title: Magnetic Resonance Elastography and Diffusion Weighted Imaging in the Evaluation of Hepatic Fibrosis in Chronic Hepatitis B.
abstract: OBJECTIVE
  Comparison of the accuracy of magnetic resonance elastography (MRE) and diffusion weighted imaging (DWI) for the diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB).
  
  
  METHODS
  In this retrospective analysis, we investigated 63 patients with CHB and liver fibrosis. DWI was performed with both breath-hold (DWI-BH) and free-breathing (DWI-FB) sequences (b=0, 500). The mean liver stiffness and apparent diffusion coefficient (ADC) were calculated by drawing regions of interest maps. Fibrosis staging according to the METAVIR system was independently performed by an experienced pathologist. A receiver operating curve (ROC) analysis was conducted to determine the accuracy of MRE, DWI-BH and DWI-FB in the detection and stratification of liver fibrosis. The performance of the detection of significant fibrosis (≥F2), advanced fibrosis (≥F3), and cirrhosis (F4) was also evaluated by comparing areas under the ROC.
  
  
  RESULTS
  There was a moderate and significantly negative correlation between the ADC values and liver stiffness. The accuracies for the detection of ≥F2/≥F3/F4 stage fibrosis with DWI-FB, DWI-BH and MRE were 0.84/0.76/0.72, 0.72/0.83/0.79 and 0.99/0.99/0.98, respectively. The performance of MRE was significantly better than DWI-FB and DWI-BH. There were no significant differences between the performance of DWI-FB and DWI-BH.
  
  
  CONCLUSIONS
  MRE is more accurate than DWI for the detection and stratification of liver fibrosis in CHB.
authors.affiliation: Department of Diagnostic Imaging, National University of Singapore, Singapore.
authors.forename: Tiffany P
authors.initials: TP
authors.lastname: Hennedige
authors.affiliation: Department of Diagnostic Imaging, National University of Singapore, Singapore.|Department of Biomedical Engineering, University of Calgary, Calgary, Canada.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Diagnostic Imaging, National University of Singapore, Singapore.|Department of Radiology, King Fahd Hospital of the University, Dammam University College of Medicine, Al Khobar, Saudi Arabia.
authors.forename: Fiona P
authors.initials: FP
authors.lastname: Leung
authors.affiliation: Department of Diagnostic Imaging, National University of Singapore, Singapore.|South West Radiology, Liverpool, Australia.
authors.forename: Hind S
authors.initials: HS
authors.lastname: Alsaif
authors.affiliation: Department of Diagnostic Imaging, National University of Singapore, Singapore.
authors.forename: Lynette Ls
authors.initials: LL
authors.lastname: Teo
authors.affiliation: Department of Gastroenterology and Hepatology, National University of Singapore, Singapore.
authors.forename: Seng Gee
authors.initials: SG
authors.lastname: Lim
authors.affiliation: Department of Pathology, National University of Singapore, Singapore.
authors.forename: Aileen
authors.initials: A
authors.lastname: Wee
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Sudhakar K
authors.initials: SK
authors.lastname: Venkatesh
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods / Q000706:statistics & numerical data*; D054459:Elasticity Imaging Techniques / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000821:virology; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Accuracy; Cirrhosis; Diffusion weighted imaging; Elastography; Liver cirrhosis