title: Staging liver fibrosis in chronic hepatitis B with T1relaxation time index on gadoxetic acid-enhanced MRI: Comparison with aspartate aminotransferase-to-platelet ratio index and FIB-4.
abstract: To assess the accuracy of the T1relaxation time index on gadoxetic acid-enhanced magnetic resonance imaging (MRI) for staging liver fibrosis in chronic hepatitis B (CHB), in comparison and combination with the aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 (FIB-4).
  
  
  
  A retrospective study of gadoxetic acid-enhanced T1mapping and serum biochemical tests was performed on 126 CHB patients who underwent gadoxetic acid-enhanced 1.5T MRI, and the histological score used as the gold standard. The reduction rate of T1relaxation time before and 20 minutes after gadoxetic acid injection (ΔT1, ΔR1%), the contrast uptake rate (KHep), APRI, and FIB-4 were calculated. The diagnostic efficacy of ΔT1, ΔR1%, KHep, APRI, and FIB-4 for predicting stage 2 or greater (≥S2), stage 3 or greater (≥S3), and stage 4 (S4) was compared.
  
  
  
  ΔT1(r = -0.513, P < 0.001), ΔR1% (r = -0.626, P < 0.001), KHep(r = -0.527, P < 0.001), APRI (r = 0.519, P < 0.001), and FIB-4 (r = 0.476, P < 0.001) correlated significantly with fibrosis stages. Areas under the curves (AUCs) of ΔR1% for detecting ≥S2, ≥S3, and S4 were 0.849, 0.827, and 0.809, which were greater than that of APRI (0.763, 0.745, 0.787) and FIB-4 (0.727, 0.738, 0.772), but significant difference was found only in discriminating ≥S2 between ΔR1% and FIB-4 (P = 0.027). The combination of all five indices performed best, with AUC, sensitivity, and specificity of 0.860, 87.21%, and 72.50% for diagnosing ≥S2, 0.878, 82.81%, and 85.48% for ≥S3, and 0.867, 80.00%, and 83.95% for S4.
  
  
  
  The gadoxetic acid-enhanced T1relaxation time index appears to be superior to APRI and FIB-4 for predicting hepatic fibrosis. The combined use of gadoxetic acid-enhanced T1mapping, APRI, and FIB-4 may be more reliable for staging liver fibrosis in CHB.
  
  
  
  4 J. Magn. Reson. Imaging 2017;45:1186-1194.
authors: Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.
authors: Li
authors: L
authors: Yang
authors: Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.|Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.
authors: Ying
authors: Y
authors: Ding
authors: Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.|Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.
authors: Shengxiang
authors: S
authors: Rao
authors: Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.
authors: Caizhong
authors: C
authors: Chen
authors: Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.
authors: Lifang
authors: L
authors: Wu
authors: Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.|Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.
authors: Ruofan
authors: R
authors: Sheng
authors: Siemens Healthcare, Shanghai, P.R. China.
authors: Caixia
authors: C
authors: Fu
authors: Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.|Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, P.R. China.
authors: Mengsu
authors: M
authors: Zeng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001792:Blood Platelets; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D019694:Hepatitis B, Chronic / Q000150:complications / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008099:Liver; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D001219:Aspartate Aminotransferases; D019786:Gadolinium DTPA
keywords: T1 relaxation time; chronic hepatitis B; gadoxetic acid; liver fibrosis; magnetic resonance imaging; serum markers