Direct comparison of US and MR elastography for staging liver fibrosis in patients with nonalcoholic fatty liver disease
Open accessAbstract
BACKGROUND & AIMS: As alternatives to the expensive liver biopsy for assessing liver fibrosis stage in patients with nonalcoholic fatty liver disease (NAFLD), we directly compared the diagnostic abilities of magnetic resonance elastography (MRE), vibration-controlled transient elastography (VCTE), and two-dimensional shear wave elastography (2D-SWE). METHODS: Overall, 231 patients with biopsy-proven NAFLD were included. Intra- and inter-observer reproducibility was analyzed using intraclass correlation coefficient in a sub-group of 70 participants, in whom liver stiffness measurement (LSM) was performed by an elastography expert and an ultrasound expert who was an elastography trainee on the same day. RESULTS: Valid LSMs were obtained for 227, 220, 204, and 201 patients using MRE, VCTE, 2D-SWE, and all three modalities combined, respectively. Although the area under the curve did not differ between the modalities for detecting stage ≥1, ≥2, and ≥3 liver fibrosis, it was higher for MRE than VCTE and 2D-SWE for stage 4. Sex was a significant predictor of discordance between VCTE and liver fibrosis stage. Skin-capsule distance and the ratio of the interquartile range of liver stiffness to the median were significantly associated with discordance between 2D-SWE and liver fibrosis stage. However, no factors were associated with discordance between MRE and liver fibrosis stage. Intra- and inter-observer reproducibility in detecting liver fibrosis was higher for MRE than VCTE and 2D-SWE. CONCLUSIONS: MRE, VCTE, and 2D-SWE demonstrated excellent diagnostic accuracy in detecting liver fibrosis in patients with NAFLD. MRE demonstrated the highest diagnostic accuracy for stage 4 detection and intra- and inter-observer reproducibility. UMIN Clinical Trials Registry No. UMIN000031491.
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Advantages of MRE for the diagnosis of advanced fibrosis were reported recently.
“Advantages of MRE for the diagnosis of advanced fi brosis were reported recently.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [159]
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- Authors
- Imajo, K., Honda, Y., Kobayashi, T., Nagai, K., Ozaki, A., Iwaki, M., Kessoku, T., Ogawa, Y., Takahashi, H., Saigusa, Y., Yoneda, M., Kirikoshi, H., Utsunomiya, D., Aishima, S., Saito, S., & Nakajima, A.
- Affiliations
- Yokohama City University (JP)
- Saga University (JP)
- Yokohama City University Hospital (JP)
- Corresponding author
- Nakajima, Atsushi
- ORCID
- Venue
- Clinical Gastroenterology and Hepatology
- Publisher
- Elsevier BV
- Published
- 2022-04
- Volume
- 20
- Issue
- 4
- Pages
- 908-917.e11
- ISSN
- 1542-3565 (ISSN-L)
- OpenAlex
- W3110769583
- Cited by
- 140
- References
- 31
- Citations by year
- 2026: 24 · 2025: 27 · 2024: 31 · 2023: 20 · 2022: 29 · 2021: 9
- FWCI
- 10.39
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Gastroenterology and Hepatology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Japan Science and Technology Agency
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Ultrasound Imaging and Elastography
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Keywords
- non-alcoholic fatty liver disease, liver fibrosis staging, magnetic resonance elastography, vibration-controlled transient elastography, shear wave elastography, liver stiffness measurement, noninvasive fibrosis assessment, observer reproducibility, diagnostic accuracy
- MeSH terms
- Female, Humans, Liver, Liver Cirrhosis, Male, Reproducibility of Results, Elasticity Imaging Techniques, Non-alcoholic Fatty Liver Disease
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