Fibrosis in nonalcoholic fatty liver disease: Noninvasive assessment using computed tomography volumetry.
OBJECTIVE
To evaluate the diagnostic performance of computed tomography (CT) volumetry for discriminating the fibrosis stage in patients with nonalcoholic fatty liver disease (NAFLD).


METHODS
A total of 38 NAFLD patients were enrolled. On the basis of CT imaging, the volumes of total, left lateral segment (LLS), left medial segment, caudate lobe, and right lobe (RL) of the liver were calculated with a dedicated liver application. The relationship between the volume percentage of each area and fibrosis stage was analyzed using Spearman's rank correlation coefficient. A receiver operating characteristic (ROC) curve analysis was performed to determine the accuracy of CT volumetry for discriminating fibrosis stage.


RESULTS
The volume percentages of the caudate lobe and the LLS significantly increased with the fibrosis stage (r= 0.815,P< 0.001; andr= 0.465,P= 0.003, respectively). Contrarily, the volume percentage of the RL significantly decreased with fibrosis stage (r= -0.563,P< 0.001). The volume percentage of the caudate lobe had the best diagnostic accuracy for staging fibrosis, and the area under the ROC curve values for discriminating fibrosis stage were as follows: ≥ F1, 0.896; ≥ F2, 0.929; ≥ F3, 0.955; and ≥ F4, 0.923. The best cut-off for advanced fibrosis (F3-F4) was 4.789%, 85.7% sensitivity and 94.1% specificity.


CONCLUSIONS
The volume percentage of the caudate lobe calculated by CT volumetry is a useful diagnostic parameter for staging fibrosis in NAFLD patients.
Nobuhiro Fujita, Akihiro Nishie, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Hiroshi Honda, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Nobuhiro
N
Fujita
Nobuhiro Fujita, Akihiro Nishie, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Hiroshi Honda, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Akihiro
A
Nishie
Nobuhiro Fujita, Akihiro Nishie, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Hiroshi Honda, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Yoshiki
Y
Asayama
Nobuhiro Fujita, Akihiro Nishie, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Hiroshi Honda, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Kousei
K
Ishigami
Nobuhiro Fujita, Akihiro Nishie, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Hiroshi Honda, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Yasuhiro
Y
Ushijima
Nobuhiro Fujita, Akihiro Nishie, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Hiroshi Honda, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Yukihisa
Y
Takayama
Nobuhiro Fujita, Akihiro Nishie, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Hiroshi Honda, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Daisuke
D
Okamoto
Nobuhiro Fujita, Akihiro Nishie, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Hiroshi Honda, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Ken
K
Shirabe
Nobuhiro Fujita, Akihiro Nishie, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Hiroshi Honda, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Tomoharu
T
Yoshizumi
Nobuhiro Fujita, Akihiro Nishie, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Hiroshi Honda, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Kazuhiro
K
Kotoh
Nobuhiro Fujita, Akihiro Nishie, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Hiroshi Honda, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Norihiro
N
Furusyo
Nobuhiro Fujita, Akihiro Nishie, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Hiroshi Honda, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Tomoyuki
T
Hida
Nobuhiro Fujita, Akihiro Nishie, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Hiroshi Honda, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Yoshinao
Y
Oda
Nobuhiro Fujita, Akihiro Nishie, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Hiroshi Honda, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Taisuke
T
Fujioka
Nobuhiro Fujita, Akihiro Nishie, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Hiroshi Honda, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Hiroshi
H
Honda
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054893:Cone-Beam Computed Tomography; D005260:Female; D005355:Fibrosis; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D009929:Organ Size; D012189:Retrospective Studies; D055815:Young Adult
Computed tomography volumetry; Fibrosis stage; Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis