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Regional Analysis of Liver Surface Nodularity in a Single Axial MR Image for Staging Liver Fibrosis
BACKGROUND: The assessment of liver surface nodularity (LSN) for staging hepatic fibrosis is restricted in clinical practice because it requires customized software and time‐consuming procedures. A simplified method to estimate LSN score may be useful in the clinic. PURPOSE: To evaluate the regional...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons, Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9790718/ https://www.ncbi.nlm.nih.gov/pubmed/35543163 http://dx.doi.org/10.1002/jmri.28208 |
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author | Kim, Tae‐Hoon Kim, Youe Ree Jeong, Chang‐Won Kim, Hyung Joong Kim, Jin Woong Lee, Young Hwan Yoon, Kwon‐Ha |
author_facet | Kim, Tae‐Hoon Kim, Youe Ree Jeong, Chang‐Won Kim, Hyung Joong Kim, Jin Woong Lee, Young Hwan Yoon, Kwon‐Ha |
author_sort | Kim, Tae‐Hoon |
collection | PubMed |
description | BACKGROUND: The assessment of liver surface nodularity (LSN) for staging hepatic fibrosis is restricted in clinical practice because it requires customized software and time‐consuming procedures. A simplified method to estimate LSN score may be useful in the clinic. PURPOSE: To evaluate the regional analysis of LSN and processing time in a single axial liver MR image for staging liver fibrosis. STUDY TYPE: Retrospective. POPULATION: A total of 210 subjects, a multicenter study. FIELD STRENGTH/SEQUENCE: A 3 T/noncontrast gradient echo T1WI. ASSESSMENT: Subjects were divided into five fibrosis groups (F(0) = 29; F(1) = 20; F(2) = 32; F(3) = 50; F(4) = 79) based on the METAVIR fibrosis scoring system. The mean LSN (on three slices) and regional LSN (on one slice) measurements, and the processing times, are compared. The regional LSN scores in five regions‐of‐interests (ROI(1‐5)) were analyzed in a single axial MRI at the level of the hilum by two independent observers. STATISTICAL TESTS: Regional variations in LSN scores were compared using ANOVA with Tukey test. Agreement between the mean and regional LSN measurements was evaluated using Pearson correlation coefficients (r) and Bland–Altman plots. The diagnostic performance of mean and regional LSN scores according to fibrosis stage was evaluated with the AUROC. A P value < 0.05 was considered statistically significant. RESULTS: Total processing time for a regional LSN measurement (3.6 min) was 75.5% less than that for mean LSN measurement (14.7 min). Mean LSN scores and all five regional LSN scores showed significant differences between fibrosis groups. Among regional LSN scores, ROI(5) showed the highest AUROC (0.871 at cut‐off 1.12) for discriminating F(0‐2) vs. F(3‐4) and the best correlation with mean LSN score (r = 0.800, −0.07 limit of agreement). CONCLUSION: Quantitative regional LSN measurement in a single axial MR image reduces processing time. Regional ROI(5) LSN score might be useful for clinical decision‐making and for distinguishing the difference between early fibrosis (F(0‐2)) and advanced fibrosis (F(3−4)) in the liver. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 2 |
format | Online Article Text |
id | pubmed-9790718 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley & Sons, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97907182022-12-28 Regional Analysis of Liver Surface Nodularity in a Single Axial MR Image for Staging Liver Fibrosis Kim, Tae‐Hoon Kim, Youe Ree Jeong, Chang‐Won Kim, Hyung Joong Kim, Jin Woong Lee, Young Hwan Yoon, Kwon‐Ha J Magn Reson Imaging Research Articles BACKGROUND: The assessment of liver surface nodularity (LSN) for staging hepatic fibrosis is restricted in clinical practice because it requires customized software and time‐consuming procedures. A simplified method to estimate LSN score may be useful in the clinic. PURPOSE: To evaluate the regional analysis of LSN and processing time in a single axial liver MR image for staging liver fibrosis. STUDY TYPE: Retrospective. POPULATION: A total of 210 subjects, a multicenter study. FIELD STRENGTH/SEQUENCE: A 3 T/noncontrast gradient echo T1WI. ASSESSMENT: Subjects were divided into five fibrosis groups (F(0) = 29; F(1) = 20; F(2) = 32; F(3) = 50; F(4) = 79) based on the METAVIR fibrosis scoring system. The mean LSN (on three slices) and regional LSN (on one slice) measurements, and the processing times, are compared. The regional LSN scores in five regions‐of‐interests (ROI(1‐5)) were analyzed in a single axial MRI at the level of the hilum by two independent observers. STATISTICAL TESTS: Regional variations in LSN scores were compared using ANOVA with Tukey test. Agreement between the mean and regional LSN measurements was evaluated using Pearson correlation coefficients (r) and Bland–Altman plots. The diagnostic performance of mean and regional LSN scores according to fibrosis stage was evaluated with the AUROC. A P value < 0.05 was considered statistically significant. RESULTS: Total processing time for a regional LSN measurement (3.6 min) was 75.5% less than that for mean LSN measurement (14.7 min). Mean LSN scores and all five regional LSN scores showed significant differences between fibrosis groups. Among regional LSN scores, ROI(5) showed the highest AUROC (0.871 at cut‐off 1.12) for discriminating F(0‐2) vs. F(3‐4) and the best correlation with mean LSN score (r = 0.800, −0.07 limit of agreement). CONCLUSION: Quantitative regional LSN measurement in a single axial MR image reduces processing time. Regional ROI(5) LSN score might be useful for clinical decision‐making and for distinguishing the difference between early fibrosis (F(0‐2)) and advanced fibrosis (F(3−4)) in the liver. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 2 John Wiley & Sons, Inc. 2022-05-11 2022-12 /pmc/articles/PMC9790718/ /pubmed/35543163 http://dx.doi.org/10.1002/jmri.28208 Text en © 2022 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 Kim, Tae‐Hoon Kim, Youe Ree Jeong, Chang‐Won Kim, Hyung Joong Kim, Jin Woong Lee, Young Hwan Yoon, Kwon‐Ha Regional Analysis of Liver Surface Nodularity in a Single Axial MR Image for Staging Liver Fibrosis |
title | Regional Analysis of Liver Surface Nodularity in a Single Axial MR Image for Staging Liver Fibrosis |
title_full | Regional Analysis of Liver Surface Nodularity in a Single Axial MR Image for Staging Liver Fibrosis |
title_fullStr | Regional Analysis of Liver Surface Nodularity in a Single Axial MR Image for Staging Liver Fibrosis |
title_full_unstemmed | Regional Analysis of Liver Surface Nodularity in a Single Axial MR Image for Staging Liver Fibrosis |
title_short | Regional Analysis of Liver Surface Nodularity in a Single Axial MR Image for Staging Liver Fibrosis |
title_sort | regional analysis of liver surface nodularity in a single axial mr image for staging liver fibrosis |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9790718/ https://www.ncbi.nlm.nih.gov/pubmed/35543163 http://dx.doi.org/10.1002/jmri.28208 |
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