Non-invasive evaluation of liver fibrosis: A comparison of ultrasound-based transient elastography and MR elastography in patients with viral hepatitis B and C
European Radiology: journal of the European Congress of Radiology , Volume 24 - Issue 3 p. 638- 648
Objective: To compare the diagnostic accuracy of TE and MRE and establish cutoff levels and diagnostic strategies for both techniques, enabling selection of patients for liver biopsy. Methods: One hundred three patients with chronic hepatitis B or C and liver biopsy were prospectively included. Areas under curves (AUROC) were compared for TE and MRE for METAVIR fibrosis grade ≥ F2 and ≥F3. We defined cutoff values for selection of patients with F0-F1 (sensitivity >95 %) and for significant fibrosis F2-F4 (specificity >95 %). Results: Following exclusions, 85 patients were analysed (65 CHB, 19 CHC, 1 co-infected). Fibrosis stages were F0 (n = 3), F1 (n = 53), F2 (n = 15), F3 (n = 8) and F4 (n = 6). TE and MRE accuracy were comparable [AUROCTE ≥ F2: 0.914 (95 % CI: 0.857-0.972) vs. AUROCMRE ≥ F2: 0.909 (0.840-0.977), P = 0.89; AUROCTE ≥ F3: 0.895 (0.816-0.974) vs. AUROCMRE ≥ F3: 0.928 (0.874-0.982), P = 0.42]. Cutoff values of <5.2 and ≥8.9 kPa (TE) and <1.66 and ≥2.18 kPa (MRE) diagnosed 64 % and 66 % of patients correctly as F0-F1 or F2-F4. A conditional strategy in inconclusive test results increased diagnostic yield to 80 %. Conclusion: TE and MRE have comparable accuracy for detecting significant fibrosis, which was reliably detected or excluded in two-thirds of patients. A conditional strategy further increased diagnostic yield to 80 %. Key Points: • Both ultrasound-based transient elastography and magnetic resonance elastography can assess hepatic fibrosis. • Both have comparable accuracy for detecting liver fibrosis in viral hepatitis. • The individual techniques reliably detect or exclude significant liver fibrosis in 66 %. • A conditional strategy for inconclusive findings increases the number of correct diagnoses.
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|European Radiology: journal of the European Congress of Radiology|
|Organisation||Department of Pathology|
Bohte, A.E, de Niet, A, Jansen, L, Bipat, S, Nederveen, A.J, Verheij, J, … Stoker, J. (2014). Non-invasive evaluation of liver fibrosis: A comparison of ultrasound-based transient elastography and MR elastography in patients with viral hepatitis B and C. European Radiology: journal of the European Congress of Radiology, 24(3), 638–648. doi:10.1007/s00330-013-3046-0