title: MRI-guided biopsy to correlate tissue specimens with MR elastography stiffness readings in liver transplants.
abstract: OBJECTIVE
  Magnetic resonance elastography (MRE) can noninvasively measure the stiffness of liver tissue and display this information in anatomic maps. Magnetic resonance imaging (MRI) guidance has not previously been used to biopsy segments of heterogeneous stiffness identified on MRE. Dedicated study of MRE in post-liver transplant patients is also limited. In this study, the ability of real-time MRI to guide biopsies of segments of the liver with different MRE stiffness values in the same post-transplant patient was assessed.
  
  
  METHODS
  MRE was performed in 9 consecutive posttransplant patients with history of hepatitis C. Segments of highest and lower stiffness on MRE served as targets for subsequent real-time MRI-guided biopsy using T2-weighted imaging. The ability of MRI-guided biopsy to successfully obtain tissue specimens was assessed. The Wilcoxon signed-rank test was used to compare mean stiffness differences for highest and lower MRE stiffness segments, with α = 0.05.
  
  
  RESULTS
  MRI guidance allowed successful sampling of liver tissue for all (18/18) biopsies. There was a statistically significant difference in mean MRE stiffness values between highest (4.61 ± 1.99 kPa) and lower stiffness (3.03 ± 1.75 kPa) (P = .0039) segments biopsied in the 9 posttransplant patients.
  
  
  CONCLUSIONS
  Real-time MRI can guide biopsy in patients after liver transplantation based on MRE stiffness values. This study supports the use of MRI guidance to sample tissue based on functional information.
authors.affiliation: Department of Radiology, Northwestern University, Chicago, IL 60611, USA.
authors.forename: Ryan B
authors.initials: RB
authors.lastname: Perumpail
authors.forename: Josh
authors.initials: J
authors.lastname: Levitsky
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.forename: Victoria S
authors.initials: VS
authors.lastname: Lee
authors.forename: Jennifer
authors.initials: J
authors.lastname: Karp
authors.forename: Ning
authors.initials: N
authors.lastname: Jin
authors.forename: Guang-Yu
authors.initials: GY
authors.lastname: Yang
authors.forename: Bradley D
authors.initials: BD
authors.lastname: Bolster
authors.forename: Saurabh
authors.initials: S
authors.lastname: Shah
authors.forename: Sven
authors.initials: S
authors.lastname: Zuehlsdorff
authors.forename: Albert A
authors.initials: AA
authors.lastname: Nemcek
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Larson
authors.forename: Frank H
authors.initials: FH
authors.lastname: Miller
authors.forename: Reed A
authors.initials: RA
authors.lastname: Omary
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods*; D054459:Elasticity Imaging Techniques; D005260:Female; D019698:Hepatitis C, Chronic / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008111:Liver Function Tests; D016031:Liver Transplantation; D053783:Magnetic Resonance Imaging, Interventional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018709:Statistics, Nonparametric