-019-06496-y

Cited by 15 publications

(10 citation statements)

References 21 publications

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“…Furthermore, future study designs can evaluate if approaches to improve pMLV may also improve the diagnostic value of the MRE evaluation. In this study, a 4% rate of technical failure was observed, which is slightly lower than reported rates of failed GRE MR elastography examinations, which have ranged from 5% to 10% [5][6][7][8][9][10][11] and 6% in a pooled meta-analysis for studies with GRE acquisitions. 11 No universal definition of MRE failure has been established in the literature.…”

Section: Discussioncontrasting

confidence: 68%

“…An important limitation of MRE is the low, but important, rate of technical failure (2%-10% in prior studies). [4][5][6][7][8][9][10][11] Factors associated with technical failure of MRE in previous studies include iron overload, increased body mass index (BMI), large volume ascites, and use of 3 T scanners compared to 1.5 T due to increased susceptibility-related signal loss at higher field strengths. [5][6][7][8][9][10][11][12] Furthermore, a substantial number of technically successful MRE examinations at the authors' institution have a relatively small volume of liver that is reliably assessed during MRE.…”

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confidence: 99%

“…[4][5][6][7][8][9][10][11] Factors associated with technical failure of MRE in previous studies include iron overload, increased body mass index (BMI), large volume ascites, and use of 3 T scanners compared to 1.5 T due to increased susceptibility-related signal loss at higher field strengths. [5][6][7][8][9][10][11][12] Furthermore, a substantial number of technically successful MRE examinations at the authors' institution have a relatively small volume of liver that is reliably assessed during MRE. Factors associated with suboptimal MRE rather than failure have not been thoroughly evaluated, as most studies using MRE dichotomize examinations as either failed or successful.…”

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confidence: 99%

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Quality Control of Magnetic Resonance Elastography Using Percent Measurable Liver Volume Estimation

Ballard

Ludwig

Fraum

et al. 2021

Magnetic Resonance Imaging

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Background: Although studies have described factors associated with failed magnetic resonance elastography (MRE), little is known about what factors influence usable elastography data. Purpose: To identify factors that have a negative impact on percent measurable liver volume (pMLV), defined as the proportion of usable liver elastography data relative to the volume of imaged liver in patients undergoing MRE. Study Type: Retrospective. Subjects: A total of 264 patients (n = 132 males, n = 132 females; mean age = 57 years) with suspected or known chronic liver disease underwent MRE paired with a liver protocol MRI. Field strength/Sequence: MRE was performed on a single 1.5 T scanner using a two-dimensional gradient-recalled echo phase-contrast sequence with a passive acoustic driver overlying the right hemiliver. Assessment: Stiffness maps (usable data at 95% confidence) and liver contours on magnitude images of the MRE acquisition were manually traced and used to assess mean stiffness and pMLV. Hepatic fat fraction and R 2 * values were also calculated. The distance from the acoustic wave generator on the skin surface to the liver edge was measured. Two radiologists performed the MR analyses with 50 overlapping cases for inter-reader analysis. Statistical Tests: Linear regression was performed to identify factors significantly associated with pMLV. Intraclass correlation was performed for inter-reader reliability. Results: pMLV was 31% AE 20% (range 0%-86%). Complete MRE failure (i.e. pMLV = 0%) occurred in 10 patients (4%). Multivariate linear regression identified higher hepatic fat fraction, R 2 *, BMI, and driver-to-liver surface distance; male sex; and lower mean liver stiffness was significantly independently associated with lower pMLV. Intraclass correlation for pMLV was 0.96, suggestive of excellent reliability. Data Conclusion: Higher fat fraction, R 2 *, BMI, driver-to-liver surface distance, male sex, and lower mean liver stiffness were associated with lower pMLV. Optimization of image acquisition parameters and driver placement may improve MRE quality, and pMLV likely serves as a diagnostic utility quality control metric. Level of Evidence: 3 Technical Efficacy Stage: 2

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Section: Discussioncontrasting

confidence: 68%

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confidence: 99%

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confidence: 99%

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Quality Control of Magnetic Resonance Elastography Using Percent Measurable Liver Volume Estimation

Ballard

Ludwig

Fraum

et al. 2021

Magnetic Resonance Imaging

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“…To lower these barriers, the spin-echo-based echo planar imaging (SE-EPI) MRE sequence was developed. This novel sequence is less sensitive to the iron overload, thus contributing to shorter imaging time and a higher technical success rate [ 35 ]. Despite the promising advances, MRE is currently time-consuming and costly.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of elastography on liver fibrosis in antiviral treatment-naive chronic hepatitis B patients: a meta-analysis

Wan

et al. 2022

Gastroenterology Report

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Background This study aimed to assess the performance of transient elastography (TE), two-dimensional shear wave elastography (2D-SWE), and magnetic resonance elastography (MRE) for staging significant fibrosis and cirrhosis in untreated chronic hepatitis B (CHB) patients. Methods Pubmed, Embase, Web of Science, and Cochrane Library were searched for terms involving CHB, TE, 2D-SWE, and MRE. Other etiologies of chronic liver disease, previous treatment in patients, or articles not published in SCI journals were excluded. Hierarchical non-linear models were used to evaluate the diagnostic accuracy of TE, 2D-SWE, and MRE. Heterogeneity was explored via analysis of threshold effect and meta-regression. Results Twenty-eight articles with a total of 4,540 untreated CHB patients were included. The summary areas under the receiver-operating characteristic curves (AUROCs) using TE, 2D-SWE, and MRE for predicting significant fibrosis (SF) were 0.84, 0.89, and 0.99, respectively. The AUROC values of TE, 2D-SWE, and MRE for staging cirrhosis were 0.9, 0.94, and 0.99, respectively. Based on the meta-analysis of studies with head-to-head comparison, 2D-SWE is superior to TE (0.92 vs 0.85, P < 0.01) in staging significant fibrosis. Conclusion TE, 2D-SWE, and MRE express acceptable diagnostic accuracies in staging significant fibrosis and cirrhosis in untreated CHB patients. 2D-SWE outperforms TE in detecting significant fibrosis in treatment-naive people with hepatitis B virus.

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“…To lower these barriers, spin-echo-based echo planar imaging (SE-EPI) MRE sequence was developed. This novel sequence is less sensitive to the iron-overload and thus contributing to shorter imaging time and a higher technical success rate [29]. Despite the promising advances, MRE is currently time-consuming and costly.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Performance of TE, 2D-SWE And MRE For Liver Fibrosis In Treatment-Naive People With HBV: A Systematic Review And Meta-Analysis

Wan

et al. 2021

Preprint

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Background/aims: To assess the performance of transient elastography (TE), two-dimensional shear wave elastography (2D-SWE), and magnetic resonance elastography (MRE) for staging significant fibrosis and cirrhosis in untreated chronic hepatitis B (CHB) patients. Methods: Pubmed, Embase, Web of Science and Cochrane Library were searched for terms involving CHB, TE, SWE, and MRE. Other etiologies of chronic liver disease (CLD), previous treatment in patients or articles not published in SCI journals were excluded. Hierarchical non-linear models were used to evaluate the diagnostic accuracy of TE, 2D-SWE and MRE. Heterogeneity was explored via analysis of threshold effect and meta-regression. Results: Twenty-eight articles with a total of 4540 untreated CHB patients were included. The summary AUROC using TE, 2D-SWE and MRE for predicting significant fibrosis (SF) were 0.84, 0.89, and 0.99, respectively. MRE is more accurate than both TE (P＜0.01) and 2D-SWE (P＜0.01) in staging SF. 2D-SWE is superior to TE in detecting SF (P＜0.01). The summary AUROC employing TE, 2D-SWE and MRE for detecting cirrhosis were 0.9, 0.94, and 0.99, respectively. TE displayed a similar diagnostic accuracy with 2D-SWE in staging cirrhosis (P=0.14). MRE and 2D-SWE are comparable for staging cirrhosis (P=0.08). MRE is superior than TE (P＜0.01) in staging cirrhosis.Conclusion: TE, 2D-SWE, and MRE express acceptable diagnostic accuracies in staging staging significant fibrosis and cirrhosis in untreated CHB patients. Both MRE and 2D-SWE are better choices while the TE can be regarded as a secondary option.

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Technical success rates and reliability of spin-echo echo-planar imaging (SE-EPI) MR elastography in patients with chronic liver disease or liver cirrhosis

Cited by 15 publications

References 21 publications

Quality Control of Magnetic Resonance Elastography Using Percent Measurable Liver Volume Estimation

Quality Control of Magnetic Resonance Elastography Using Percent Measurable Liver Volume Estimation

Diagnostic performance of elastography on liver fibrosis in antiviral treatment-naive chronic hepatitis B patients: a meta-analysis

Diagnostic Performance of TE, 2D-SWE And MRE For Liver Fibrosis In Treatment-Naive People With HBV: A Systematic Review And Meta-Analysis

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