title: A comparison of MR elastography and 31P MR spectroscopy with histological staging of liver fibrosis.
abstract: OBJECTIVE
  Conventional imaging techniques are insensitive to liver fibrosis. This study assesses the diagnostic accuracy of MR elastography (MRE) stiffness values and the ratio of phosphomonoesters (PME)/phosphodiesters (PDE) measured using (31)P spectroscopy against histological fibrosis staging.
  
  
  METHODS
  The local research ethics committee approved this prospective, blinded study. A total of 77 consecutive patients (55 male, aged 49 ± 11.5 years) with a clinical suspicion of liver fibrosis underwent an MR examination with a liver biopsy later the same day. Patients underwent MRE and (31)P spectroscopy on a 1.5 T whole body system. The liver biopsies were staged using an Ishak score for chronic hepatitis or a modified NAS fibrosis score for fatty liver disease.
  
  
  RESULTS
  MRE increased with and was positively associated with fibrosis stage (Spearman's rank = 0.622, P < 0.001). PME/PDE was not associated with fibrosis stage (Spearman's rank = -0.041, p = 0.741). Area under receiver operating curves for MRE stiffness values were high (range 0.75-0.97). The diagnostic utility of PME/PDE was no better than chance (range 0.44-0.58).
  
  
  CONCLUSIONS
  MRE-estimated liver stiffness increases with fibrosis stage and is able to dichotomise fibrosis stage groupings. We did not find a relationship between (31)P MR spectroscopy and fibrosis stage.
  
  
  CONCLUSIONS
  Magnetic resonance elastography (MRE) and MR spectroscopy can both assess the liver. MRE is superior to ( 31 ) P MR spectroscopy in staging hepatic fibrosis. MRE is able to dichotomise liver fibrosis stage groupings. Gradient-echo MRE may be problematic in genetic haemochromatosis.
authors: St James' Hospital, Beckett Street, Leeds, LS9 7TF, UK. edmund.godfrey@leedsth.nhs.uk
authors: Edmund M
authors: EM
authors: Godfrey
authors: Andrew J
authors: AJ
authors: Patterson
authors: Andrew N
authors: AN
authors: Priest
authors: Susan E
authors: SE
authors: Davies
authors: Ilse
authors: I
authors: Joubert
authors: Anant S
authors: AS
authors: Krishnan
authors: Nyree
authors: N
authors: Griffin
authors: Ashley S
authors: AS
authors: Shaw
authors: Graeme J
authors: GJ
authors: Alexander
authors: Michael E
authors: ME
authors: Allison
authors: William J H
authors: WJ
authors: Griffiths
authors: Alexander E S
authors: AE
authors: Gimson
authors: David J
authors: DJ
authors: Lomas
mesh_terms: D001706:Biopsy; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve