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Extracellular volume fraction obtained by dual-energy CT depicting the etiological differences of liver fibrosis

  • Hepatobiliary
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To assess etiological differences in extracellular volume fraction (ECV) and evaluate its influence on staging performance.

Methods

A total of 166 patients with normal liver (n = 14) and chronic liver disease related to viral hepatitis (n = 71), alcohol (n = 44), and nonalcoholic steatohepatitis (NASH) (n = 37) underwent dual-energy CT (DECT) of the liver (5-min equilibrium-phase images) between January 2020 and July 2022. The iodine densities of the parenchyma and aorta were measured and ECV was calculated. Comparisons of ECV between each etiology and METAVIR fibrosis stage were statistically analyzed (p < 0.05).

Results

ECV in each etiology and all patients significantly increased with higher fibrosis stage (p < 0.001) and showed a strong or moderate correlation with fibrosis stage (Spearman’s ρ; all patients, 0.701; viral hepatitis, 0.638; alcoholic, 0.885; NASH, 0.791). In stages F2–F4, ECV in alcoholic liver disease was significantly larger than those for viral hepatitis and NASH (p < 0.05); however, no significant difference in stage F1 was found among the three etiologies. The cutoff values and areas under the receiver operating characteristic curve (AUC-ROCs) for discriminating fibrosis stage (≥ F1– ≥ F4) were higher for alcohol (cutoff values and AUC-ROC; 20.1% and 0.708 for ≥ F1, 23.8% and 0.990 for ≥ F2, 24.3% and 0.968 for ≥ F3, and 26.6% and 0.961 for ≥ F4, respectively) compared with those for the others.

Conclusion

ECV in alcoholic liver disease is higher than that in other etiologies in the advanced stages of fibrosis, and etiological differences in ECV affect the staging performance of fibrosis.

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Funding

The authors did not receive support from any organization for the submitted work.

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Author notes

  1. Kumi Ozaki

    Present address: Department of Radiology, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan

Authors and Affiliations

  1. Department of Radiology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan

    Kumi Ozaki & Hirohiko KImura

  2. Radiological Center, University of Fukui Hospital, Eiheiji, Japan

    Takashi Ohtani, Shota Ishida, Tomokazu Ishida, Kouki Takahashi & Yuki Matta

  3. Department of Radiological Technology, Faculty of Medical Science, Kyoto College of Medical Science, Kyoto, Japan

    Shota Ishida

  4. Department of Pathology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan

    Shohei Higuchi

  5. Department of Radiology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan

    Toshifumi Gabata

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Contributions

KO: conceptualization; KO, TI: methodology; TO, SI, SH, TI, KT, YM: data curation and investigation; SI: formal analysis; SH: visualization; KO, TO: writing—original draft preparation; SI, HK, TG: writing—review and editing; TG: supervision.

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Correspondence to Kumi Ozaki.

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Conflict of interest

All authors declare that they have no conflicts of interest.

Ethical approval

This single-center retrospective study was approved by our institution’s Research Ethics Committee (approval No.: 20190164). Informed consent for contrast-enhanced CT was obtained from all patients before the examinations.

Research involving human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Ozaki, K., Ohtani, T., Ishida, S. et al. Extracellular volume fraction obtained by dual-energy CT depicting the etiological differences of liver fibrosis. Abdom Radiol 48, 1975–1986 (2023). https://doi.org/10.1007/s00261-023-03873-6

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