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Comparison of the diagnostic performance of 2D and 3D MR elastography in staging liver fibrosis

  • Hepatobiliary-Pancreas
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Abstract

Objectives

To compare the diagnostic performance and image quality of state-of-the-art 2D MR elastography (MRE) and 3D MRE in the basic application of liver fibrosis staging.

Methods

This retrospective study assessed data from 293 patients who underwent 2D and 3D MRE examinations. MRE image quality was assessed with a qualitative 2-point grading system by evaluating artifacts. Two experienced analysts independently measured mean liver stiffness values. The interobserver agreement of liver stiffness measurement was assessed by the intraclass correlation coefficient (ICC). The area under the receiver operating characteristic curve (AUC) was used to assess the diagnostic performance of 2D and 3D MRE and blood-based markers for fibrosis staging using the pathology-proven liver fibrosis stage as the gold standard.

Results

The image quality provided by 3D MRE was graded as significantly higher than that obtained with the 2D MRE method (p < 0.01). Interobserver agreement in liver stiffness measurements was higher for 3D MRE (ICC: 3D 0.979 vs 2D 0.955). The AUC values for discriminating ≥ F1, ≥ F2, ≥ F3, and F4 fibrosis for 3D MRE (0.89, 0.92, 0.95, and 0.93) were similar to those for 2D MRE (0.89, 0.91, 0.94, and 0.92). Both the 2D and 3D MRE methods provided superior accuracy to the blood-based biomarkers, including APRI, FIB-4, and Forns index, especially for ≥ F2, ≥ F3, and F4 fibrosis stages (all p < 0.01).

Conclusions

While 3D MRE offers certain advantages and opportunities for new applications of MRE, current widely deployed 2D MRE technology has comparable performance in the basic application of detecting and staging liver fibrosis.

Key Points

• 2D MRE and 3D MRE have comparable diagnostic performance in detecting and staging liver fibrosis.

• 3D MRE has superior image quality and interobserver agreement compared to 2D MRE.

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Abbreviations

2D:

Two-dimensional

3D:

Three-dimensional

APRI:

Aspartate transaminase-to-platelet ratio index

AUC:

Area under the curve

BMI:

Body mass index

FIB-4:

Fibrosis index based on four factors

FOV:

Field of view

GRE:

Gradient recalled echo

ICC:

Intraclass correlation coefficient

IQR:

Interquartile range

MRE:

Magnetic resonance elastography

NPV:

Negative predictive value

PPV:

Positive predictive value

ROC:

Receiver operating characteristic

ROI:

Regions of interest

SE-EPI:

Spin-echo echo-planar imaging

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Acknowledgements

The authors thank Dr. Jing Zhou for assessment of pathologic specimens.

Funding

The authors state that this study has received funding by the National Natural Science Foundation of China grant 91959118 (JW), Science and Technology Program of Guangzhou, China 201704020016 (JW), Clinical Research Foundation of the 3rd Affiliated Hospital of Sun Yat-Sen University YHJH201901 (JW), and Guangdong Basic and Applied Basic Research Foundation (No.2021A1515010582) (JW).

Author information

Author notes

  1. Mengsi Li and Hao Yang contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, The Third Affiliated Hospital, Sun Yat-Sen University (SYSU), No. 600, Tianhe Road, Guangzhou, Guangdong, 510630, People’s Republic of China

    Mengsi Li, Hao Yang, Linqi Zhang, Jingbiao Chen, Ying Deng, Yuanqiang Xiao, Jie Zhu, Zhuoya Yi, Bing Hu, Sichi Kuang, Bingjun He & Jin Wang

  2. Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University (SYSU), No. 107, Yanjiangxi Road, Guangzhou, Guangdong, 510120, People’s Republic of China

    Hao Yang

  3. Department of Pathology, The Third Affiliated Hospital, Sun Yat-Sen University (SYSU), No. 600, Tianhe Road, Guangzhou, Guangdong, 510630, People’s Republic of China

    Yong Liu

  4. Department of Radiology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA

    Kevin J. Glaser, Meng Yin, Sudhakar K. Venkatesh & Richard L. Ehman

Authors
  1. Mengsi Li
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  2. Hao Yang
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Corresponding author

Correspondence to Jin Wang.

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The scientific guarantor of this publication is Jin Wang.

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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.

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• performed at one institution

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Li, M., Yang, H., Liu, Y. et al. Comparison of the diagnostic performance of 2D and 3D MR elastography in staging liver fibrosis. Eur Radiol 31, 9468–9478 (2021). https://doi.org/10.1007/s00330-021-08053-y

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  • DOI: https://doi.org/10.1007/s00330-021-08053-y

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