Staging Chronic Hepatitis B Related Liver Fibrosis with Diffusion-weighted MRI-based Virtual Elastography: Comparisons with Serum Fibrosis Indexes

L Yang; G Zhou; L Liu; S Rao; W Wang; K Jin; F Wu; C Fu; M Zeng; Y Ding

doi:10.1016/j.crad.2024.106750

Staging Chronic Hepatitis B Related Liver Fibrosis with Diffusion-weighted MRI-based Virtual Elastography: Comparisons with Serum Fibrosis Indexes

Clin Radiol. 2024 Nov 16:80:106750. doi: 10.1016/j.crad.2024.106750. Online ahead of print.

Authors

L Yang¹, G Zhou², L Liu², S Rao², W Wang², K Jin², F Wu², C Fu³, M Zeng², Y Ding⁴

Affiliations

¹ Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Radiology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China.
² Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China.
³ MR Application Development, Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, China.
⁴ Department of Radiology, Shanghai Institute of Medical Imaging, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address: ding.ying@zs-hospital.sh.cn.

PMID: 39657563
DOI: 10.1016/j.crad.2024.106750

Abstract

Aim: To evaluate and compare the diagnostic performance of diffusion-weighted imaging (DWI)-based virtual magnetic resonance (MR) elastography and serum fibrosis indexes for staging liver fibrosis in patients with chronic hepatitis B (CHB).

Materials and methods: This retrospective study included 145 patients with CHB. Virtual shear modulus (μ_Diff) was derived from DWI acquisition with b values of 200 and 1500/mm². Aspartate aminotransferase to platelet ratio index (APRI), fibrosis-4 index (FIB-4), S index, Fibro Q and gamma-glutamyl transpeptidase to platelet ratio (GPR) were calculated. The diagnostic efficacies of μ_Diff and serum indexes for staging liver fibrosis were compared.

Results: μ_Diff, APRI, FIB-4, S index, Fibro Q, and GPR increased as the hepatic fibrosis progressed (r=0.23-0.52, P<0.05). Areas under the curves (AUCs) of μ_Diff were 0.725, 0.817 and 0.764 for significant fibrosis, advanced fibrosis, and cirrhosis, respectively. μ_Diff had greater AUC over FIB-4 (0.686) and Fibro Q (0.638) for advanced fibrosis (P<0.05). The AUCs of combination of μ_Diff with APRI, FIB-4, S index, Fibro Q, and GPR individually were 0.779, 0.772, 0.763, 0.728, and 0.756 for significant fibrosis, 0.856, 0.842, 0.834, 0.831, and 0.834 for advanced fibrosis, 0.811, 0.818, 0.784, 0.835, and 0.788 for cirrhosis, respectively. The AUCs of the combinations were significantly higher than individual serum index for advanced fibrosis and cirrhosis (all P<0.05).

Conclusion: DWI-based virtual MR elastography could estimate liver fibrosis stages in patients with CHB, which outperformed FIB-4 and Fibro Q for advanced fibrosis. The combination of μ_Diff with each serum index appears superior to individual serum index for advanced fibrosis and cirrhosis.