A study of T sub(1) relaxation time as a measure of liver fibrosis and the influence of confounding histological factors

• Published in: NMR in biomedicine 2015-06, Vol.28 (6), p.706-714
• Main Authors: Hoad, Caroline L, Palaniyappan, Naaventhan, Kaye, Philip, Chernova, Yulia, James, Martin W, Costigan, Carolyn, Austin, Andrew, Marciani, Luca, Gowland, Penny A, Guha, Indra N, Francis, Susan T, Aithal, Guruprasad P
• Format: Article
• Language: English
• ISSN: 0952-3480; 1099-1492
• DOI: 10.1002/nbm.3299

Liver biopsy is the standard test for the assessment of fibrosis in liver tissue of patients with chronic liver disease. Recent studies have used a non-invasive measure of T sub(1) relaxation time to estimate the degree of fibrosis in a single slice of the liver. Here, we extend this work to measure T sub(1) of the whole liver and investigate the effects of additional histological factors such as steatosis, inflammation and iron accumulation on the relationship between liver T sub(1) and fibrosis. We prospectively enrolled patients who had previously undergone liver biopsy to have MR scans. A non-breath-holding, fast scanning protocol was used to acquire MR relaxation time data (T sub(1) and T sub(2)*), and blood serum was used to determine the enhanced liver fibrosis (ELF) score. Areas under the receiver operator curves (AUROCs) for T sub(1) to detect advanced fibrosis and cirrhosis were derived in a training cohort and then validated in a second cohort. Combining the cohorts, the influence of various histology factors on liver T sub(1) relaxation time was investigated. The AUROCs (95% confidence interval (CI)) for detecting advanced fibrosis (F greater than or equal to 3) and cirrhosis (F=4) for the training cohort were 0.81 (0.65-0.96) and 0.92 (0.81-1.0) respectively (p