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Cited by 64Liver Diseases and ImmunityLiver Disease Diagnosis and TreatmentUltrasound Imaging and Elastography

Liver Stiffness Measured by Either Magnetic Resonance or Transient Elastography Is Associated With Liver Fibrosis and Is an Independent Predictor of Outcomes Among Patients With Primary Biliary Cholangitis

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Osman, Karim T., Maselli, Daniel B., Idilman, Ilkay S., Rowan, Daniel J., Viehman, Jason K., Harmsen, William S., Harnois, Denise M., Carey, Elizabeth J. +5 more·2021·Journal of Clinical Gastroenterology
DOI 10.1097/mcg.0000000000001433PMC PMC8529876
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Abstract

Goals: We aimed to describe the diagnostic and prognostic performance of transient elastography (TE) and magnetic resonance elastography (MRE) in patients with primary biliary cholangitis (PBC). Background: The diagnostic performance of TE and MRE in detecting advanced fibrosis in PBC and in predicting outcomes independent of existing serologic prognostic markers is incompletely understood. Materials and Methods: Five hundred thirty-eight consecutive patients with PBC at 3 centers with liver stiffness (LS) measurements by TE (n=286) or MRE (n=332) were reviewed. LS cutoffs for predicting fibrosis stages were determined by receiver operating characteristic curves among those with a liver biopsy (TE, n=63; MRE, n=98). Cox proportional hazard regression modeling was used to identify associations between covariates and hepatic decompensation. Results: The optimal LS thresholds for predicting histologic stage F4 were 14.40 kPa (area under the curve=0.94) for TE and 4.60 kPa (area under the curve=0.82) for MRE. Both TE and MRE outperformed biochemical markers for the prediction of histologic advanced fibrosis. Optimal LS thresholds to predict hepatic decompensation were 10.20 kPa on TE and 4.30 kPa on MRE. LS by TE and MRE (respectively) remained predictors of hepatic decompensation after adjusting for ursodeoxycholic acid responsiveness [hazard ratio (HR), 1.14; 95% confidence interval (CI), 1.05-1.24 and HR, 1.68; 95% CI, 1.28-2.19] and the GLOBE score (HR, 1.13; 95% CI, 1.07-1.19 and HR, 2.09; 95% CI, 1.57-2.78). Conclusion: LS measurement with either TE or MRE can accurately detect advanced fibrosis and offers additional prognostic value beyond existing serologic predictive tools.

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  • Magnetic elastography reliably quantifies liver stiffness as a surrogate of fibrosis.

    “Magnetic elastography also reliably quantifies liver stiffness as a surrogate of fibrosis.126”

    From Primary biliary cholangitis. (2024) · cites this paper as [126]

    The Results (Diagnostic performance of liver stiffness; page not provided) report that MRE-measured liver stiffness correlates with fibrosis stage and can detect cirrhosis in patients with primary biliary cholangitis. They also say its ability to distinguish fibrosis stages, particularly earlier stages, was suboptimal. Thus the paper supports its use as a fibrosis indicator, but not an unqualified claim of reliability across fibrosis stages. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • The predictive value of LSM is stable over time and is effective for stratification on treatment.

    “The predictive value of LSM is stable over time and is effective for stratification on treatment.126”

    From Primary biliary cholangitis. (2024) · cites this paper as [126]

    The Discussion (page not provided) says liver stiffness retains prognostic value regardless of UDCA treatment response, supporting its use for risk stratification in treated patients. But it also says there were too few serial measurements to assess changes in liver stiffness or their prognostic relevance, so the claim that its predictive value is stable over time is not established. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

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Authors
Osman, K. T., Maselli, D. B., Idilman, I. S., Rowan, D. J., Viehman, J. K., Harmsen, W. S., Harnois, D. M., Carey, E. J., Gossard, A. A., LaRusso, N. F., Lindor, K. D., Venkatesh, S. K., & Eaton, J. E.
Affiliations
  • Division of Gastroenterology and Hepatology
  • Radiology
  • Pathology
  • Mayo Clinic (US)
Corresponding author
  • Osman, Karim T.
  • Maselli, Daniel B.
  • Gossard, Andrea A.
  • LaRusso, Nicholas F.
  • Eaton, John E.
ORCID
Venue
Journal of Clinical Gastroenterology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2020-09-23
Volume
55
Issue
5
Pages
449-457
ISSN
0192-0790 (ISSN-L)
DOI
10.1097/mcg.0000000000001433
PMC
PMC8529876
OpenAlex
W3088744978
Cited by
64
References
5
Citations by year
2026: 11 · 2025: 10 · 2024: 11 · 2023: 11 · 2022: 10 · 2021: 11
FWCI
4.70
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Biomedical Imaging and Bioengineering (R37EB001981)
Topics
  • Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Ultrasound Imaging and Elastography
Keywords
primary biliary cirrhosis, liver stiffness, transient elastography, magnetic resonance elastography, liver fibrosis, hepatic decompensation, prognosis, ursodeoxycholic acid response, GLOBE score, fibrosis staging
MeSH terms
Humans, Liver, Liver Cirrhosis, Liver Cirrhosis, Biliary, Magnetic Resonance Spectroscopy, ROC Curve, Elasticity Imaging Techniques

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