title: MR elastography for noninvasive assessment of hepatic fibrosis: experience from a tertiary center in Asia.
abstract: OBJECTIVE
  To determine the sensitivity and specificity of MR elastography (MRE) in the staging of hepatic fibrosis (HF) using histopathology as the reference standard in an Asian population.
  
  
  METHODS
  MRE was performed on 55 patients with chronic liver diseases or biliary diseases and on 5 living related liver donors (48 men and 12 women; mean age, 55.7 years). MRE was performed with modified, phase-contrast, gradient-echo sequences, and the mean stiffness values were measured on the elastograms in kilopascals(kPa). Receiver operating characteristic curve analysis was performed to determine the cutoff value and accuracy of MRE for staging HF. Histopathologic staging of HF according to the METAVIR scoring system served as the reference.
  
  
  RESULTS
  Liver stiffness increased systematically along with the fibrosis stage. With a shear stiffness cutoff value of 3.05 kPa, the predicted sensitivity and specificity for differentiating significant liver fibrosis (≥ F2) from mild fibrosis (F1) were 89.7% and 87.1%, respectively. In addition, MRE was able to discriminate between patients with severe fibrosis (F3) and those with liver cirrhosis (sensitivity, 100%; specificity, 92.2%), with a shear stiffness cutoff value of 5.32 kPa.
  
  
  CONCLUSIONS
  MRE could be a promising, noninvasive technique with excellent diagnostic accuracy for detecting significant HF and liver cirrhosis.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Bo Hee
authors.initials: BH
authors.lastname: Kim
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Ye Ji
authors.initials: YJ
authors.lastname: Lee
authors.forename: Kyoung Bun
authors.initials: KB
authors.lastname: Lee
authors.forename: Kyung-Suk
authors.initials: KS
authors.lastname: Suh
authors.forename: Joon Koo
authors.initials: JK
authors.lastname: Han
authors.forename: Byung Ihn
authors.initials: BI
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia; D001706:Biopsy / Q000379:methods; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D005355:Fibrosis; D005762:Gastroenterology / Q000379:methods; D006782:Hospitals, Special; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology; D019520:Living Donors; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity