scholarly journals Equilibrium CT Texture Analysis for the Evaluation of Hepatic Fibrosis: Preliminary Evaluation against Histopathology and Extracellular Volume Fraction

2020 ◽  
Vol 10 (2) ◽  
pp. 46
Author(s):  
Jason Yeung ◽  
Balaji Ganeshan ◽  
Raymond Endozo ◽  
Andrew Hall ◽  
Simon Wan ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Texture Analysis ◽  
Volume Fraction ◽  
Extracellular Volume ◽  
Equilibrium Phase ◽  
Extracellular Volume Fraction ◽  
Diffuse Fibrosis ◽  
Preliminary Evaluation ◽  
Ct Texture Analysis

Background: Evaluate equilibrium contrast-enhanced CT (EQ-CT) texture analysis (EQ-CTTA) against histologically-quantified fibrosis, serum-based enhanced liver fibrosis panel (ELF) and imaging-based extracellular volume fraction (ECV) in chronic hepatitis. Methods: This study was a re-analysis of image data from a previous prospective study. Pre- and equilibrium-phase post-IV contrast CT datasets were collected from patients with chronic hepatitis with contemporaneous liver biopsy and serum ELF measurement between April 2011 and July 2013. Biopsy samples were analysed to derive collagen proportionate area (CPA). EQ-CTTA was performed with a filtration histogram technique using texture analysis software, with texture quantification using statistical and histogram-based metrics (mean, skewness, standard deviation, entropy, etc.). Association between pre-contrast and EQ-CTTA against CPA, ECV and ELF was evaluated using Spearman’s rank correlation coefficient (rs). Results: Complete datasets collected in 29 patients (16 male; 13 female), mean age (range): 49 (22–66 years). Liver ECV, CPA and ELF had a median (interquartile range) of 0.26 (0.24–0.29); 5.0 (3.0–13.7) and 9.71 (8.39–10.92). Difference in segment VII hepatic CTTA (medium texture scale) between EQ-CT and pre-contrast images was significantly and positively associated with ELF score (mean: rs = 0.69, p < 0.001; skewness: rs = 0.57, p = 0.007). Significant negative associations were observed between pre-contrast and EQ-CT whole hepatic CTTA (coarse texture scale) with CPA (pre-contrast, SD: rs = −0.66, p < 0.001) and ECV (EQ-CT, entropy: rs = −0.58, p = 0.006). Conclusions: Hepatic EQ-CTTA demonstrates significant association with validated markers of liver fibrosis, suggesting a role in non-invasive quantification of severity in diffuse fibrosis.

scholarly journals P1585 Cardiac magnetic resonance estimated extracellular volume fraction, but not native T1 mapping, detects scar in patients referred for cardiac resynchronization therapy

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C Kjellstad Larsen ◽  
J Duchenne ◽  
E Galli ◽  
J M Aalen ◽  
E Kongsgaard ◽  
...  
Keyword(s):  
T1 Mapping ◽  
Volume Fraction ◽  
Extracellular Volume ◽  
Extracellular Volume Fraction ◽  
Cardiac Resynchronization ◽  
Diffuse Fibrosis ◽  
Resynchronization Therapy ◽  
Native T1 ◽  
T1 Relaxation ◽  
Contrast Agent Injection

Abstract Funding Acknowledgements The study was supported by Center for Cardiological Innovation Background Myocardial scar burden (focal fibrosis) is associated with poor response to cardiac resynchronization therapy (CRT), and should preferably be detected prior to device implantation. Late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) is considered reference standard for scar detection, but is not available in renal failure. Diffuse fibrosis is assessed by T1 mapping CMR with or without calculation of extracellular volume fraction (ECV). The method is vulnerable to partial volume effects, thus subendocardial tissue is most often not included in mapping analyses. Whether the contrast-free native T1mapping could replace LGE in the preoperative evaluation of patients referred for CRT is unknown. Purpose To investigate if native T1 mapping and calculation of ECV can adequately detect scar in patients referred for CRT. Methods Scar was quantified as percentage segmental LGE in 45 patients (age 65 ± 10 years, 71% male, QRS-width 165 ± 17ms) referred for CRT. In total 720 segments were analyzed, and LGE≥50% was considered transmural scar. T1-mapping before and after contrast agent injection was performed in all patients. ECV was calculated based on the ratio between tissue T1 relaxation change and blood T1 relaxation change after contrast agent injection, corrected for the haematocrit level. The agreement between native T1/ECV and scar was evaluated with receiver operating characteristic (ROC) curves with calculation of area under the curve (AUC) and 95% confidence interval (CI). Results LGE was present in 255 segments, 465 segments were without LGE. Average native T1 in segments with LGE was 1028 ± 88 ms, and 1040 ± 60 ms in segments without LGE (p = 0.16). The corresponding numbers for ECV were 38.7 ± 10.9% and 30.0 ± 4.7%, p &lt; 0.001. Native T1 showed poor agreement to scar independent of scar size (AUC = 0.532, 95% CI 0.485-0.578 for scars of all sizes, and AUC = 0.572, 95% CI 0.495-0.650 for transmural scars). ECV, on the other hand, showed reasonable agreement with scar of all sizes (AUC = 0.777, 95% CI 0.739-0.815), and good agreement with transmural scars (AUC = 0.856, 95% CI 0.811-0.902). (Figure) Conclusion The contrast-free CMR technique T1 mapping does not adequately detect scars in patients referred for CRT. Adding post contrast T1 measurements and calculating ECV improves accuracy, especially for transmural scars. Future studies should investigate if diffuse fibrosis could be predictive of CRT response. Abstract P1585 Figure. Detection of transmural scars

Quantitative liver MRI including extracellular volume fraction for non-invasive quantification of liver fibrosis: a prospective proof-of-concept study

Gut ◽  
2017 ◽  
Vol 67 (3) ◽  
pp. 593-594 ◽  
Author(s):  
Julian A Luetkens ◽  
Sabine Klein ◽  
Frank Traeber ◽  
Frederic C Schmeel ◽  
Alois M Sprinkart ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Volume Fraction ◽  
Extracellular Volume ◽  
Extracellular Volume Fraction ◽  
Proof Of Concept ◽  
Liver Mri ◽  
Concept Study ◽  
Non Invasive

scholarly journals Quantification of Liver Fibrosis at T1 and T2 Mapping with Extracellular Volume Fraction MRI: Preclinical Results

Radiology ◽  
2018 ◽  
Vol 288 (3) ◽  
pp. 748-754 ◽  
Author(s):  
Julian A. Luetkens ◽  
Sabine Klein ◽  
Frank Träber ◽  
Frederic C. Schmeel ◽  
Alois M. Sprinkart ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Volume Fraction ◽  
T2 Mapping ◽  
Extracellular Volume ◽  
Extracellular Volume Fraction ◽  
T1 And T2

T1 Mapping for Noninvasively Detecting Diffuse Fibrosis in Severe Aortic Stenosis

2020 ◽  
Vol 10 (7) ◽  
pp. 1534-1539
Author(s):  
Jiajun Xie ◽  
Xuhua Jian ◽  
Qiyang Lu ◽  
Jinxiu Meng ◽  
Yu-Hsiang Juan ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Cardiac Mri ◽  
T1 Mapping ◽  
Volume Fraction ◽  
Severe Aortic Stenosis ◽  
Extracellular Volume ◽  
Extracellular Volume Fraction ◽  
Left Ventricular ◽  
Diffuse Fibrosis ◽  
Mapping Technique

Purpose: To evaluate myocardial diffuse fibrosis in severe aortic stenosis (SAS) with cardiac magnetic resonance imaging (MRI) T1 mapping technique. Methods: Twenty-seven SAS patients and 15 controls were enrolled and performed cardiac MRI. Left ventricular (LV) structure, function and T1-derived parameters were measured to compare between SAS group and the controls. Correlation between T1-derived parameters and the extent of histologic fibrosis was performed in 15 patients who underwent aortic valve replacement surgery and myocardial biopsy. Results: The SAS group had LV remodeling with ventricular dilatation, hypertrophy, and contractile dysfunction. The native T1 (1336.2±62.5 ms vs. 1277.6±40.7 ms, p = 0.002) and extracellular volume fraction (ECV%) (26.7±2.2% vs. 24.9±2.2%, p = 0.018) were elevated in the SAS in comparison to the controls. Only ECV and λ correlated with the extent of fibrosis as measured by histology. Conclusion: Cardiac MRI with T1 mapping provides a noninvasive approach to evaluate LV myocardial diffuse fibrosis in SAS.

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