Comparison of non-invasive assessment of liver fibrosis in patients with alpha1-antitrypsin deficiency using magnetic resonance elastography (MRE), acoustic radiation force impulse (ARFI) Quantification, and 2D-shear wave elastography (2D-SWE)

Although it has been known for decades that patients with alpha1-antitrypsin deficiency (AATD) have an increased risk of cirrhosis and hepatocellular carcinoma, limited data exist on non-invasive imaging-based methods for assessing liver fibrosis such as magnetic resonance elastography (MRE) and aco...

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Published in:	PloS one 2018-04, Vol.13 (4), p.e0196486-e0196486
Main Authors:	Reiter, Rolf, Wetzel, Martin, Hamesch, Karim, Strnad, Pavel, Asbach, Patrick, Haas, Matthias, Siegmund, Britta, Trautwein, Christian, Hamm, Bernd, Klatt, Dieter, Braun, Jürgen, Sack, Ingolf, Tzschätzsch, Heiko
Format:	Article
Language:	eng
Subjects:	Acoustic resonance Acoustics Bioengineering Biology and Life Sciences Cirrhosis College campuses Comparative analysis Correlation Diagnostic imaging Engineering schools Fibrosis Franklin, Benjamin (1706-1790) Gastroenterology Genetic disorders Health aspects Hepatocellular carcinoma Hospitals Identification methods Intensive care Liver Liver cirrhosis Liver diseases Magnetic resonance Medical diagnosis Medicine and Health Sciences Metabolic disorders Methods Motivation Patients Physical Sciences Radiation Research and Analysis Methods Resonance Rheumatology Shear Systematic review Ultrasonic imaging
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Summary:	Although it has been known for decades that patients with alpha1-antitrypsin deficiency (AATD) have an increased risk of cirrhosis and hepatocellular carcinoma, limited data exist on non-invasive imaging-based methods for assessing liver fibrosis such as magnetic resonance elastography (MRE) and acoustic radiation force impulse (ARFI) quantification, and no data exist on 2D-shear wave elastography (2D-SWE). Therefore, the purpose of this study is to evaluate and compare the applicability of different elastography methods for the assessment of AATD-related liver fibrosis. Fifteen clinically asymptomatic AATD patients (11 homozygous PiZZ, 4 heterozygous PiMZ) and 16 matched healthy volunteers were examined using MRE and ARFI quantification. Additionally, patients were examined with 2D-SWE. A high correlation is evident for the shear wave speed (SWS) determined with different elastography methods in AATD patients: 2D-SWE/MRE, ARFI quantification/2D-SWE, and ARFI quantification/MRE (R = 0.8587, 0.7425, and 0.6914, respectively; P≤0.0089). Four AATD patients with pathologically increased SWS were consistently identified with all three methods-MRE, ARFI quantification, and 2D-SWE. The high correlation and consistent identification of patients with pathologically increased SWS using MRE, ARFI quantification, and 2D-SWE suggest that elastography has the potential to become a suitable imaging tool for the assessment of AATD-related liver fibrosis. These promising results provide motivation for further investigation of non-invasive assessment of AATD-related liver fibrosis using elastography.
ISSN:	1932-6203 1932-6203