• Hamm, Bernd
• Haas, Matthias
• Reiter, Rolf
• Tzschätzsch, Heiko
• Asbach, Patrick
• Braun, Jürgen
• Uyanik, Meltem
• Majumdar, Shreyan
• Klatt, Dieter
• Muche, Marion
• Bayerl, Christian
• Schwahofer, Florian
• Sack, Ingolf

Abstract

<jats:title>Abstract</jats:title><jats:sec><jats:title>Objectives</jats:title><jats:p>To determine the diagnostic performance, cut-off values, and optimal drive frequency range for staging hepatic fibrosis using tomoelastography by multifrequency MR elastography of the liver and spleen.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This prospective study consecutively enrolled a total of 61 subjects between June 2014 and April 2017: 45 patients with chronic liver disease and proven stage of fibrosis and 16 healthy volunteers. Tomoelastography was performed at 1.5 T using six drive frequencies from 35 to 60 Hz. Cut-off values and AUC were calculated. Shear wave speed (in m/s) of the liver and spleen was assessed separately and in combination as a surrogate of stiffness.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>For compound multifrequency processing of the liver, cut-off and AUC values by fibrosis stage were as follows: F1, 1.52 m/s and 0.89; F2, 1.55 m/s and 0.94; F3, 1.67 m/s and 0.98; and F4, 1.72 m/s and 0.98. Diagnostic performance of the best single drive frequencies (45 Hz, 55 Hz, 60 Hz) was similar (mean AUC = 0.95, respectively). Combined analysis of the liver and spleen slightly improved performance at 60 Hz in F4 patients (mean AUC = 0.97 vs. 0.95, <jats:italic>p</jats:italic> = 0.03). Full-field-of-view elastograms displayed not only the liver and spleen but also small anatomical structures including the pancreas and major vessels.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Tomoelastography provides full-field-of-view elastograms with unprecedented detail resolution and excellent diagnostic accuracy for staging hepatic fibrosis. Our analysis of single-frequency tomoelastography suggests that scan time can be further reduced in future studies, making tomoelastography easier to implement in clinical routine.</jats:p></jats:sec><jats:sec><jats:title>Key Points</jats:title><jats:p><jats:italic>• Tomoelastography provides full-field-of-view elastograms of the abdomen with unprecedented detail resolution and excellent diagnostic accuracy for staging hepatic fibrosis.</jats:italic></jats:p><jats:p><jats:italic>• Diagnostic performance of single-frequency tomoelastography at higher frequencies (45 Hz, 55 Hz, 60 Hz) and compound multifrequency processing are equivalent for staging hepatic fibrosis.</jats:italic></jats:p><jats:p><jats:italic>• Combined assessment of hepatic and splenic stiffness slightly improves diagnostic performance for staging hepatic fibrosis.</jats:italic></jats:p></jats:sec>

Topics

• compound
• size-exclusion chromatography