A196 A COMPARISON OF LIVER FIBROSIS AND SIMPLE STEATOSIS ASSESSMENT USING GADOXETIC-ACID ENHANCED MRI WITH MR ELASTOGRAPHY AND MRI FAT FRACTION
Notice bibliographique
Résumé
Non-alcoholic fatty liver disease (NAFLD) has become a pandemic, affecting up to 25% of the global population, with high incidence and prevalence in North America.1 The spectrum of disease ranges from simple steatosis to steatohepatitis, with or without fibrosis (NASH). It is important to be able to diagnose patients with simple steatosis, but even more so to identify those with NASH given their increased risk of progression to cirrhosis. The gold standard for NASH diagnosis remains liver biopsy. However, given its invasive nature and recognized sampling error from heterogeneity of disease distribution, there has been an increase in the use of non-invasive techniques.2 MRI-fat fraction (MR-FF) is validated for the assessment of hepatic steatosis3 and MR elastography (MRE) for fibrosis.4 MRE requires special hardware and software not readily available. As such, a more readily available imaging modality known as gadoxetic-acid enhanced MRI (GE-MRI), has shown to potentially differentiate simple steatosis from NASH.5 To determine if GE-MRI can differentiate NAFLD from healthy controls compared to MR-FF, and/or simple steatosis from NASH compared to MRE. Healthy controls and NAFLD patients provided informed written consent to participate in this cross-sectional cohort study. The study was approved by the Research Ethics Board at Western University. The diagnosis of NAFLD was based on the AASLD definition.6 These NAFLD patients were divided into those with simple steatosis or NASH based on liver biopsy or transient elastography. All patients underwent MRI-FF, MRE, and GE-MRI. A total of 17 patients were studied. Five healthy control and 12 NAFLD patients, of whom 3 had biopsy proven NASH and 4 had fibrosis based on transient elastography, the remaining 5 had simple steatosis. GE-MRI was able to differentiate healthy patients from NAFLD patients [mean enhancement difference -35.07 ± 11.66 (p=0.0088)]. MR-FF had a statistically significant difference [0.2823 ± 0.03726 (p<0.0001)] and differentiated all patients with NAFLD. GE-MRI was not able to differentiate between hepatic steatosis and NASH, but there was a mean difference in enhancement of 18.67. MRE was able to differentiate between all patients with simple steatosis and NASH with statistical significance [mean difference -1.799 (95% CI = -3.584 to -0.01313, p=0.0482)]. This study shows the difference in enhancement on GE-MRI is much lower in patients with fatty liver and particularly those with liver fibrosis, potentially due to altered hepatocyte uptake of gadoxetic acid. Given the small patient size, specific cut-off values cannot reliably be established. The study also confirms that MR-FF is a reliable modality for the diagnosis of NAFLD, but not liver fibrosis, and that MRE is reliable for the diagnosis of NASH. None
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».