Staging Chronic Hepatitis B Related Liver Fibrosis with a Fractional Order Calculus Diffusion Model

• Published in: Academic radiology Vol. 29; no. 7; p. 951
• Main Authors: Sheng, Ruofan, Zhang, Yunfei, Sun, Wei, Ji, Yuan, Zeng, Mengsu, Yao, Xiuzhong, Dai, Yongming
• Format: Journal Article
• Language: English
• Published: United States 01.07.2022
• Subjects: Calculi - complications; Diffusion Magnetic Resonance Imaging - methods; Hepatitis B, Chronic - complications; Hepatitis B, Chronic - diagnostic imaging; Humans; Liver - diagnostic imaging; Liver Cirrhosis - complications; Liver Cirrhosis - diagnostic imaging; Prospective Studies; Diffusion-weighted imaging; Fractional order calculus; Liver fibrosis; Magnetic resonance imaging
• ISSN: 1878-4046
• DOI: 10.1016/j.acra.2021.07.005

Accurately staging liver fibrosis is of great clinical significance. We aimed to evaluate the clinical potential of the non-Gaussian fractional order calculus (FROC) diffusion model in staging liver fibrosis. A total of 82 patients with chronic hepatitis B (CHB) were included in this prospective study. Diffusion weighted imaging (DWI)-derived parameters including the diffusion coefficient (D), fractional order parameter (β) and microstructural quantity (μ) sourced from FROC-DWI, and apparent diffusion coefficient (ADC) derived from mono-exponential DWI, as well as the aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 (FIB-4) were calculated. Their correlations with fibrosis stages and the diagnostic efficacy in predicting liver fibrosis were assessed and compared. D (r = -0.667), β (r = -0.671), μ (r = -0.481), and ADC (r = -0.665) displayed significant correlations with fibrosis stages (p < 0.001). D, β and ADC (p < 0.01) were independently associated with fibrosis; and compared to inflammatory activity, fibrosis was the independent factor significantly correlated with D, β and ADC (p < 0.001). There were no significant differences between the area under curves of D, β, μ or their combinations and ADC for predicting different fibrosis stages (p > 0.05). The diagnostic performance of the combined index with four diffusion metrics was better than D, β, μ or ADC used alone (p < 0.05) as well as APRI or FIB-4 (p < 0.01) in fibrosis staging. FROC-DWI was valuable in staging liver fibrosis in patients with CHB, but there were no significant differences between the FROC-DWI parameters and the classical ADC. However, the combined DWI-derived index including D, β, μ and ADC offered the best diagnostic efficacy and may serve as a reliable tool for fibrosis evaluation, superior to APRI and FIB-4.