MRI Extracellular Volume Fraction in Liver Fibrosis—A Comparison of Different Time Points and Blood Pool Measurements

Abstract

BackgroundExtracellular volume (ECV) correlates with the degree of liver fibrosis.PurposeTo analyze the performance of liver MRI‐based ECV evaluations with different blood pool measurements at different time points.Study TypeProspective.Sample73 consecutive patients (n = 31 females, mean age 56 years) with histopathology‐proven liver fibrosis.Field Strength/Sequence3T acquisition within 90 days of biopsy, including shortened modified look–locker inversion recovery T1 mapping.AssessmentPolygonal regions of interest were manually drawn in the liver, aorta, vena cava, and in the main, left and right portal vein on four slices before and after Gd‐DOTA administration at 5/10/15 minutes. ECV was calculated 1) on one single slice on portal bifurcation level, and 2) averaged over all four slices.Statistical TestsParameters were compared between patients with fibrosis grades F0‐2 and F3‐F4 with the Mann–Whitney U and fishers exact test. ROC analysis was used to assess the performance of the parameters to predict F3‐4 fibrosis. A P‐value <0.05 was considered statistically significant.ResultsECV was significantly higher in F3‐4 fibrosis (35.4% [33.1%–37.6%], 36.1% [34.2%–37.5%], and 37.0% [34.8%–39.2%] at 5/10/15 minutes) than in patients with F0‐2 fibrosis (33.3% [30.8%–34.8%], 33.7% [31.6%–34.7%] and 34.9% [32.2%–36.0%]; AUC = 0.72–0.75). Blood pool T1 relaxation times in the aorta and vena cava were longer on the upper vs. lower slices at 5 minutes, but not at 10/15 minutes. AUC values were similar when measured on a single slice (AUC = 0.69–0.72) or based on blood pool measurements in the cava or portal vein (AUC = 0.63–0.67 and AUC = 0.65–0.70).Data ConclusionLiver ECV is significantly higher in F3‐4 fibrosis compared to F0‐2 fibrosis with blood pool measurements performed in the aorta, inferior vena cava, and portal vein at 5, 10, and 15 minutes. However, a smaller variability was observed for blood pool measurements between slices at 15 minutes.Level of Evidence1Technical EfficacyStage 3