Elsevier

Journal of Hepatology

Volume 60, Issue 1, January 2014, Pages 69-77
Journal of Hepatology

Research Article
Multiparametric magnetic resonance for the non-invasive diagnosis of liver disease

https://doi.org/10.1016/j.jhep.2013.09.002Get rights and content
Under a Creative Commons license
open access

Background & Aims

With the increasing prevalence of liver disease worldwide, there is an urgent clinical need for reliable methods to diagnose and stage liver pathology. Liver biopsy, the current gold standard, is invasive and limited by sampling and observer dependent variability. In this study, we aimed to assess the diagnostic accuracy of a novel magnetic resonance protocol for liver tissue characterisation.

Methods

We conducted a prospective study comparing our magnetic resonance technique against liver biopsy. The individual components of the scanning protocol were T1 mapping, proton spectroscopy and T2 mapping, which quantified liver fibrosis, steatosis and haemosiderosis, respectively. Unselected adult patients referred for liver biopsy as part of their routine care were recruited. Scans performed prior to liver biopsy were analysed by physicians blinded to the histology results. The associations between magnetic resonance and histology variables were assessed. Receiver-operating characteristic analyses were also carried out.

Results

Paired magnetic resonance and biopsy data were obtained in 79 patients. Magnetic resonance measures correlated strongly with histology (rs = 0.68 p <0.0001 for fibrosis; rs = 0.89 p <0.001 for steatosis; rs = −0.69 p <0.0001 for haemosiderosis). The area under the receiver operating characteristic curve was 0.94, 0.93, and 0.94 for the diagnosis of any degree of fibrosis, steatosis and haemosiderosis respectively.

Conclusion

The novel scanning method described here provides high diagnostic accuracy for the assessment of liver fibrosis, steatosis and haemosiderosis and could potentially replace liver biopsy for many indications. This is the first demonstration of a non-invasive test to differentiate early stages of fibrosis from normal liver.

Abbreviations

MR
Magnetic Resonance
BMI
Body Mass Index
NAFLD
Non-Alcoholic Fatty Liver Disease
CPA
Collagen Proportionate Area
CoV
Coefficient of Variance
1H MRS
Proton Magnetic Resonance Spectroscopy
shMOLLI
shortened Modified Look Locker Inversion
HLC
Hepatic Lipid Content
ROI
Region of interest
ANOVA
Analysis of Variance
AUROC
Area Under the Receiver Operating Characteristic Curve

Keywords

Magnetic resonance T1 mapping
Proton magnetic resonance spectroscopy
Magnetic resonance T2 mapping
Iron corrected T1
Liver fibrosis
Liver steatosis
Liver haemosiderosis

Cited by (0)

These authors contributed equally to this work.

These authors share senior authorship.