title: Non-Invasive Evaluation of Hepatic Fibrosis: The Diagnostic Performance of Magnetic Resonance Elastography in Patients with Viral Hepatitis B or C.
abstract: OBJECTIVE
  To compare the accuracy of magnetic resonance elastography (MRE) with that of aspartate aminotransferase-to-platelet ratio index (APRI) for estimating the stage of hepatic fibrosis in patients with chronic hepatitis B virus (HBV) or chronic hepatitis C virus (HCV) infection.
  
  
  METHODS
  We retrospectively enrolled 160 patients with chronic hepatitis and 25 healthy living liver donors. Fibrosis stage (METAVIR, F0 to F4) was determined histopathologically for all patients. APRI was recorded at the time of histopathologic examination and liver stiffness values were measured on MRE quantitative stiffness maps. The cutoff values, sensitivity, and specificity of MRE and APRI for each fibrosis stage were determined using receiver operating characteristic (ROC) analysis.
  
  
  RESULTS
  MRE had a significantly greater area under the ROC curve than APRI score for discriminating among METAVIR stages F2-F4. Using a cutoff value of 2.80 kPa, MRE had a sensitivity of 94.4% and a specificity of 97.8% for detecting significant fibrosis (≥F2). There were no significant differences in fibrosis stage between patients with HBV and those with HCV infection. For ≥F2, the cutoffs were 2.47 kPa (100% sensitivity), 2.80 kP (maximum sum of sensitivity and specificity), and 3.70 kPa (100% specificity).
  
  
  CONCLUSIONS
  MRE is a more accurate modality than APRI for detecting significant fibrosis in patients with chronic HBV or HCV infection. Antiviral treatment should be considered in patients with liver stiffness values ≥ 2.8 kPa.
authors.affiliation: Department of Diagnostic Radiology, Lu-Kang Christian Hospital, Changhua City, Taiwan, R.O.C; Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei City, Taiwan, R.O.C.
authors.forename: Wen-Pei
authors.initials: WP
authors.lastname: Wu
authors.affiliation: Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei City, Taiwan, R.O.C; Department of Radiology, Chang-Hua Christian Hospital, Changhua City, Taiwan, R.O.C.
authors.forename: Chen-Te
authors.initials: CT
authors.lastname: Chou
authors.affiliation: Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei City, Taiwan, R.O.C; Department of Radiology, Taipei City Hospital, Taipei City, Taiwan, R.O.C.
authors.forename: Ran-Chou
authors.initials: RC
authors.lastname: Chen
authors.affiliation: Department of Radiology, Chang-Hua Christian Hospital, Changhua City, Taiwan, R.O.C.
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Lee
authors.affiliation: Department of Radiology, Chang-Hua Christian Hospital, Changhua City, Taiwan, R.O.C.
authors.forename: Kwo-Whei
authors.initials: KW
authors.lastname: Lee
authors.affiliation: Department of Radiology, Chang-Hua Christian Hospital, Changhua City, Taiwan, R.O.C.
authors.forename: Hwa-Koon
authors.initials: HK
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D001219:Aspartate Aminotransferases / Q000378:metabolism*; D001792:Blood Platelets / Q000201:enzymology*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D019694:Hepatitis B, Chronic / Q000097:blood / Q000201:enzymology / Q000473:pathology*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000201:enzymology / Q000473:pathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D001219:Aspartate Aminotransferases