Native T1 mapping compared to ultrasound elastography for staging and monitoring liver fibrosis: an animal study of repeatability, reproducibility, and accuracy
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To investigate the repeatability, reproducibility, and staging and monitoring of the performance of native T1 mapping for noninvasively assessing liver fibrosis in comparison with acoustic radiation force impulse (ARFI) elastography.
The repeatability and reproducibility were explored in 8 male Sprague-Dawley rats with intraclass correlation coefficient (ICC). Different degrees of fibrosis were induced in 52 rats by carbon-tetrachloride (CCl4) insult. Another 16 rats were used to build fibrosis progression and regression models. The native T1 values and shear wave velocity (SWV) were quantified by using native T1 mapping and ARFI elastography, respectively. The METAVIR system (F0–F4) was used for the staging of fibrosis. The area under the receiver operating characteristic curve (AUC) was determined to assess the performance of quantitative parameters for staging and monitoring fibrosis.
Native T1 values shared similar good repeatability (ICC = 0.93) and reproducibility (ICC = 0.87) with SWV (ICC = 0.84–0.93). The AUC of native T1 values were 0.84, 0.84, and 0.75 for diagnosing significant fibrosis (≥ F2) and liver cirrhosis (F4) and detecting fibrosis progression, and those of SWV were 0.81, 0.86, and 0.7, respectively. No significant difference in performance was found between the two quantitative parameters (p ≥ 0.496). For detecting fibrosis regression, native T1 values had a better accuracy (AUC = 0.99) than SWV (AUC = 0.56; p = 0.002).
Native T1 mapping may be a reliable and accurate method for noninvasively assessing liver fibrosis. Compared with ARFI elastography, it provides similar good repeatability and reproducibility, a similar high accuracy for staging fibrosis, and a better accuracy for detecting fibrosis regression.
• Native T1 mapping is a valuable tool for noninvasively assessing liver fibrosis and can be measured on virtually all clinical MRI machines without additional hardware or gadolinium chelate injection.
• Compared with acoustic radiation force impulse elastography, native T1 mapping yields similar good repeatability and reproducibility and a similar high accuracy for staging fibrosis.
• Native T1 mapping provides a significantly better performance for detecting fibrosis regression than acoustic radiation force impulse elastography.
KeywordsMagnetic resonance imaging Elastography Liver fibrosis Liver cirrhosis
Acoustic radiation force impulse
Area under the receiver operating characteristic curve
Intraclass correlation coefficient
Magnetic resonance elastography
Magnetic resonance imaging
Region of interest
Shear wave velocity
Within-subject coefficient of variation
We thank Dr. Shengli Gu, Department of Ultrasound, for performing the ARFI elastography on livers of rats and Dr. Xiaoying Wang, Department of Pathology (Xinhua Hospital), for pathological analysis of liver specimens. We are also grateful to Xi Zhang, PhD (Clinical Research Unite, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China), for her statistical support of this study.
This work was supported by the fund of National Natural Science Foundation of China (NSFC No. 81371621), Shanghai Shenkang Hospital Development Center (No. SHDC 22015022), and Shanghai Municipal Planning Commission of Science and Research Fund (201640143). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Compliance with ethical standards
The scientific guarantor of this publication is Dengbin Wang, MD, PhD, the chief of the Department of Radiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
We have consulted an expert in statistics (Xi Zhang, PhD, Clinical Research Unite, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China).
All experimental procedures were approved by the Institutional Animal Care and Use Committee of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.
• experimental study
• performed at one institution
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