title: Liver Fibrosis Staging with MR Elastography: Comparison of Diagnostic Performance between Patients with Chronic Hepatitis B and Those with Other Etiologic Causes.
abstract: Purpose To evaluate the diagnostic performance of magnetic resonance (MR) elastography in staging liver fibrosis in patients with chronic hepatitis B (CHB) and other etiologic causes. Materials and Methods This retrospective study was institutional review board-approved and the requirement for informed consent was waived. Before surgery, MR elastographic imaging was performed in 352 patients with chronic liver diseases (281 patients with CHB, 71 patients without CHB) and hepatocellular carcinomas and 64 living liver donor candidates. Liver stiffness (LS) values were measured on quantitative shear-stiffness maps of MR elastography, and the diagnostic performance of MR elastography in staging liver fibrosis was evaluated by using receiver operating characteristic curve analysis and the Obuchowski measure with the histopathologic analysis of liver fibrosis in the CHB group and in the group composed of other etiologic causes. In 120 patients (97 with CHB, 23 without CHB) and 51 donors, diagnostic performance of MR elastography was validated. Results Areas under the curve of LS values for the diagnosis of significant fibrosis (≥stage F2), severe fibrosis (≥stage F3), and cirrhosis (stage F4) in the CHB group were 0.972 (95% confidence interval: 0.948, 0.987), 0.946 (95% confidence interval: 0.916, 0.968), and 0.920 (95% confidence interval: 0.885, 0.947), respectively. Obuchowski measures were similarly high in the CHB group and in the group composed of other etiologic causes (0.970 vs 0.977). However, the estimated cutoff value for stage F4 in the group with CHB was substantially lower than in the participants with other etiologic causes: 3.67 kPa versus 4.65 kPa. In the validation study for stage F1 or greater, stage F2 or greater, stage F3 or greater, and stage F4, the Youden indexes were 0.807, 0.842, 0.806, and 0.639, respectively, in the group with CHB, and 0.783, 0.900, 1.000, and 0.917, respectively, in the group without CHB. Conclusion The diagnostic performance of MR elastography in liver fibrosis staging was similarly high in the groups with and without CHB, but the cutoff LS values for diagnosing liver cirrhosis differed between the groups with and without CHB. (©) RSNA, 2016 Online supplemental material is available for this article.
authors: From the Departments of Radiology (W.C., J.M.L., Jeong Hee Yoon, J.K.H., B.I.C.), Internal Medicine (Jung Hwan Yoon), Pathology (K.B.L.), and Surgery (K.W.L., N.J.Y., K.S.S.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea; and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea (J.M.L., J.K.H., B.I.C.).
authors: Won
authors: W
authors: Chang
authors: From the Departments of Radiology (W.C., J.M.L., Jeong Hee Yoon, J.K.H., B.I.C.), Internal Medicine (Jung Hwan Yoon), Pathology (K.B.L.), and Surgery (K.W.L., N.J.Y., K.S.S.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea; and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea (J.M.L., J.K.H., B.I.C.).
authors: Jeong Min
authors: JM
authors: Lee
authors: From the Departments of Radiology (W.C., J.M.L., Jeong Hee Yoon, J.K.H., B.I.C.), Internal Medicine (Jung Hwan Yoon), Pathology (K.B.L.), and Surgery (K.W.L., N.J.Y., K.S.S.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea; and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea (J.M.L., J.K.H., B.I.C.).
authors: Jeong Hee
authors: JH
authors: Yoon
authors: From the Departments of Radiology (W.C., J.M.L., Jeong Hee Yoon, J.K.H., B.I.C.), Internal Medicine (Jung Hwan Yoon), Pathology (K.B.L.), and Surgery (K.W.L., N.J.Y., K.S.S.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea; and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea (J.M.L., J.K.H., B.I.C.).
authors: Joon Koo
authors: JK
authors: Han
authors: From the Departments of Radiology (W.C., J.M.L., Jeong Hee Yoon, J.K.H., B.I.C.), Internal Medicine (Jung Hwan Yoon), Pathology (K.B.L.), and Surgery (K.W.L., N.J.Y., K.S.S.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea; and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea (J.M.L., J.K.H., B.I.C.).
authors: Byung Ihn
authors: BI
authors: Choi
authors: From the Departments of Radiology (W.C., J.M.L., Jeong Hee Yoon, J.K.H., B.I.C.), Internal Medicine (Jung Hwan Yoon), Pathology (K.B.L.), and Surgery (K.W.L., N.J.Y., K.S.S.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea; and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea (J.M.L., J.K.H., B.I.C.).
authors: Jung Hwan
authors: JH
authors: Yoon
authors: From the Departments of Radiology (W.C., J.M.L., Jeong Hee Yoon, J.K.H., B.I.C.), Internal Medicine (Jung Hwan Yoon), Pathology (K.B.L.), and Surgery (K.W.L., N.J.Y., K.S.S.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea; and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea (J.M.L., J.K.H., B.I.C.).
authors: Kyoung Bun
authors: KB
authors: Lee
authors: From the Departments of Radiology (W.C., J.M.L., Jeong Hee Yoon, J.K.H., B.I.C.), Internal Medicine (Jung Hwan Yoon), Pathology (K.B.L.), and Surgery (K.W.L., N.J.Y., K.S.S.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea; and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea (J.M.L., J.K.H., B.I.C.).
authors: Kwang-Woong
authors: KW
authors: Lee
authors: From the Departments of Radiology (W.C., J.M.L., Jeong Hee Yoon, J.K.H., B.I.C.), Internal Medicine (Jung Hwan Yoon), Pathology (K.B.L.), and Surgery (K.W.L., N.J.Y., K.S.S.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea; and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea (J.M.L., J.K.H., B.I.C.).
authors: Nam-Joon
authors: NJ
authors: Yi
authors: From the Departments of Radiology (W.C., J.M.L., Jeong Hee Yoon, J.K.H., B.I.C.), Internal Medicine (Jung Hwan Yoon), Pathology (K.B.L.), and Surgery (K.W.L., N.J.Y., K.S.S.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea; and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea (J.M.L., J.K.H., B.I.C.).
authors: Kyung-Suk
authors: KS
authors: Suh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology; D008107:Liver Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult