Author of 2 Presentations
SS 1.8 - Quantitative MRI characterisation of non-alcoholic steatohepatitis in a dietary rodent model
Abstract
Purpose
To assess the diagnostic performance of quantitative MRI parameters for the diagnosis of early non-alcoholic steatohepatitis (NASH) in a dietary rodent model.
Material and methods
We included 74 mice (C57bl6) with 2 control groups fed with normal diet (for 5 and 17 weeks, N=7), 3 dietary groups (5, 11 and 16 weeks, N=10) fed with high-fat diet deficient in choline and supplemented with methionine and 3 dietary groups (5, 11 and 16 weeks, N=10) fed with high-fat diet. The liver was scanned with a 7T system. Proton density fat fraction (PDFF), R2*, mechanical properties at 400, 600 and 800Hz including storage modulus (G’), loss modulus (G’’), damping ratio, shear modulus (G*) and G* frequency dispersion coefficient were obtained with dedicated imaging sequences. At histopathology, the grade of steatosis, ballooning, inflammation, and the fibrosis stage were assessed. NASH was diagnosed according to the FLIP algorithm. Receiver operating characteristic (ROC) analysis, Spearman correlations and multivariate regression were used to test the variables.
Results
Nineteen mice had NASH including 15 with stage 1 fibrosis. Thirty-two had simple steatosis. G’’ at 400Hz had the largest AUROC for NASH (0.84; p<0.01) and for diagnosing NASH versus simple steatosis (0.80; p<0.01). Cutoff of G’’>0.38 kPa had 89% sensitivity and 79% specificity for NASH diagnosis. PDFF correlated with steatosis % (rho 0.81; p<0.01). In multivariate analysis, inflammation was the only determinant of the frequency dispersion coefficient.
Conclusion
At quantitative MRI, the loss modulus had the best diagnostic performance for diagnosing early NASH. Frequency dispersion coefficient might be a marker of liver inflammation.
Video-on-demand
SS 11.5 - Head-to-head comparison of liver stiffness measurement using transient elastography, 2D-shear wave elastography and MR elastography for non-invasive evaluation of clinically significant portal hypertension
Abstract
Purpose
To compare technical success rate and diagnostic performance of transient elastography (TE), 2D-shear wave elastography (2D-SWE) and MR elastography (MRE) for the detection of clinically significant portal hypertension (CSPH) in patients with compensated cirrhosis.
Material and methods
A monocentric prospective study was conducted including patients with biopsy-proven cirrhosis, without history of liver decompensation, undergoing TE, 2D-SWE, MRE and hepatic venous portal gradient (HVPG) measurements within <30 days. Technical success rate was defined for TE according to European Association for the Study of the Liver (EASL) guidelines; for 2D-SWE as homogenous color with stability for ≥3 seconds in the region of interest, and for MRE as any value obtained. Ability of estimating HVPG and identifying patients with CSPH was compared between TE, 2D-SWE and MRE using area under ROC curve (AUROCs).
Results
We included 44 patients (32 men; median 58 yr; 26 (59%) with CSPH). Technical success rate was higher with MRE (100%), than with TE (89%; p=0.024) or 2D-SWE (93%; p=0.075). HVPG correlated with TE (r=0.692; p<0.0001), 2D-SWE (r=0.623; p<0.0001), and MRE parameters [storage modulus (Gd), r=0.522, p=0.001; loss modulus (Gl) r=0.540, p=0.0007; shear modulus (Gabs) r=0.529, p=0.0009)]. Patients with CSPH had higher liver stiffness by TE (32 vs. 17kPa; p=0.01), 2D-SWE (20 vs. 14kPa; p=0.008) or MRE (Gd 5.9 vs. 3.8kPa, p=0.01; Gl 3.2 vs.1.9kPa, p=0.005; Gabs 7.0 vs. 4.5kPa; p=0.008) than patients without. AUROCs ranged from 0.87 to 0.81 and did not significantly differ between the three methods.
Conclusion
In patients without any history of cirrhosis decompensation, liver TE, 2D-SWE and MRE correlated well with HVPG and had similar performance for detecting CSPH.
Video-on-demand
Author of 2 Presentations
SS 1.8 - Quantitative MRI characterisation of non-alcoholic steatohepatitis in a dietary rodent model (ID 695)
Abstract
Purpose
To assess the diagnostic performance of quantitative MRI parameters for the diagnosis of early non-alcoholic steatohepatitis (NASH) in a dietary rodent model.
Material and methods
We included 74 mice (C57bl6) with 2 control groups fed with normal diet (for 5 and 17 weeks, N=7), 3 dietary groups (5, 11 and 16 weeks, N=10) fed with high-fat diet deficient in choline and supplemented with methionine and 3 dietary groups (5, 11 and 16 weeks, N=10) fed with high-fat diet. The liver was scanned with a 7T system. Proton density fat fraction (PDFF), R2*, mechanical properties at 400, 600 and 800Hz including storage modulus (G’), loss modulus (G’’), damping ratio, shear modulus (G*) and G* frequency dispersion coefficient were obtained with dedicated imaging sequences. At histopathology, the grade of steatosis, ballooning, inflammation, and the fibrosis stage were assessed. NASH was diagnosed according to the FLIP algorithm. Receiver operating characteristic (ROC) analysis, Spearman correlations and multivariate regression were used to test the variables.
Results
Nineteen mice had NASH including 15 with stage 1 fibrosis. Thirty-two had simple steatosis. G’’ at 400Hz had the largest AUROC for NASH (0.84; p<0.01) and for diagnosing NASH versus simple steatosis (0.80; p<0.01). Cutoff of G’’>0.38 kPa had 89% sensitivity and 79% specificity for NASH diagnosis. PDFF correlated with steatosis % (rho 0.81; p<0.01). In multivariate analysis, inflammation was the only determinant of the frequency dispersion coefficient.
Conclusion
At quantitative MRI, the loss modulus had the best diagnostic performance for diagnosing early NASH. Frequency dispersion coefficient might be a marker of liver inflammation.
Video-on-demand
SS 11.5 - Head-to-head comparison of liver stiffness measurement using transient elastography, 2D-shear wave elastography and MR elastography for non-invasive evaluation of clinically significant portal hypertension (ID 617)
Abstract
Purpose
To compare technical success rate and diagnostic performance of transient elastography (TE), 2D-shear wave elastography (2D-SWE) and MR elastography (MRE) for the detection of clinically significant portal hypertension (CSPH) in patients with compensated cirrhosis.
Material and methods
A monocentric prospective study was conducted including patients with biopsy-proven cirrhosis, without history of liver decompensation, undergoing TE, 2D-SWE, MRE and hepatic venous portal gradient (HVPG) measurements within <30 days. Technical success rate was defined for TE according to European Association for the Study of the Liver (EASL) guidelines; for 2D-SWE as homogenous color with stability for ≥3 seconds in the region of interest, and for MRE as any value obtained. Ability of estimating HVPG and identifying patients with CSPH was compared between TE, 2D-SWE and MRE using area under ROC curve (AUROCs).
Results
We included 44 patients (32 men; median 58 yr; 26 (59%) with CSPH). Technical success rate was higher with MRE (100%), than with TE (89%; p=0.024) or 2D-SWE (93%; p=0.075). HVPG correlated with TE (r=0.692; p<0.0001), 2D-SWE (r=0.623; p<0.0001), and MRE parameters [storage modulus (Gd), r=0.522, p=0.001; loss modulus (Gl) r=0.540, p=0.0007; shear modulus (Gabs) r=0.529, p=0.0009)]. Patients with CSPH had higher liver stiffness by TE (32 vs. 17kPa; p=0.01), 2D-SWE (20 vs. 14kPa; p=0.008) or MRE (Gd 5.9 vs. 3.8kPa, p=0.01; Gl 3.2 vs.1.9kPa, p=0.005; Gabs 7.0 vs. 4.5kPa; p=0.008) than patients without. AUROCs ranged from 0.87 to 0.81 and did not significantly differ between the three methods.
Conclusion
In patients without any history of cirrhosis decompensation, liver TE, 2D-SWE and MRE correlated well with HVPG and had similar performance for detecting CSPH.