Magnetic Resonance Elastography for the Staging of Liver Fibrosis: Comparison of Diagnostic Performance Between Patients with Chronic Hepatitis B and Those with Other Etiologies

Abstract

Introduction: To evaluate the diagnostic performance of magnetic resonance elastography (MRE) in staging liver fibrosis (LF) in patients with chronic hepatitis B (CHB) and other etiologies. Methods: This retrospective study was institutional review board approved and the requirement for informed consent was waived. A total of 352 patients with chronic liver diseases (280 with CHB, 26 with chronic hepatitis C (CHC), 17 with alcoholic liver disease (ALD), and 29 patients without definite etiologies) and hepatocellular carcinomas, as well as 63 living liver donors underwent MRE before surgery at our institute. Liver stiffness values (LSVs) were measured on quantitative shear-stiffness maps of MRE, and the diagnostic performance of MRE in staging LF was evaluated using receiver operating characteristic curve (ROC) analysis and the Obuchowski measure on the basis of the histopathologic analysis of LF in the CHB group and in the group comprising other etiologies. Results: Areas under the curve (AUCs) of LSVs for the diagnosis of significant fibrosis (F2), severe fibrosis (F3), and cirrhosis (F4) in the CHB group were 0.973 (95% confidence interval [CI], 0.930–0.977), 0.947 (95% CI, 0.918–0.969), and 0.918 (95% CI, 0,883–0.945), respectively. Obuchowski measures were similarly high in the CHB group and in the group comprising other etiologies (0.970 vs. 0.971). However, the estimated cutoff value for F4 in the CHB group was lower than those in other etiologies: 3.56 kPa vs 4.65 kPa, p< 0.001.