Use of magnetic resonance elastography for assessing liver functional reserve: A clinical study

Li, Bin; Min, Jie; Liang, Weiren; Zhang, Guangqiang; Wu, Jianjun; Jin, Kai; Huang, Wei; Ying, Cai-Yu; Chao, M.

doi:10.3748/wjg.v21.i24.7522

Cited by 9 publications

(10 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ICG-r15 appears to be accurately related to liver decompensation, confirming the preliminary findings of its association with portal hypertension in compensated patients, and can be used for patient prognostication[36]. Li et al[37] assessed the hepatic functional reserve in patients with HCC through the use of magnetic resonance elastography (MRE). Regions of interest were identified in different slices of the liver parenchyma free of tumour to measure average stiffness.…”

Section: Emerging Non-invasive Assessment Of Extensive Fibrosis or CImentioning

confidence: 82%

Evolving strategies for liver fibrosis staging: The non-invasive assessment

Stasi

Milani

2017

WJG

View full text Add to dashboard Cite

Transient elastography and the acoustic radiation force impulse techniques may play a pivotal role in the study of liver fibrosis. Some studies have shown that elastography can detect both the progression and regression of fibrosis. Similarly, research results have been analysed and direct and indirect serum markers of hepatic fibrosis have shown high diagnostic accuracy for advanced fibrosis/cirrhosis. The prognosis of different stages of cirrhosis is well established and various staging systems have been proposed, largely based on clinical data. However, it is still unknown if either non-invasive markers of liver fibrosis or elastography may contribute to a more accurate staging of liver cirrhosis, in terms of prognosis and fibrosis regression after effective therapy. In fact, not enough studies have shown both the fibrosis regression in different cirrhosis stages and the point beyond which the prognosis does not change - even in the event of fibrosis regression. Therefore, future studies are needed to validate non-invasive methods in predicting the different phases of liver cirrhosis.

show abstract

Section: Emerging Non-invasive Assessment Of Extensive Fibrosis or CImentioning

confidence: 82%

Evolving strategies for liver fibrosis staging: The non-invasive assessment

Stasi

Milani

2017

WJG

View full text Add to dashboard Cite

show abstract

“…Therefore, to evaluate the efficacy of our elasticity map for diagnosing the liver functional reserve, further comparison of our elasticity map with the GSA‐SPECT and ICG clearance tests needs to be performed. Recently, several studies have reported the efficacies of UTE and MRE for diagnosing the liver functional reserve, which are comparable to the GSA‐SPECT and ICG clearance tests 38,71,72 . Therefore, adapting liver elasticity information to radiotherapy planning could be useful in the prevention of RILD; however, additional research is required.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have reported that MRI‐based elastography (MRE) has a predictive ability comparable to that of the histologic staging of liver fibrosis and greater than that of DWI and Gd‐EOB‐DTPA‐enhanced MRI 36,37 . Furthermore, Bin et al 38 demonstrated that MRE examinations can be used to assess the liver functional reserve accurately. However, these functional images provided by MRI, SPECT/CT, and elastography are not routinely acquired in clinical radiotherapy planning.…”

Section: Introductionmentioning

confidence: 99%

Estimation of liver elasticity using the finite element method and four‐dimensional computed tomography images as a biomarker of liver fibrosis

et al. 2021

View full text Add to dashboard Cite

Purpose Current radiotherapy planning procedures are generally designed based on anatomical information only and use computed tomography (CT) images that do not incorporate organ‐functional information. In this study, we developed a method for estimating liver elasticity using the finite element method (FEM) and four‐dimensional CT (4DCT) images acquired during radiotherapy planning, and we subsequently evaluated its feasibility as a biomarker for liver fibrosis. Materials and methods Twenty patients who underwent 4DCT and ultrasound‐based transient elastography (UTE) were enrolled. All patients had chronic liver disease or cirrhosis. Liver elasticity measurements of the UTE were performed on the right lobe of the patient’s liver in 20 patients. The serum biomarkers of the aspartate aminotransferase (AST)‐to‐platelet ratio index (APRI) and fibrosis‐4 index (FIB‐4) were available in 18 of the 20 total patients, which were measured within 1 week after undergoing 4DCT. The displacement between the 4DCT images obtained at the endpoints of exhalation and inspiration was determined using the actual (via deformable image registration) and simulated (via FEM) respiration‐induced displacement. The elasticity of each element of the liver model was optimized by minimizing the error between the actual and simulated respiration‐induced displacement. Then, each patient's estimated liver elasticity was defined as the mean Young’s modulus of the liver’s right lobe and that of the whole liver using the estimated elasticity map. The estimated liver elasticity was evaluated for correlations with the elasticity obtained via UTE and with two serum biomarkers (APRI and FIB‐4). Results The mean ± standard deviation (SD) of the errors between the actual and simulated respiration‐induced displacement in the liver model was 0.54 ± 0.33 mm. The estimated liver’s right lobe elasticity was statistically significantly correlated with the UTE (r = 0.87, P < 0.001). Furthermore, the estimated whole liver elasticity was statistically significantly correlated with the UTE (r = 0.84, P < 0.001), APRI score (r = 0.62, P = 0.005), and FIB‐4 score (r = 0.54, P = 0.021). Conclusion In this study, liver elasticity was estimated through FEM‐based simulation and actual respiratory‐induced liver displacement obtained from 4DCT images. Furthermore, we assessed that the estimated elasticity of the liver’s right lobe was strongly correlated with the UTE. Therefore, the estimated elasticity has the potential to be a feasible imaging biomarker for assessing liver fibrosis using only 4DCT images without additional inspection or equipment costs. Because our results were derived from a limited sample of 20 patients, it is necessary to evaluate the accuracy of elasticity estimation for each liver segment on larger groups of biopsied patients to utilize liver elasticity information for radiotherapy planning.

show abstract

“…Importantly, it is necessary to perform pathological examination and reserve function evaluation of the donor liver before liver transplantation. Currently, the commonly used methods, such as liver biopsy, serum biochemical index examination and imaging examination (22,23), are not fully applicable due to the diminishing accuracy of liver functional assessment (24,25). Quantitative methods for liver function with high accuracy and practicability, such as the ICG clearance test (26,27), can only be performed on live livers.…”

Section: Discussionmentioning

confidence: 99%

Assessment of liver injury using indocyanine green fluorescence imaging

Chen¹,

Liu²,

Wu³

et al. 2021

Ann Transl Med

View full text Add to dashboard Cite

Background: To investigate whether indocyanine green (ICG) fluorescence imaging can be used to evaluate chronic and acute liver injury induced by either a high-fat (HF) diet or carbon tetrachloride (CCl 4 ).Methods: Sprague-Dawley (SD) rats were randomly divided into three groups: control group, HF diet-induced model group, and CCl 4 -induced model group. The chronic and acute liver injury models were induced by a HF diet and intraperitoneal injection of CCl 4 , respectively. After HF feeding, the liver index, levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) of the rats were determined. The livers were also collected to evaluate histopathology damage by hematoxylin and eosin (H&E) staining. After in vitro perfusion of the liver and ICG administration, the liver fluorescence intensity and corresponding spectral value were measured by using real-image guided system (REAL-IGS).Results: After HF feeding, the liver index and levels of serum ALT and AST were significantly increased, and the livers of the rats showed severe histopathological changes. Compared with the control group, the hepatic lobes of the model rats exhibited incomplete green fluorescence, and the corresponding spectral value was markedly reduced.Conclusions: ICG fluorescence imaging can be used to evaluate liver injury induced by either a HF diet or CCl 4 .

show abstract

Use of magnetic resonance elastography for assessing liver functional reserve: A clinical study

Abstract: MRE is accurate and non-invasive; furthermore, it can be used to effectively assess the liver functional reserve of HCC patients.

Cited by 9 publications

References 33 publications

Evolving strategies for liver fibrosis staging: The non-invasive assessment

Evolving strategies for liver fibrosis staging: The non-invasive assessment

Estimation of liver elasticity using the finite element method and four‐dimensional computed tomography images as a biomarker of liver fibrosis

Assessment of liver injury using indocyanine green fluorescence imaging

Contact Info

Product

Resources

About