Liver stiffness via magnetic resonance/transient elastography predicts fibrosis in PBC
07 May 2021
This is a liver section that shows liver fibrosis revealed by staining of collagen accumulation in a mouse with human-like NASH. Credit: UC San Diego Health.Liver stiffness (LS) measured by either transient (TE) or magnetic resonance elastography (MRE) is associated with advanced fibrosis and can independently predict outcomes in patients with primary biliary cholangitis (PBC), suggests a study.
The investigators described the diagnostic and prognostic performance of TE and MRE in 538 consecutive PBC patients at three centres with LS measurements by TE (n=286) or MRE (n=332). They determined LS cutoffs for predicting fibrosis stages among those with a liver biopsy (TE: n=63; MRE: n=98) using receiver operating characteristic curves.
Associations between covariates and hepatic decompensation were identified using Cox proportional hazard regression modeling.
The optimal LS thresholds for predicting histologic stage F4 were 14.40 kPa (area under the curve [AUC], 0.94) and 4.60 kPa (AUC, 0.82) for TE and MRE, respectively. Both TE and MRE were better than biochemical markers in predicting histologic advanced fibrosis.
For predicting hepatic decompensation, the optimal LS thresholds were 10.20 and 4.30 kPa on TE and MRE, respectively. LS by TE and MRE remained predictors of hepatic decompensation after adjustment for ursodeoxycholic acid responsiveness (TE: hazard ratio [HR], 1.14, 95 percent confidence interval [CI], 1.05–1.24; MRE: HR, 1.68, 95 percent CI, 1.28–2.19) and the GLOBE score (TE: HR, 1.13, 95 percent CI, 1.07–1.19; MRE: HR, 2.09, 95 percent CI, 1.57–2.78).
“LS measurement with either TE or MRE can accurately detect advanced fibrosis and offers additional prognostic value beyond existing serologic predictive tools,” the investigators noted.