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Assessment of Imaging Modalities Against Liver Biopsy in Nonalcoholic Fatty Liver Disease: The Amsterdam NAFLD‐NASH Cohort
BACKGROUND: Noninvasive diagnostic methods are urgently required in disease stratification and monitoring in nonalcoholic fatty liver disease (NAFLD). Multiparametric magnetic resonance imaging (MRI) is a promising technique to assess hepatic steatosis, inflammation, and fibrosis, potentially enabli...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons, Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9290703/ https://www.ncbi.nlm.nih.gov/pubmed/33991378 http://dx.doi.org/10.1002/jmri.27703 |
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author | Troelstra, Marian A. Witjes, Julia J. van Dijk, Anne‐Marieke Mak, Anne L. Gurney‐Champion, Oliver Runge, Jurgen H. Zwirs, Diona Stols‐Gonçalves, Daniela Zwinderman, Aelko H. ten Wolde, Marije Monajemi, Houshang Ramsoekh, Sandjai Sinkus, Ralph van Delden, Otto M. Beuers, Ulrich H. Verheij, Joanne Nieuwdorp, Max Nederveen, Aart J. Holleboom, Adriaan G. |
author_facet | Troelstra, Marian A. Witjes, Julia J. van Dijk, Anne‐Marieke Mak, Anne L. Gurney‐Champion, Oliver Runge, Jurgen H. Zwirs, Diona Stols‐Gonçalves, Daniela Zwinderman, Aelko H. ten Wolde, Marije Monajemi, Houshang Ramsoekh, Sandjai Sinkus, Ralph van Delden, Otto M. Beuers, Ulrich H. Verheij, Joanne Nieuwdorp, Max Nederveen, Aart J. Holleboom, Adriaan G. |
author_sort | Troelstra, Marian A. |
collection | PubMed |
description | BACKGROUND: Noninvasive diagnostic methods are urgently required in disease stratification and monitoring in nonalcoholic fatty liver disease (NAFLD). Multiparametric magnetic resonance imaging (MRI) is a promising technique to assess hepatic steatosis, inflammation, and fibrosis, potentially enabling noninvasive identification of individuals with active and advanced stages of NAFLD. PURPOSE: To examine the diagnostic performance of multiparametric MRI for the assessment of disease severity along the NAFLD disease spectrum with comparison to histological scores. STUDY TYPE: Prospective, cohort. POPULATION: Thirty‐seven patients with NAFLD. FIELD STRENGTH/SEQUENCE: Multiparametric MRI at 3.0 T consisted of magnetic resonance (MR) spectroscopy (MRS) with multi‐echo stimulated‐echo acquisition mode, magnitude‐based and three‐point Dixon using a two‐dimensional multi‐echo gradient echo, MR elastography (MRE) using a generalized multishot gradient‐recalled echo sequence and intravoxel incoherent motion (IVIM) using a multislice diffusion weighted single‐shot echo‐planar sequence. ASSESSMENT: Histological steatosis grades were compared to proton density fat fraction measured by MRS (PDFF(MRS)), magnitude‐based MRI (PDFF(MRI‐M)), and three‐point Dixon (PDFF(Dixon)), as well as FibroScan® controlled attenuation parameter (CAP). Fibrosis and disease activity were compared to IVIM and MRE. FibroScan® liver stiffness measurements were compared to fibrosis levels. Diagnostic performance of all imaging parameters was determined for distinction between simple steatosis and nonalcoholic steatohepatitis (NASH). STATISTICAL TESTS: Spearman's rank test, Kruskal–Wallis test, Dunn's post‐hoc test with Holm‐Bonferroni P‐value adjustment, receiver operating characteristic curve analysis. A P‐value <0.05 was considered statistically significant. RESULTS: Histological steatosis grade correlated significantly with PDFF(MRS) (r ( s ) = 0.66, P < 0.001), PDFF(MRI‐M) (r ( s ) = 0.68, P < 0.001), and PDFF(Dixon) (r ( s ) = 0.67, P < 0.001), whereas no correlation was found with CAP. MRE and IVIM diffusion and perfusion significantly correlated with disease activity (r ( s ) = 0.55, P < 0.001, r ( s ) = −0.40, P = 0.016, r ( s ) = −0.37, P = 0.027, respectively) and fibrosis (r ( s ) = 0.55, P < 0.001, r ( s ) = −0.46, P = 0.0051; r ( s ) = −0.53, P < 0.001, respectively). MRE and IVIM diffusion had the highest area‐under‐the‐curve for distinction between simple steatosis and NASH (0.79 and 0.73, respectively). DATA CONCLUSION: Multiparametric MRI is a promising method for noninvasive, accurate, and sensitive distinction between simple hepatic steatosis and NASH, as well as for the assessment of steatosis and fibrosis severity. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: 2 |
format | Online Article Text |
id | pubmed-9290703 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley & Sons, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92907032022-07-20 Assessment of Imaging Modalities Against Liver Biopsy in Nonalcoholic Fatty Liver Disease: The Amsterdam NAFLD‐NASH Cohort Troelstra, Marian A. Witjes, Julia J. van Dijk, Anne‐Marieke Mak, Anne L. Gurney‐Champion, Oliver Runge, Jurgen H. Zwirs, Diona Stols‐Gonçalves, Daniela Zwinderman, Aelko H. ten Wolde, Marije Monajemi, Houshang Ramsoekh, Sandjai Sinkus, Ralph van Delden, Otto M. Beuers, Ulrich H. Verheij, Joanne Nieuwdorp, Max Nederveen, Aart J. Holleboom, Adriaan G. J Magn Reson Imaging Research Articles BACKGROUND: Noninvasive diagnostic methods are urgently required in disease stratification and monitoring in nonalcoholic fatty liver disease (NAFLD). Multiparametric magnetic resonance imaging (MRI) is a promising technique to assess hepatic steatosis, inflammation, and fibrosis, potentially enabling noninvasive identification of individuals with active and advanced stages of NAFLD. PURPOSE: To examine the diagnostic performance of multiparametric MRI for the assessment of disease severity along the NAFLD disease spectrum with comparison to histological scores. STUDY TYPE: Prospective, cohort. POPULATION: Thirty‐seven patients with NAFLD. FIELD STRENGTH/SEQUENCE: Multiparametric MRI at 3.0 T consisted of magnetic resonance (MR) spectroscopy (MRS) with multi‐echo stimulated‐echo acquisition mode, magnitude‐based and three‐point Dixon using a two‐dimensional multi‐echo gradient echo, MR elastography (MRE) using a generalized multishot gradient‐recalled echo sequence and intravoxel incoherent motion (IVIM) using a multislice diffusion weighted single‐shot echo‐planar sequence. ASSESSMENT: Histological steatosis grades were compared to proton density fat fraction measured by MRS (PDFF(MRS)), magnitude‐based MRI (PDFF(MRI‐M)), and three‐point Dixon (PDFF(Dixon)), as well as FibroScan® controlled attenuation parameter (CAP). Fibrosis and disease activity were compared to IVIM and MRE. FibroScan® liver stiffness measurements were compared to fibrosis levels. Diagnostic performance of all imaging parameters was determined for distinction between simple steatosis and nonalcoholic steatohepatitis (NASH). STATISTICAL TESTS: Spearman's rank test, Kruskal–Wallis test, Dunn's post‐hoc test with Holm‐Bonferroni P‐value adjustment, receiver operating characteristic curve analysis. A P‐value <0.05 was considered statistically significant. RESULTS: Histological steatosis grade correlated significantly with PDFF(MRS) (r ( s ) = 0.66, P < 0.001), PDFF(MRI‐M) (r ( s ) = 0.68, P < 0.001), and PDFF(Dixon) (r ( s ) = 0.67, P < 0.001), whereas no correlation was found with CAP. MRE and IVIM diffusion and perfusion significantly correlated with disease activity (r ( s ) = 0.55, P < 0.001, r ( s ) = −0.40, P = 0.016, r ( s ) = −0.37, P = 0.027, respectively) and fibrosis (r ( s ) = 0.55, P < 0.001, r ( s ) = −0.46, P = 0.0051; r ( s ) = −0.53, P < 0.001, respectively). MRE and IVIM diffusion had the highest area‐under‐the‐curve for distinction between simple steatosis and NASH (0.79 and 0.73, respectively). DATA CONCLUSION: Multiparametric MRI is a promising method for noninvasive, accurate, and sensitive distinction between simple hepatic steatosis and NASH, as well as for the assessment of steatosis and fibrosis severity. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: 2 John Wiley & Sons, Inc. 2021-05-15 2021-12 /pmc/articles/PMC9290703/ /pubmed/33991378 http://dx.doi.org/10.1002/jmri.27703 Text en © 2021 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC. on behalf of International Society for Magnetic Resonance in Medicine. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Articles Troelstra, Marian A. Witjes, Julia J. van Dijk, Anne‐Marieke Mak, Anne L. Gurney‐Champion, Oliver Runge, Jurgen H. Zwirs, Diona Stols‐Gonçalves, Daniela Zwinderman, Aelko H. ten Wolde, Marije Monajemi, Houshang Ramsoekh, Sandjai Sinkus, Ralph van Delden, Otto M. Beuers, Ulrich H. Verheij, Joanne Nieuwdorp, Max Nederveen, Aart J. Holleboom, Adriaan G. Assessment of Imaging Modalities Against Liver Biopsy in Nonalcoholic Fatty Liver Disease: The Amsterdam NAFLD‐NASH Cohort |
title | Assessment of Imaging Modalities Against Liver Biopsy in Nonalcoholic Fatty Liver Disease: The Amsterdam NAFLD‐NASH Cohort |
title_full | Assessment of Imaging Modalities Against Liver Biopsy in Nonalcoholic Fatty Liver Disease: The Amsterdam NAFLD‐NASH Cohort |
title_fullStr | Assessment of Imaging Modalities Against Liver Biopsy in Nonalcoholic Fatty Liver Disease: The Amsterdam NAFLD‐NASH Cohort |
title_full_unstemmed | Assessment of Imaging Modalities Against Liver Biopsy in Nonalcoholic Fatty Liver Disease: The Amsterdam NAFLD‐NASH Cohort |
title_short | Assessment of Imaging Modalities Against Liver Biopsy in Nonalcoholic Fatty Liver Disease: The Amsterdam NAFLD‐NASH Cohort |
title_sort | assessment of imaging modalities against liver biopsy in nonalcoholic fatty liver disease: the amsterdam nafld‐nash cohort |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9290703/ https://www.ncbi.nlm.nih.gov/pubmed/33991378 http://dx.doi.org/10.1002/jmri.27703 |
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