title: Prospective comparison of magnetic resonance imaging to transient elastography and serum markers for liver fibrosis detection.
abstract: Establishing accurate non-invasive methods of liver fibrosis quantification remains a major unmet need. Here, we assessed the diagnostic value of a multiparametric magnetic resonance imaging (MRI) protocol including diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE)-MRI and magnetic resonance elastography (MRE) in comparison with transient elastography (TE) and blood tests [including ELF (Enhanced Liver Fibrosis) and APRI] for liver fibrosis detection.
  
  
  
  In this single centre cross-sectional study, we prospectively enrolled 60 subjects with liver disease who underwent multiparametric MRI (DWI, DCE-MRI and MRE), TE and blood tests. Correlation was assessed between non-invasive modalities and histopathologic findings including stage, grade and collagen content, while accounting for covariates such as age, sex, BMI, HCV status and MRI-derived fat and iron content. ROC curve analysis evaluated the performance of each technique for detection of moderate-to-advanced liver fibrosis (F2-F4) and advanced fibrosis (F3-F4).
  
  
  
  Magnetic resonance elastography provided the strongest correlation with fibrosis stage (r = 0.66, P < 0.001), inflammation grade (r = 0.52, P < 0.001) and collagen content (r = 0.53, P = 0.036). For detection of moderate-to-advanced fibrosis (F2-F4), AUCs were 0.78, 0.82, 0.72, 0.79, 0.71 for MRE, TE, DCE-MRI, DWI and APRI, respectively. For detection of advanced fibrosis (F3-F4), AUCs were 0.94, 0.77, 0.79, 0.79 and 0.70, respectively.
  
  
  
  Magnetic resonance elastography provides the highest correlation with histopathologic markers and yields high diagnostic performance for detection of advanced liver fibrosis and cirrhosis, compared to DWI, DCE-MRI, TE and serum markers.
authors.affiliation: Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Hadrien A
authors.initials: HA
authors.lastname: Dyvorne
authors.affiliation: Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Guido H
authors.initials: GH
authors.lastname: Jajamovich
authors.affiliation: Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Octavia
authors.initials: O
authors.lastname: Bane
authors.affiliation: Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: M Isabel
authors.initials: MI
authors.lastname: Fiel
authors.affiliation: Department of Medicine, Division of Liver Diseases, Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Hsin
authors.initials: H
authors.lastname: Chou
authors.affiliation: Department of Medicine, Division of Liver Diseases, Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Schiano
authors.affiliation: Department of Medicine, Division of Liver Diseases, Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Dieterich
authors.affiliation: Department of Radiology, New York University Langone Medical Center, New York, NY, USA.
authors.forename: James S
authors.initials: JS
authors.lastname: Babb
authors.affiliation: Department of Medicine, Division of Liver Diseases, Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Scott L
authors.initials: SL
authors.lastname: Friedman
authors.affiliation: Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.|Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Bachir
authors.initials: B
authors.lastname: Taouli
mesh_terms: D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood*; D003430:Cross-Sectional Studies; D038524:Diffusion Magnetic Resonance Imaging; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000000981:diagnostic imaging*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009518:New York; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D062606:Tertiary Care Centers
chemical_list: D015415:Biomarkers
keywords: diffusion-weighted imaging; dynamic contrast-enhanced MRI; elastography; liver fibrosis; magnetic resonance imaging