Combining hepatic surface nodularity and serum tests better predicts hepatic fibrosis stages in chronic liver disease

Purpose Hepatic surface nodularity quantified on CT images has shown promising results in staging hepatic fibrosis in chronic hepatitis C. The aim of this study was to evaluate hepatic surface nodularity, serum fibrosis indices, and a linear combination of them for staging fibrosis in chronic liver...

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Published in:Abdominal imaging 2021-09, Vol.46 (9), p.4189-4199
Main Authors: Cho, Hyo Jung, Choi, Jaewon, Kim, Bohyun, Ko, JeongGil, Choi, Joon-Il, Huh, Jimi, Lee, Jei Hee, Kim, Jai Keun
Format: Article
Language:English
Subjects:
Aspartate aminotransferase
Cirrhosis
Computed tomography
Fibrosis
Gastroenterology
Hepatitis
Hepatitis B
Hepatitis C
Hepatobiliary
Hepatology
Imaging
Liver
Liver cirrhosis
Liver diseases
Medical imaging
Medicine
Medicine & Public Health
Platelets
Radiology
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Summary:Purpose Hepatic surface nodularity quantified on CT images has shown promising results in staging hepatic fibrosis in chronic hepatitis C. The aim of this study was to evaluate hepatic surface nodularity, serum fibrosis indices, and a linear combination of them for staging fibrosis in chronic liver disease, mainly chronic hepatitis B. Methods We developed a semiautomated software quantifying hepatic surface nodularity on CT images. Hepatic surface nodularity and serum fibrosis indices were assessed in the development group of 125 patients to generate 3 linear models combining hepatic surface nodularity with the aspartate aminotransferase to platelet ratio index, fibrosis-4 index, or platelet count in reference to the METAVIR scoring system. The models were validated in 183 patients. Results Hepatic surface nodularity and serum fibrosis indices all significantly correlated with fibrosis stages. For binary classifications into cirrhosis (F4), advanced fibrosis (≥ F3), and significant fibrosis (≥ F2), hepatic surface nodularity was significantly different across categories. The areas under the curve (AUCs) of the best model were 0.901, 0.872, and 0.794 for cirrhosis, advanced fibrosis, and significant fibrosis, respectively, higher than serum fibrosis indices alone (0.797–0.802, 0.799–0.818, and 0.761–0.773). In the validation group, the same model likewise showed higher AUCs (0.872, 0.831, and 0.850) compared to serum fibrosis indices (0.722–0.776, 0.692–0.768, and 0.695–0.769; p  
ISSN:2366-004X
2366-0058
DOI:10.1007/s00261-021-03113-9