Comparison of non-invasive assessment of liver fibrosis in patients with alpha1-antitrypsin deficiency using magnetic resonance elastography (MRE), acoustic radiation force impulse (ARFI) Quantification, and 2D-shear wave elastography (2D-SWE)

• Published in: PloS one Vol. 13; no. 4; p. e0196486
• Main Authors: Reiter, Rolf, Wetzel, Martin, Hamesch, Karim, Strnad, Pavel, Asbach, Patrick, Haas, Matthias, Siegmund, Britta, Trautwein, Christian, Hamm, Bernd, Klatt, Dieter, Braun, Jürgen, Sack, Ingolf, Tzschätzsch, Heiko
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 26.04.2018; Public Library of Science (PLoS)
• Subjects: Acoustic resonance; Acoustics; Adult; Aged; alpha 1-Antitrypsin - blood; alpha 1-Antitrypsin - genetics; alpha 1-Antitrypsin Deficiency - complications; alpha 1-Antitrypsin Deficiency - diagnosis; alpha 1-Antitrypsin Deficiency - genetics; Bioengineering; Biology and Life Sciences; Body Mass Index; Case-Control Studies; Cirrhosis; College campuses; Correlation; Elasticity Imaging Techniques - methods; Engineering schools; Female; Fibrosis; Franklin, Benjamin (1706-1790); Gastroenterology; Genotype; Hepatocellular carcinoma; Hospitals; Humans; Identification methods; Intensive care; Liver; Liver - diagnostic imaging; Liver cancer; Liver cirrhosis; Liver Cirrhosis - complications; Liver Cirrhosis - diagnostic imaging; Liver Cirrhosis - pathology; Liver diseases; Magnetic resonance; Male; Medical diagnosis; Medicine and Health Sciences; Metabolic disorders; Methods; Middle Aged; Motivation; Patients; Physical Sciences; Prospective Studies; Radiation; Research and Analysis Methods; Resonance; Rheumatology; Shear; Systematic review; Ultrasonic imaging; Chicago Illinois; Aachen Germany; United States > US; Illinois; Germany
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0196486

Although it has been known for decades that patients with alpha1-antitrypsin deficiency (AATD) have an increased risk of cirrhosis and hepatocellular carcinoma, limited data exist on non-invasive imaging-based methods for assessing liver fibrosis such as magnetic resonance elastography (MRE) and acoustic radiation force impulse (ARFI) quantification, and no data exist on 2D-shear wave elastography (2D-SWE). Therefore, the purpose of this study is to evaluate and compare the applicability of different elastography methods for the assessment of AATD-related liver fibrosis. Fifteen clinically asymptomatic AATD patients (11 homozygous PiZZ, 4 heterozygous PiMZ) and 16 matched healthy volunteers were examined using MRE and ARFI quantification. Additionally, patients were examined with 2D-SWE. A high correlation is evident for the shear wave speed (SWS) determined with different elastography methods in AATD patients: 2D-SWE/MRE, ARFI quantification/2D-SWE, and ARFI quantification/MRE (R = 0.8587, 0.7425, and 0.6914, respectively; P≤0.0089). Four AATD patients with pathologically increased SWS were consistently identified with all three methods-MRE, ARFI quantification, and 2D-SWE. The high correlation and consistent identification of patients with pathologically increased SWS using MRE, ARFI quantification, and 2D-SWE suggest that elastography has the potential to become a suitable imaging tool for the assessment of AATD-related liver fibrosis. These promising results provide motivation for further investigation of non-invasive assessment of AATD-related liver fibrosis using elastography.