title: Non-invasive assessment of liver fibrosis using magnetic resonance elastography in liver transplant recipients with hepatitis C.
abstract: BACKGROUND
  Liver biopsy has been the reference standard when evaluating fibrosis due to recurrent hepatitis after liver transplantation. Magnetic resonance elastography estimates liver stiffness, correlating to fibrosis.
  
  
  OBJECTIVE
  To investigate the utility of elastography in staging liver fibrosis in transplant recipients with hepatitis C.
  
  
  METHODS
  Fifty-four patients, ≥12 months post-transplant, underwent elastography within three months of biopsy. Discriminatory capability for METAVIR fibrosis stages F0-2 vs. F3-4 and receiver operating characteristic curve (ROC) analysis were determined.
  
  
  RESULTS
  On biopsy, 27 patients had METAVIR fibrosis score 0-1; 12 had a 3 or 4. There was significant correlation between histologic fibrosis and shear stiffness (R² = 0.588, p < 0.0001). Using a cutoff value of 3.5 kPa, elastography was 91% sensitive and 72% specific in differentiating fibrosis scores of ≥3 from 0 to 1. The AUC of elastography in predicting a fibrosis score of ≥3 was 0.92. Multivariate analysis revealed no correlation between the grade of histologic inflammation and liver stiffness measured by magnetic resonance elastography (R² = 0.265, p = 0.47).
  
  
  CONCLUSIONS
  Magnetic resonance elastography is an accurate non-invasive technique for excluding stage ≥3 graft in recipients with hepatitis C.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Sergio
authors.initials: S
authors.lastname: Crespo
authors.forename: Mellena
authors.initials: M
authors.lastname: Bridges
authors.forename: Raouf
authors.initials: R
authors.lastname: Nakhleh
authors.forename: Andre
authors.initials: A
authors.lastname: McPhail
authors.forename: Surakit
authors.initials: S
authors.lastname: Pungpapong
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Keaveny
mesh_terms: D000328:Adult; D000368:Aged; D054459:Elasticity Imaging Techniques; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000472:pathogenicity*; D006526:Hepatitis C / Q000150:complications / Q000601:surgery* / Q000821:virology; D006801:Humans; D007501:Iron / Q000032:analysis; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve
chemical_list: D007501:Iron
keywords: biopsy; fibrosis; liver stiffness