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2D-MRE predicted advanced fibrosis in patients with NAFLD
In a recent study, two-dimensional magnetic resonance elastography was accurate in predicting advanced stages of liver fibrosis among patients with nonalcoholic fatty liver disease.
“This is the first prospective cohort study in NAFLD to examine the diagnostic accuracy of magnetic resonance elastography in patients who had a clinical indication for a liver biopsy with liver biopsy as the reference standard,” Rohit Loomba, MD, MHSc, of the division of gastroenterology and epidemiology, University of California at San Diego, told Healio.com/Hepatology.
Rohit Loomba
In a prospective cohort study, Loomba and colleagues analyzed data from 117 patients with NAFLD who underwent an advanced magnetic resonance exam, including a two-dimensional magnetic resonance elastography (2D-MRE) between January 2011 and November 2013. Forty-seven other patients seen in the NAFLD Translational Unit at UCSD did not undergo MRE and were excluded. However, those patients were more likely to have a milder disease and less likely to have nonalcoholic steatohepatitis and advanced disease compared with patients who underwent MRE.
Advanced fibrosis prevalence was 19% among all of the patients (n=22). The area under the receiver operating characteristic (AUROC) curve for 2D-MRE differentiating advanced fibrosis, or stage 3 and 4, from stages 0 to 2 was 0.924 (P<.0001), according to the research. A threshold >3.63 kilopascal was observed, with a sensitivity of 0.86 (95% CI, 0.65-0.97) and specificity of 0.91 (95% CI, 0.83-0.96). In addition, a positive predictive value of 0.68 and negative predictive value of 0.97 were evident. The AUROC for diagnosing NASH among the patients was 0.73 (P<.0001).
“In the future, we would be using imaging modalities such as MRE for diagnosis of advanced liver disease and move away from liver biopsies, as patients prefer noninvasive tests over invasive tests like the liver biopsy,” Loomba said.
Disclosure: One researcher reports owning stock and receiving grants from Resoundant Inc. Another researcher reports receiving grants from GE Healthcare, as well as consults, advises and is on the speakers’ bureau for Bayer.