Assessing liver fibrosis in chronic liver disease: Comparison of diffusion-weighted MR elastography and two-dimensional shear-wave elastography using histopathologic assessment as the reference standard

Introduction and Objectives: Liver stiffness measurement (LSM) by two-dimensional shear-wave elastography (2D SWE) is a well-established method for assessing hepatic fibrosis. Diffusion-weighted imaging (DWI) can be converted into virtual shear modulus (µDiff) to estimate liver elasticity. The purpo...

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Main Authors: Li Yang, Guofeng Zhou, Liheng Liu, Shengxiang Rao, Wentao Wang, Kaipu Jin, Caixia Fu, Mengsu Zeng, Ying Ding
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Annals of Hepatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S166526812400526X
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author Li Yang
Guofeng Zhou
Liheng Liu
Shengxiang Rao
Wentao Wang
Kaipu Jin
Caixia Fu
Mengsu Zeng
Ying Ding
author_facet Li Yang
Guofeng Zhou
Liheng Liu
Shengxiang Rao
Wentao Wang
Kaipu Jin
Caixia Fu
Mengsu Zeng
Ying Ding
author_sort Li Yang
collection DOAJ
description Introduction and Objectives: Liver stiffness measurement (LSM) by two-dimensional shear-wave elastography (2D SWE) is a well-established method for assessing hepatic fibrosis. Diffusion-weighted imaging (DWI) can be converted into virtual shear modulus (µDiff) to estimate liver elasticity. The purpose of this study was to correlate and compare the diagnostic performance of DWI-based virtual elastography and 2D SWE for staging hepatic fibrosis in patients with chronic liver disease, using histopathologic assessment as the reference standard. Patients and Methods: This retrospective study included 111 patients who underwent preoperative multiple b-value DWI and 2D SWE. The µDiff was calculated using DWI acquisition with b-values of 200 and 1,500 /mm2, and LSM was obtained by 2D SWE. Correlation between µDiff and LSM was assessed, as well as the correlation between these noninvasive methods and histologic fibrosis stages. The diagnostic efficacy of µDiff and LSM for staging liver fibrosis was compared with receiver operating characteristic (ROC) curve analysis. Results: There was a significant positive correlation between µDiff and LSM (rho= 0.48, P < 0.001). µDiff (rho= 0.54, P < 0.001) and LSM (rho= 0.76, P < 0.001) were positively correlated with liver fibrosis stages. Areas under the curves (AUCs) of µDiff and LSM, respectively, were 0.81 and 0.90 for significant fibrosis, 0.89 and 0.98 for advanced fibrosis, and 0.77 and 0.91 for cirrhosis. The AUCs of 2D SWE for diagnosing advanced fibrosis and cirrhosis were significantly higher than those of µDiff (P < 0.05 for both). Conclusions: LSM by 2D SWE yields larger AUCs compared to µDiff obtained from DWI-based virtual elastography for various stages of liver fibrosis. LSM is superior to µDiff in predicting advanced fibrosis and cirrhosis.
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spelling doaj-art-bf337d1efe09483fb3224bac3f0e4bd42025-08-20T02:04:49ZengElsevierAnnals of Hepatology1665-26812025-01-0130110174310.1016/j.aohep.2024.101743Assessing liver fibrosis in chronic liver disease: Comparison of diffusion-weighted MR elastography and two-dimensional shear-wave elastography using histopathologic assessment as the reference standardLi Yang0Guofeng Zhou1Liheng Liu2Shengxiang Rao3Wentao Wang4Kaipu Jin5Caixia Fu6Mengsu Zeng7Ying Ding8Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, PR China; Department of Radiology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, PR ChinaDepartment of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, PR ChinaDepartment of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, PR ChinaDepartment of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, PR ChinaDepartment of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, PR ChinaDepartment of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, PR ChinaMR Application Development, Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, PR ChinaDepartment of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, PR ChinaDepartment of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, PR China; Corresponding author.Introduction and Objectives: Liver stiffness measurement (LSM) by two-dimensional shear-wave elastography (2D SWE) is a well-established method for assessing hepatic fibrosis. Diffusion-weighted imaging (DWI) can be converted into virtual shear modulus (µDiff) to estimate liver elasticity. The purpose of this study was to correlate and compare the diagnostic performance of DWI-based virtual elastography and 2D SWE for staging hepatic fibrosis in patients with chronic liver disease, using histopathologic assessment as the reference standard. Patients and Methods: This retrospective study included 111 patients who underwent preoperative multiple b-value DWI and 2D SWE. The µDiff was calculated using DWI acquisition with b-values of 200 and 1,500 /mm2, and LSM was obtained by 2D SWE. Correlation between µDiff and LSM was assessed, as well as the correlation between these noninvasive methods and histologic fibrosis stages. The diagnostic efficacy of µDiff and LSM for staging liver fibrosis was compared with receiver operating characteristic (ROC) curve analysis. Results: There was a significant positive correlation between µDiff and LSM (rho= 0.48, P < 0.001). µDiff (rho= 0.54, P < 0.001) and LSM (rho= 0.76, P < 0.001) were positively correlated with liver fibrosis stages. Areas under the curves (AUCs) of µDiff and LSM, respectively, were 0.81 and 0.90 for significant fibrosis, 0.89 and 0.98 for advanced fibrosis, and 0.77 and 0.91 for cirrhosis. The AUCs of 2D SWE for diagnosing advanced fibrosis and cirrhosis were significantly higher than those of µDiff (P < 0.05 for both). Conclusions: LSM by 2D SWE yields larger AUCs compared to µDiff obtained from DWI-based virtual elastography for various stages of liver fibrosis. LSM is superior to µDiff in predicting advanced fibrosis and cirrhosis.http://www.sciencedirect.com/science/article/pii/S166526812400526XLiver fibrosisElastographyDiffusion-weighted imaging MRI-based virtual elastographyVirtual shear modulus2D shear-wave elastographyLiver stiffness measurement
spellingShingle Li Yang
Guofeng Zhou
Liheng Liu
Shengxiang Rao
Wentao Wang
Kaipu Jin
Caixia Fu
Mengsu Zeng
Ying Ding
Assessing liver fibrosis in chronic liver disease: Comparison of diffusion-weighted MR elastography and two-dimensional shear-wave elastography using histopathologic assessment as the reference standard
Annals of Hepatology
Liver fibrosis
Elastography
Diffusion-weighted imaging MRI-based virtual elastography
Virtual shear modulus
2D shear-wave elastography
Liver stiffness measurement
title Assessing liver fibrosis in chronic liver disease: Comparison of diffusion-weighted MR elastography and two-dimensional shear-wave elastography using histopathologic assessment as the reference standard
title_full Assessing liver fibrosis in chronic liver disease: Comparison of diffusion-weighted MR elastography and two-dimensional shear-wave elastography using histopathologic assessment as the reference standard
title_fullStr Assessing liver fibrosis in chronic liver disease: Comparison of diffusion-weighted MR elastography and two-dimensional shear-wave elastography using histopathologic assessment as the reference standard
title_full_unstemmed Assessing liver fibrosis in chronic liver disease: Comparison of diffusion-weighted MR elastography and two-dimensional shear-wave elastography using histopathologic assessment as the reference standard
title_short Assessing liver fibrosis in chronic liver disease: Comparison of diffusion-weighted MR elastography and two-dimensional shear-wave elastography using histopathologic assessment as the reference standard
title_sort assessing liver fibrosis in chronic liver disease comparison of diffusion weighted mr elastography and two dimensional shear wave elastography using histopathologic assessment as the reference standard
topic Liver fibrosis
Elastography
Diffusion-weighted imaging MRI-based virtual elastography
Virtual shear modulus
2D shear-wave elastography
Liver stiffness measurement
url http://www.sciencedirect.com/science/article/pii/S166526812400526X
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