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Abdominal radiology (New York)
06, 2023;48 (6): 1975-1986.

Extracellular volume fraction obtained by dual-energy CT depicting the etiological differences of liver fibrosis.

Kumi Ozaki, Takashi Ohtani, Shota Ishida, Shohei Higuchi, Tomokazu Ishida, Kouki Takahashi, Yuki Matta, Hirohiko KImura, Toshifumi Gabata
Author Information
  1. Kumi Ozaki: Department of Radiology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan. ozakik-rad@umin.org. ORCID
  2. Takashi Ohtani: Radiological Center, University of Fukui Hospital, Eiheiji, Japan.
  3. Shota Ishida: Radiological Center, University of Fukui Hospital, Eiheiji, Japan.
  4. Shohei Higuchi: Department of Pathology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan.
  5. Tomokazu Ishida: Radiological Center, University of Fukui Hospital, Eiheiji, Japan.
  6. Kouki Takahashi: Radiological Center, University of Fukui Hospital, Eiheiji, Japan.
  7. Yuki Matta: Radiological Center, University of Fukui Hospital, Eiheiji, Japan.
  8. Hirohiko KImura: Department of Radiology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan.
  9. Toshifumi Gabata: Department of Radiology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan.
PMID: 36939910 DOI: 10.1007/s00261-023-03873-6

Abstract

PURPOSE: To assess etiological differences in extracellular volume fraction (ECV) and evaluate its influence on staging performance.
METHODS: A total of 166 patients with normal liver (n = 14) and chronic liver disease related to viral hepatitis (n = 71), alcohol (n = 44), and nonalcoholic steatohepatitis (NASH) (n = 37) underwent dual-energy CT (DECT) of the liver (5-min equilibrium-phase images) between January 2020 and July 2022. The iodine densities of the parenchyma and aorta were measured and ECV was calculated. Comparisons of ECV between each etiology and METAVIR fibrosis stage were statistically analyzed (p < 0.05).
RESULTS: ECV in each etiology and all patients significantly increased with higher fibrosis stage (p < 0.001) and showed a strong or moderate correlation with fibrosis stage (Spearman's ρ; all patients, 0.701; viral hepatitis, 0.638; alcoholic, 0.885; NASH, 0.791). In stages F2-F4, ECV in alcoholic liver disease was significantly larger than those for viral hepatitis and NASH (p < 0.05); however, no significant difference in stage F1 was found among the three etiologies. The cutoff values and areas under the receiver operating characteristic curve (AUC-ROCs) for discriminating fibrosis stage (≥ F1- ≥ F4) were higher for alcohol (cutoff values and AUC-ROC; 20.1% and 0.708 for ≥ F1, 23.8% and 0.990 for ≥ F2, 24.3% and 0.968 for ≥ F3, and 26.6% and 0.961 for ≥ F4, respectively) compared with those for the others.
CONCLUSION: ECV in alcoholic liver disease is higher than that in other etiologies in the advanced stages of fibrosis, and etiological differences in ECV affect the staging performance of fibrosis.

Keywords

Alcohol Extracellular volume fraction Hepatitis virus Liver fibrosis Nonalcoholic steatohepatitis

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MeSH Term

Humans
Non-alcoholic Fatty Liver Disease
Retrospective Studies
Liver Cirrhosis
Liver
Fibrosis
Liver Diseases, Alcoholic
Ethanol
Tomography, X-Ray Computed

Chemicals

Ethanol
Journal Article
Article has an altmetric score of 5

Word Cloud

Created with Highcharts 10.0.0fibrosis0ECVliverstageetiologicaldifferencesvolumefractionpatientsdiseaseviralhepatitisNASHp < 0higheralcoholicstagingperformancealcoholsteatohepatitisdual-energyCTetiology05significantlystagesetiologiescutoffvaluesExtracellularPURPOSE:assessextracellularevaluateinfluenceMETHODS:total166normaln = 14chronicrelatedn = 71n = 44nonalcoholicn = 37underwentDECT5-minequilibrium-phaseimagesJanuary2020July2022iodinedensitiesparenchymaaortameasuredcalculatedComparisonsMETAVIRstatisticallyanalyzedRESULTS:increased001showedstrongmoderatecorrelationSpearman'sρ701638885791F2-F4largerhoweversignificantdifferenceF1foundamongthreeareasreceiveroperatingcharacteristiccurveAUC-ROCsdiscriminating≥ F1- ≥ F4AUC-ROC201%708for ≥ F1238%990for ≥ F2243%968for ≥ F3266%961for ≥ F4respectivelycomparedothersCONCLUSION:advancedaffectobtaineddepictingAlcoholHepatitisvirusLiverNonalcoholic

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