title: Staging liver fibrosis by using liver-enhancement ratio of gadoxetic acid-enhanced MR imaging: comparison with aspartate aminotransferase-to-platelet ratio index.
abstract: OBJECTIVE
  To compare the diagnostic ability of gadoxetic acid-enhanced hepatocyte-phase MR images with aspartate aminotransferase-to-platelet ratio index (APRI) to predict liver fibrosis stage.
  
  
  METHODS
  Our study included 100 patients who underwent gadoxetic acid-enhanced MRI and either liver biopsy or liver surgery. Liver fibrosis stage was histologically determined according to the METAVIR system: F0 (n=16), F1 (n=17), F2 (n=10), F3 (n=21) and F4 (n=36). Four measures were used as imaging-based fibrosis markers: liver-spleen contrast ratio, liver-enhancement ratio, corrected liver-enhancement ratio and spleen index. APRI represented a blood test-based fibrosis marker. The diagnostic ability of those fibrosis markers were compared through receiver-operating characteristic analysis.
  
  
  RESULTS
  The area under the curve (AUC) for APRI prediction of severe fibrosis (≥F3 and F4) was significantly greater than that of corrected liver-enhancement ratio. However, corrected liver-enhancement ratio had a greater AUC for prediction of mild fibrosis (≥F1) than APRI, although the difference was insignificant.
  
  
  CONCLUSIONS
  Corrected liver-enhancement ratio with gadoxetic acid-enhanced MRI is correlated to the stage of liver fibrosis. APRI, however, has greater reliability for predicting severe fibrosis and cirrhosis than does the imaging-based fibrosis marker tested in this study.
authors.affiliation: Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan.
authors.forename: Utaroh
authors.initials: U
authors.lastname: Motosugi
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Oguri
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Sano
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sou
authors.forename: Ali
authors.initials: A
authors.lastname: Muhi
authors.forename: Masanori
authors.initials: M
authors.lastname: Matsuda
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Enomoto
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Araki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001219:Aspartate Aminotransferases / Q000378:metabolism*; D001792:Blood Platelets / Q000201:enzymology*; D003287:Contrast Media / Q000494:pharmacology; D005355:Fibrosis / Q000473:pathology; D019786:Gadolinium DTPA / Q000494:pharmacology*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D012372:ROC Curve
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D001219:Aspartate Aminotransferases; D019786:Gadolinium DTPA