Imaging biomarkers for steatohepatitis and fibrosis detection in non-alcoholic fatty liver disease

Rocío Gallego-Durán, Pablo Cerro-Salido, Emilio Gomez-Gonzalez, María Jesús Pareja, Javier Ampuero, María Carmen Rico, Rafael Aznar, Eduardo Vilar-Gomez, Elisabetta Bugianesi, Javier Crespo, Francisco José González-Sánchez, Reyes Aparcero, Inmaculada Moreno, Susana Soto, María Teresa Arias-Loste, Javier Abad, Isidora Ranchal, Raúl Jesús Andrade, Jose Luis Calleja, Miguel Pastrana, Oreste Lo Iacono, Manuel Romero-Gómez, Rocío Gallego-Durán, Pablo Cerro-Salido, Emilio Gomez-Gonzalez, María Jesús Pareja, Javier Ampuero, María Carmen Rico, Rafael Aznar, Eduardo Vilar-Gomez, Elisabetta Bugianesi, Javier Crespo, Francisco José González-Sánchez, Reyes Aparcero, Inmaculada Moreno, Susana Soto, María Teresa Arias-Loste, Javier Abad, Isidora Ranchal, Raúl Jesús Andrade, Jose Luis Calleja, Miguel Pastrana, Oreste Lo Iacono, Manuel Romero-Gómez

Abstract

There is a need, in NAFLD management, to develop non-invasive methods to detect steatohepatitis (NASH) and to predict advanced fibrosis stages. We evaluated a tool based on optical analysis of liver magnetic resonance images (MRI) as biomarkers for NASH and fibrosis detection by investigating patients with biopsy-proven NAFLD who underwent magnetic resonance (MR) protocols using 1.5T General Electric (GE) or Philips devices. Two imaging biomarkers (NASHMRI and FibroMRI) were developed, standardised and validated using area under the receiver operating characteristic curve (AUROC) analysis. The results indicated NASHMRI diagnostic accuracy for steatohepatitis detection was 0.83 (95% CI: 0.73-0.93) and FibroMRI diagnostic accuracy for significant fibrosis determination was 0.85 (95% CI: 0.77-0.94). These findings were independent of the MR system used. We conclude that optical analysis of MRI has high potential to define non-invasive imaging biomarkers for the detection of steatohepatitis (NASHMRI) and the prediction of significant fibrosis (FibroMRI) in NAFLD patients.

Figures

Figure 1. Analysis of diagnostic accuracy for…
Figure 1. Analysis of diagnostic accuracy for NASH detection comparing NASHMRI and CK-18 (AUROC: 0.86; 95% CI: 0.76–0.96 vs. AUROC: 0.44; 95% CI: 0.29–0.60, respectively; p < 0.0001).
Figure 2. Analysis of diagnostic accuracy for…
Figure 2. Analysis of diagnostic accuracy for significant fibrosis (≥F2) comparing FibroMRI, Sydney Index and NAFLD Fibrosis Score (AUROC: 0.85; 95% CI: 0.74–0.97 vs. AUROC: 0.69; 95% CI: 0.50–0.87 vs. AUROC: 0.76; 95% CI: 0.61–0.91, respectively; p < 0.001).
Figure 3. Analysis of diagnostic accuracy for…
Figure 3. Analysis of diagnostic accuracy for significant fibrosis (≥F2) detection comparing Fibro-MRI and valid transient elastography measurements (AUROC: 0.95; 95% CI: 0.88–1.00 vs. AUROC: 0.91; 95% CI: 0.81–1.00, respectively; p = ns).

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