scholarly journals Advances in liver US, CT, and MRI: moving toward the future

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Federica Vernuccio ◽  
Roberto Cannella ◽  
Tommaso Vincenzo Bartolotta ◽  
Massimo Galia ◽  
An Tang ◽  
...  
Keyword(s):  
Liver Disease ◽  
Resource Constraints ◽  
Volume Fraction ◽  
Transient Elastography ◽  
Extracellular Volume ◽  
Proton Density ◽  
Liver Imaging ◽  
Hepatobiliary Phase ◽  
Backscatter Coefficient ◽  
Nonalcoholic Fatty Liver

AbstractOver the past two decades, the epidemiology of chronic liver disease has changed with an increase in the prevalence of nonalcoholic fatty liver disease in parallel to the advent of curative treatments for hepatitis C. Recent developments provided new tools for diagnosis and monitoring of liver diseases based on ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI), as applied for assessing steatosis, fibrosis, and focal lesions. This narrative review aims to discuss the emerging approaches for qualitative and quantitative liver imaging, focusing on those expected to become adopted in clinical practice in the next 5 to 10 years. While radiomics is an emerging tool for many of these applications, dedicated techniques have been investigated for US (controlled attenuation parameter, backscatter coefficient, elastography methods such as point shear wave elastography [pSWE] and transient elastography [TE], novel Doppler techniques, and three-dimensional contrast-enhanced ultrasound [3D-CEUS]), CT (dual-energy, spectral photon counting, extracellular volume fraction, perfusion, and surface nodularity), and MRI (proton density fat fraction [PDFF], elastography [MRE], contrast enhancement index, relative enhancement, T1 mapping on the hepatobiliary phase, perfusion). Concurrently, the advent of abbreviated MRI protocols will help fulfill an increasing number of examination requests in an era of healthcare resource constraints.

scholarly journals Magnetic Resonance Imaging-Proton Density Fat Fraction vs. Transient Elastography-Controlled Attenuation Parameter in Diagnosing Non-alcoholic Fatty Liver Disease in Children and Adolescents: A Meta-Analysis of Diagnostic Accuracy

2022 ◽  
Vol 9 ◽  
Author(s):  
Shuangzhen Jia ◽  
Yuzhen Zhao ◽  
Jiaqi Liu ◽  
Xu Guo ◽  
Moxian Chen ◽  
...  
Keyword(s):  
Liver Disease ◽  
Children And Adolescents ◽  
Transient Elastography ◽  
Meta Analysis ◽  
Proton Density ◽  
Controlled Attenuation Parameter ◽  
Alcoholic Fatty Liver ◽  
Post Test ◽  
Fat Fraction ◽  
Alcoholic Fatty Liver Disease

Background and Aim: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in children and adolescents, and its prevalence increases with obesity. Magnetic resonance imaging (MRI) and transient elastography (TE) have been widely used to non-invasively evaluate NAFLD in adults. This study aimed to determine the efficacy and accuracy of MRI-proton density fat fraction (MRI-PDFF) and TE-controlled attenuation parameter (TE-CAP) in distinguishing hepatic steatosis in children and adolescents.Materials and Methods: In this meta-analysis, the PubMed, Cochrane Library, Embase, Medline, and Web of Science databases were searched for articles that reported studies on the accuracy of MRI-PDFF or TE-CAP in grading the steatosis in children and adolescents with NAFLD. This study compared the sensitivity, specificity, and hierarchical summary receiver operating characteristic curves (HSROCs) of MRI-PDFF and TE-CAP in distinguishing between steatosis grades S0 and S1–3.Results: A total of eight articles involving 874 children and adolescents with NAFLD were included in this study. The proportions of steatosis grades were 5 and 95% for S0 and S1–3, respectively. MRI-PDFF accurately diagnosed S1–3 steatosis, with a summary sensitivity of 0.95 (95% CI, 0.92–0.97), specificity of 0.92 (95% CI, 0.77–0.98), and HSROC of 0.96 (95% CI, 0.94–0.98). Likewise, TE-CAP accurately diagnosed S1–3 steatosis, with a summary sensitivity of 0.86 (95% CI, 0.70–0.94), specificity of 0.88 (95% CI, 0.71–0.96), and HSROC of 0.94 (95% CI, 0.91–0.95). Following a “positive” measurement (over the threshold value) for S1–3, the corresponding post-test probabilities of MRI-PDFF and TE-CAP for the presence of steatosis reached 92 and 88%, respectively, at the pretest probability of 50%. When the values were below the mentioned threshold values (“negative” results), the post-test probabilities of MRI-PDFF and TE-CAP became 5 and 13%, respectively.Conclusion: Both MRI-PDFF and TE-CAP are highly accurate non-invasive methods to grade the hepatic steatosis in children and adolescents with NAFLD. Furthermore, MRI-PDFF is significantly more accurate in assessing steatosis grade than TE-CAP.Systematic Review Registration: PROSPERO, identifier: CRD42021220422.

scholarly journals Optimizing the Use of the Gamma-Glutamyl Transpeptidase-to-Platelet Ratio and Transient Elastography to Identify Liver Cirrhosis in Patients with Chronic Hepatitis B Concurrent with Nonalcoholic Fatty Liver Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-11
Author(s):  
Geng-lin Zhang ◽  
Shi-cheng Xu ◽  
Jie Zeng ◽  
Zheng Chen ◽  
Yi-Ping Li ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Chronic Hepatitis ◽  
Liver Disease ◽  
Fatty Liver Disease ◽  
Transient Elastography ◽  
Gamma Glutamyl Transpeptidase ◽  
Excellent Performance ◽  
Nonalcoholic Fatty Liver ◽  
Optimal Approach ◽  
Glutamyl Transpeptidase

Background and Aim. Little information is available about the assessment and optimal use of the gamma-glutamyl transpeptidase-to-platelet ratio (GPR) and transient elastography (TE) in predicting liver cirrhosis in patients with chronic hepatitis B (CHB) and concurrent nonalcoholic fatty liver disease (NAFLD). This study is aimed at comparing their diagnostic performances and developing an optimal approach for predicting liver cirrhosis in CHB patients with NAFLD. Methods. Consecutive CHB patients with NAFLD were enrolled. The GPR was calculated, and TE was performed using liver biopsy as a reference standard. The accuracy of predicting liver cirrhosis using GPR and TE was assessed and compared, and an optimal approach was developed. Results. Both TE and GPR correlated significantly with the histological fibrosis stage. TE and GPR had excellent performance in predicting liver cirrhosis, and the comparison of areas under the receiver operating characteristic curves revealed that TE was superior to GPR (0.95 vs. 0.85, P=0.039). Moreover, the dual cutoffs established by the likelihood ratio showed that GPR had a similar misclassification but higher indeterminate rate than TE (54.5% vs. 11.7%, P<0.001). Additionally, a 2-step approach using GPR followed by TE had comparable performance to that of both GPR and TE tests for all patients (misclassification: 8.9% vs. 8.3%, P=0.866; indeterminate rate: 15.2% vs. 17.2%, P=0.750) but could reduce TE scans by approximately one-third. Conclusions. Both TE and GPR show excellent performance in predicting liver cirrhosis in CHB patients with NAFLD. The 2-step approach using GPR followed by TE may be optimal for the assessment of cirrhosis in CHB patients with NAFLD.

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