Diagnostic value of MR-based texture analysis for the assessment of hepatic fibrosis in patients with nonalcoholic fatty liver disease (NAFLD).

Abstract

To investigate the performance of MR-based texture analysis (TA) for the assessment of hepatic fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). Fifty-four adult patients (33 females, 21 males, mean age 49.8 ± 13.5years) with biopsy-proven NAFLD were enrolled and underwent MR imaging on a 1.5 T system. TA parameters were extracted on axial noncontrast 3D-GRE T1W images (slice thickness = 4.6mm) using a commercially available research software (TexRAD). Receiver operating curves (ROC), areas under the ROC (AUROC) and 95% confidence intervals (CI) were calculated to assess the accuracy of each TA parameter for the diagnosis of significant (F ≥ 2) and advanced fibrosis (F ≥ 3). The correlation between TA and histopathological features of nonalcoholic steatohepatitis (NASH) was tested calculating the Spearman's rank correlation coefficient (ρ). Thirty-seven (68%) subjects had significant fibrosis and 20 (37%) had advanced fibrosis. The TA parameters with the best performance were standard deviation (SD) and entropy, respectively, with AUROC 0.755 (95% CI 0.619-0.862, p ≤ 0.0002) and 0.769 (95% CI 0.634-0.873, p < 0.0001) for significant fibrosis and AUROC 0.746 (95% CI 0.609-0.854, p ≤ 0.0004) and 0.754 (95% CI 0.618-0.861, p ≤ 0.0002) for advanced fibrosis. SD and entropy demonstrated a moderate correlation with the degree of fibrosis (ρ = 0.457 and 0.480; p < 0.01). No significant correlation was found between TA parameters and other histopathological features of NASH. Entropy and SD extracted on T1-weighted MR images have fair accuracy for the diagnosis of significant and advanced hepatic fibrosis in patients with NAFLD.