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MRI cine‐tagging of cardiac‐induced motion for noninvasive staging of liver fibrosis
Author(s) -
Lefebvre Thierry,
Petitclerc Léonie,
Hébert Mélanie,
Bilodeau Laurent,
Sebastiani Giada,
Olivié Damien,
Gao ZuHua,
Sylvestre MariePierre,
Cloutier Guy,
Nguyen Bich N.,
Gilbert Guillaume,
Tang An
Publication year - 2020
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.26935
Subject(s) - medicine , receiver operating characteristic , fibrosis , liver biopsy , biopsy , mann–whitney u test , radiology , coronal plane , elastography , harp , nuclear medicine , confidence interval , ultrasound , pathology , physics , quantum mechanics
Background MR elastography is a noninvasive technique that provides high diagnostic accuracy for the staging of liver fibrosis; however, it requires external hardware and mainly assesses the right lobe. Purpose To evaluate the diagnostic performance of MRI cine‐tagging for staging fibrosis in the left liver lobe, using biopsy as the reference standard. Study Type Institutional Review Board (IRB)‐approved two‐center prospective study. Population Seventy‐six patients with chronic liver disease who underwent an MRI cine‐tagging examination and a liver biopsy within a 6‐week interval. Field Strength/Sequence 2D‐GRE multislice sequence at 3.0T with spatial modulation of the magnetization preparation sequence and peripheral pulse‐wave triggering on two coronal slices chosen underneath the heart apex to capture maximal deformation with consecutive breath‐holds adapted to patient cardiac frequency. Assessment A region of interest was selected in the liver close to the heart apex. Maximal strain was evaluated with the harmonic phase (HARP) technique. Statistical Tests Spearman's correlation, Kruskal–Wallis test, Mann–Whitney U ‐test, and receiver operating characteristic (ROC) analysis were performed. Results Liver strain measured on tagged images decreased with higher histological fibrosis stage ( ρ = –0.68, P < 0.0001). Strain values were significantly different between all fibrosis stages ( P < 0.0001), and between groups of fibrosis stages ≤F3 vs. F4 ( P < 0.05). Areas under the ROC curves were 0.95 (95% confidence interval: 0.89–1.00) to distinguish fibrosis stages F0 vs. F4, 0.81 (0.70–0.92) for stages F0 vs. ≥F1, 0.84 (0.76–0.93) for stages ≤F1 vs. ≥F2, 0.86 (0.78–0.94) for stages ≤F2 vs. ≥F3, and 0.87 (0.77–0.96) for stages ≤F3 vs. F4. Data Conclusion MRI cine‐tagging is a promising technique for measuring liver strain without additional elastography hardware. It could be used to assess the left liver lobe as a complement to current techniques assessing the right lobe. Level of Evidence: 1 Technical Efficacy: 3 J. Magn. Reson. Imaging 2020;51:1570–1580.