title: Multiparametric magnetic resonance imaging for the assessment of non-alcoholic fatty liver disease severity.
abstract: The diagnosis of non-alcoholic steatohepatitis and fibrosis staging are central to non-alcoholic fatty liver disease assessment. We evaluated multiparametric magnetic resonance in the assessment of non-alcoholic steatohepatitis and fibrosis using histology as standard in non-alcoholic fatty liver disease.
  
  
  
  Seventy-one patients with suspected non-alcoholic fatty liver disease were recruited within 1 month of liver biopsy. Magnetic resonance data were used to define the liver inflammation and fibrosis score (LIF 0-4). Biopsies were assessed for steatosis, lobular inflammation, ballooning and fibrosis and classified as non-alcoholic steatohepatitis or simple steatosis, and mild or significant (Activity ≥2 and/or Fibrosis ≥2 as defined by the Fatty Liver Inhibition of Progression consortium) non-alcoholic fatty liver disease. Transient elastography was also performed.
  
  
  
  Magnetic resonance success rate was 95% vs 59% for transient elastography (P<.0001). Fibrosis stage on biopsy correlated with liver inflammation and fibrosis (rs=.51, P<.0001). The area under the receiver operating curve using liver inflammation and fibrosis for the diagnosis of cirrhosis was 0.85. Liver inflammation and fibrosis score for ballooning grades 0, 1 and 2 was 1.2, 2.7 and 3.5 respectively (P<.05) with an area under the receiver operating characteristic curve of 0.83 for the diagnosis of ballooning. Patients with steatosis had lower liver inflammation and fibrosis (1.3) compared to patients with non-alcoholic steatohepatitis (3.0) (P<.0001); area under the receiver operating characteristic curve for the diagnosis of non-alcoholic steatohepatitis was 0.80. Liver inflammation and fibrosis scores for patients with mild and significant non-alcoholic fatty liver disease were 1.2 and 2.9 respectively (P<.0001). The area under the receiver operating characteristic curve of liver inflammation and fibrosis for the diagnosis of significant non-alcoholic fatty liver disease was 0.89.
  
  
  
  Multiparametric magnetic resonance is a promising technique with good diagnostic accuracy for non-alcoholic fatty liver disease histological parameters, and can potentially identify patients with non-alcoholic steatohepatitis and cirrhosis.
authors: Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.|Translational Gastroenterology Unit, University of Oxford, Oxford, UK.|The Oxford NIHR Biomedical Research Centre, Oxford, UK.
authors: Michael
authors: M
authors: Pavlides
authors: Perspectum Diagnostics, Oxford, UK.
authors: Rajarshi
authors: R
authors: Banerjee
authors: Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
authors: Elizabeth M
authors: EM
authors: Tunnicliffe
authors: Perspectum Diagnostics, Oxford, UK.
authors: Catherine
authors: C
authors: Kelly
authors: Translational Gastroenterology Unit, University of Oxford, Oxford, UK.
authors: Jane
authors: J
authors: Collier
authors: Department of Histopathology, Oxford University Hospitals, Oxford, UK.
authors: Lai Mun
authors: LM
authors: Wang
authors: Department of Histopathology, Oxford University Hospitals, Oxford, UK.
authors: Kenneth A
authors: KA
authors: Fleming
authors: Translational Gastroenterology Unit, University of Oxford, Oxford, UK.|The Oxford NIHR Biomedical Research Centre, Oxford, UK.
authors: Jeremy F
authors: JF
authors: Cobbold
authors: Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
authors: Matthew D
authors: MD
authors: Robson
authors: Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.|The Oxford NIHR Biomedical Research Centre, Oxford, UK.
authors: Stefan
authors: S
authors: Neubauer
authors: Translational Gastroenterology Unit, University of Oxford, Oxford, UK.|The Oxford NIHR Biomedical Research Centre, Oxford, UK.|The Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK.
authors: Eleanor
authors: E
authors: Barnes
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D019540:Area Under Curve; D001706:Biopsy; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012720:Severity of Illness Index
keywords: diagnostic accuracy; non-alcoholic steatohepatitis; non-invasive test; sensitivity and specificity