Single Breath-Hold 3-Dimensional Magnetic Resonance Elastography Depicts Liver Fibrosis and Inflammation in Obese Patients.

Objectives: Three-dimensional (3D) magnetic resonance elastography (MRE) measures liver fibrosis and inflammation but requires several breath-holds that hamper clinical acceptance. The aim of this study was to evaluate the technical and clinical feasibility of a single breath-hold 3D MRE sequence as a means of measuring liver fibrosis and inflammation in obese patients.
Methods: From November 2020 to December 2021, subjects were prospectively enrolled and divided into 2 groups. Group 1 included healthy volunteers (n = 10) who served as controls to compare the single breath-hold 3D MRE sequence with a multiple-breath-hold 3D MRE sequence. Group 2 included liver patients (n = 10) who served as participants to evaluate the clinical feasibility of the single breath-hold 3D MRE sequence in measuring liver fibrosis and inflammation. Controls and participants were scanned at 60 Hz mechanical excitation with the single breath-hold 3D MRE sequence to retrieve the magnitude of the complex-valued shear modulus (|G*| [kPa]), the shear wave speed (Cs [m/s]), and the loss modulus (G" [kPa]). The controls were also scanned with a multiple-breath-hold 3D MRE sequence for comparison, and the participants had histopathology (Ishak scores) for correlation with Cs and G".
Results: For the 10 controls, 5 were female, and the mean age and body mass index were 33.1 ± 9.5 years and 23.0 ± 2.1 kg/m 2 , respectively. For the 10 participants, 8 were female, and the mean age and body mass index were 45.1 ± 16.5 years and 33.1 ± 4.0 kg/m 2 (obese range), respectively. All participants were suspected of having nonalcoholic fatty liver disease. Bland-Altman analysis of the comparison in controls shows there are nonsignificant differences in |G*|, Cs, and G" below 6.5%, suggesting good consensus between the 2 sequences. For the participants, Cs and G" correlated significantly with Ishak fibrosis and inflammation grades, respectively ( ρ = 0.95, P < 0.001, and ρ = 0.84, P = 0.002).
Conclusion: The single breath-hold 3D MRE sequence may be effective in measuring liver fibrosis and inflammation in obese patients.
Competing Interests: Conflicts of interest and sources of funding: Omar Darwish is a PhD candidate, and their university tuitions fees are covered by Siemens Healthineers. Dr Radhouene Neji is an employee of Siemens Healthineers United Kingdom, Dr Daniel Stäb is an employee of Siemens Healthcare Australia, and Dr Peter Speier is an employee of Siemens Healthcare Germany. For the remaining authors, none were declared. Sources of funding: CRUK City of London Centre Award (C7893/A26233), CRUK (EDDCPGM/100001), Siemens Healthineers, ITMO Aviesan 2020 (DESP/PB n°241), National Institutes of Health intramural fund, and by US Agency for International Development (USAID) and National Academy of Sciences through Subaward 2000012771 (any opinions, findings, conclusions, or recommendations expressed are those of the authors alone, and do not necessarily reflect the views of USAID or National Academy of Sciences).
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