scholarly journals Diffusion-weighted magnetic resonance imaging for the assessment of liver fibrosis in chronic viral hepatitis

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248024
Author(s):  
Phunchai Charatcharoenwitthaya ◽  
Kamonthip Sukonrut ◽  
Pornpim Korpraphong ◽  
Ananya Pongpaibul ◽  
Pairash Saiviroonporn
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Viral Hepatitis ◽  
Predictive Value ◽  
Chronic Viral Hepatitis ◽  
Fibrosis Stage ◽  
Resonance Imaging ◽  
Weighted Magnetic Resonance Imaging

Background Accurate noninvasive methods for the assessment of liver fibrosis are urgently needed. This prospective study evaluated the diagnostic accuracy of diffusion-weighted magnetic resonance imaging (DWI) for the staging of liver fibrosis and proposed a diagnostic algorithm using DWI to identify cirrhosis in patients with chronic viral hepatitis. Methods One hundred twenty-one treatment-naïve patients with chronic hepatitis B or C were evaluated with DWI followed by liver biopsy on the same day. Breath-hold single-shot echo-planar DWI was performed to measure the apparent diffusion coefficient (ADC) of the liver and spleen. Normalized liver ADC was calculated as the ratio of liver ADC to spleen ADC. Results There was an inverse correlation between fibrosis stage and normalized liver ADC (p<0.05). For the prediction of fibrosis stage ≥2, stage ≥3, and cirrhosis, the area under the receiver-operating curve of normalized liver ADC was 0.603, 0.704, and 0.847, respectively. The normalized liver ADC value ≤1.02×10−3 mm2/s had 88% sensitivity, 81% specificity, 25% positive predictive value (PPV), and 99% negative predictive value (NPV) for the diagnosis of cirrhosis. Using a sequential approach with the Fibrosis-4 index followed by DWI, normalized liver ADC ≤1.02×10−3 mm2/s in patients with Fibrosis-4 >3.25 yielded an 80% PPV for cirrhosis, and a 100% NPV to exclude cirrhosis in patients with Fibrosis-4 between 1.45 and 3.25. Only 15.7% of patients would require a liver biopsy. This sequential strategy can reduce DWI examinations by 53.7%. Conclusion Normalized liver ADC measurement on DWI is an accurate and noninvasive tool for the diagnosis of cirrhosis in patients with chronic viral hepatitis.

Diffusion-Weighted Magnetic Resonance Imaging for Diagnosis of Liver Fibrosis and Inflammation in Chronic Viral Hepatitis: The Performance of Low or High b Values and Small or Large Regions of Interest

2012 ◽  
Vol 63 (4) ◽  
pp. 304-311 ◽  
Author(s):  
Seyed M. Vaziri-Bozorg ◽  
Ahmad R. Ghasemi-Esfe ◽  
Omid Khalilzadeh ◽  
Mehdi Mazloumi ◽  
Mohsen Nassiri-Toosi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Diffusion Coefficient ◽  
Magnetic Resonance ◽  
Liver Fibrosis ◽  
Viral Hepatitis ◽  
Chronic Viral Hepatitis ◽  
Regions Of Interest ◽  
Resonance Imaging ◽  
B Values ◽  
Apparent Diffusion

Objective To investigate the performance of different b values and regions of interest (ROI) for diagnosing liver fibrosis in patients with chronic viral hepatitis by using diffusion-weighted (DW) magnetic resonance imaging (MRI). Methods Eleven healthy participants and 33 patients with viral hepatitis B or C were enrolled. The stage of liver fibrosis and the grade of necroinflammation were determined by using a histologic activity index. Single-shot spin-echo echo-planar DW-MRI was performed in all participants at b values of 0-500, 0-700, and 0-1000 s/mm2 by using 2 circular small and large ROIs of 100 and 200 mm2. To evaluate the performance of different b values for determining cirrhosis, the receiver-operating characteristic curves were depicted, and the areas under the curves were compared. Results The average values of apparent diffusion coefficients significantly decreased with increasing stage or grade categories at all the 3 b values and for both small and large ROIs. The performance at b = 500 s/mm2 was significantly better than b = 1000 s/mm2 for determining cirrhosis or bridging fibrosis. The cut point of 153.4 for apparent diffusion coefficient (×10−5 mm2/s) at b = 500 s/mm2 could determine cirrhosis or bridging fibrosis with a sensitivity of 96% and specificity of 82%. No difference was found between the average apparent diffusion coefficient values of large or small ROIs. Also, there was no difference in performance of large or small ROIs in the diagnosis of liver fibrosis. Conclusions This study provided beneficial data for clinical utilisation of DW-MRI in diagnosing liver fibrosis: b = 500 s/mm2 is better in performance than b = 1000 s/mm2, and a small ROI of 100 mm2 is sufficient for determining cirrhosis or bridging fibrosis.

scholarly journals Diffusion-weighted magnetic resonance imaging for evaluation of malignant lymph node invasion in patients with female genital neoplasms

2020 ◽  
pp. 102-102
Author(s):  
Marijana Basta-Nikolic ◽  
Dragan Nikolic ◽  
Sanja Stojanovic ◽  
Srdjan Djurdjevic ◽  
Olivera Nikolic ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lymph Nodes ◽  
Predictive Value ◽  
Resonance Imaging ◽  
Adc Value ◽  
Inguinal Lymph Nodes ◽  
Gynecological Malignancies ◽  
Weighted Magnetic Resonance Imaging ◽  
Malignant Lymph Nodes

Background / Aim: Functional imaging, including diffusion-weighted magnetic resonance imaging (DWI MRI) and ADC map, provides promising results in discrimination benign from malignant pelvic and inguinal lymph nodes in patients with gynecological malignancies. Aim of the study was to assess diagnostic performances of DWI in differentiation between benign and malignant pelvic and inguinal lymph nodes in patients with gynecological malignancies. Methods: The prospective clinical study was conducted at Clinical Center of Vojvodina from 2013 to 2016, comprising 80 patients with malignant gynecological tumors. Preoperatively, all patients underwent MRI examination, followed by standard surgical treatment with complete pelvic and/or inguinal lymphadenectomy. Histopathological examination of surgically removed material and lymph nodes separated in pelvic and inguinal anatomic groups was performed after the surgery. Results: The total of 2320 of lymph nodes were mapped and histopathologically examined in 80 patients included in the study. Metastases in lymph nodes were histopathologically confirmed in 28 patients (35%). Measured ADC values were significantly lower in metastatic (mean ? SD, ADC: 0.8725 x 10-3 mm2/s ? 0.0125) than benign lymph nodes (mean ? SD, ADC: 1.116 x 10-3 mm2/s ? 0.1848; P=0.001). If ADC value of 0.860 x 10- 3 mm2 / s is determined as a cut off value for discrimination between benign and malignant lymph nodes, DWI sensitivity was 89%, specificity 85% and overall accuracy was 86%. Combination of ADC value criteria and size-based criteria yields MRI the following diagnostic performances in discrimination between benign and malignant lymph nodes: sensitivity 95%, specificity 92%, overall accuracy 92.5%, positive predictive value 46% and negative predictive value 99.6%. Conclusion: DWI MRI sequence is fast, simple, noninvasive method which aids significantly to MRI diagnostic performances in discrimination between benign and malignant pelvic and inguinal lymph nodes.

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