Imaging Diagnosis of Liver Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 3156

Special Issue Editor


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Guest Editor
Department of Radiology, Medical Imaging Center, Faculty of Medicine, Semmelweis University, Korányi S. u. 2., 1083 Budapest, Hungary
Interests: medical imaging; diagnostic radiology; abdominal imaging; oncoradiology image analysis; radiomics; artificial intelligence elastography; MR relaxometry; multiparametric MR imaging

Special Issue Information

Dear Colleagues,

Chronic liver diseases, including hepatic steatosis and fibrosis, are a major global health concern as they affect around 1.5 billion people worldwide. Imaging studies are increasingly important in the diagnosis, classification, and follow-up of CLD. With the introduction of new imaging biomarkers into clinical practice, the objective and highly reproducible non-invasive diagnosis of CLD has become a reality. Currently, research is in progress to develop new non-invasive methods not only to quantitate pathological changes in the composition of the liver parenchyma but also to identify the causative agents and determine the activity of the underlying CLD.

One of the most rapidly developing techniques in the field is quantitative ultrasound (QUS), which has shown great promise in initial studies as a rapid, accessible, cost-effective tool for screening and follow-up CLD. Meanwhile, sophisticated imaging techniques are becoming increasingly available in cross-sectional modalities such as multiparametric MRI or spectral CT to provide highly accurate measurements of tissue composition or perfusion of the liver parenchyma. Artificial intelligence is also rapidly gaining importance for the automated evaluation of diffuse liver diseases in imaging studies.

Considering the multitude of etiologies, disease processes, and clinical management options associated with CLD, finding the best-fit imaging protocols for the different patient populations necessitates a large volume of research and excites significant interest from clinicians. The aim of this Special Issue is to reveal various aspects of research conducted in the field and to propose new imaging-based solutions for the diagnosis of CLD.

Dr. Pál Kaposi
Guest Editor

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Keywords

  • chronic liver diseases
  • hepatic steatosis
  • fibrosis
  • quantitative ultrasound
  • multiparametric MRI
  • spectral CT

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Published Papers (3 papers)

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Research

11 pages, 1659 KiB  
Article
Redox Homeostasis and Non-Invasive Assessment of Significant Liver Fibrosis by Shear Wave Elastography
by Anna Egresi, Anna Blázovics, Gabriella Lengyel, Adrienn Gréta Tóth, Barbara Csongrády, Zsuzsanna Jakab and Krisztina Hagymási
Diagnostics 2024, 14(17), 1945; https://doi.org/10.3390/diagnostics14171945 - 3 Sep 2024
Viewed by 680
Abstract
Hepatic fibrosis with various origins can be estimated non-invasively by using certain biomarkers and imaging-based measurements. The aim of our study was to examine redox homeostasis biomarkers and liver stiffness measurements for the assessment of significant liver fibrosis in different etiologies of chronic [...] Read more.
Hepatic fibrosis with various origins can be estimated non-invasively by using certain biomarkers and imaging-based measurements. The aim of our study was to examine redox homeostasis biomarkers and liver stiffness measurements for the assessment of significant liver fibrosis in different etiologies of chronic liver diseases. A cohort study consisting of 88 chronic liver disease patients of both sexes (age 49.1 ± 14.7 years) was performed. Cytokine profiles as well as redox homeostasis characteristics were determined. Liver fibrosis stages were assessed with shear wave elastography. The plasma levels of four cytokines showed no significant alteration between the four fibrotic stages; however, higher values were measured in the F2–4 stages. Free sulfhydryl group concentration, the marker of redox homeostasis, was lower in significant fibrosis (F0–F1: 0.36 ± 0.06 vs. F2–4: 0.29 ± 0.08 mmol/L, p < 0.05). Higher chemiluminescence values, as free radical–antioxidant parameters, were detected in advanced fibrosis stages in erythrocytes (F0–F1: 36.00 ± 37.13 vs. F2–4: 51.47 ± 44.34 RLU%). These data suggest that oxidative stress markers can predict significant fibrosis, with the aim of reducing the number of protocol liver biopsies in patients unlikely to have significant disease; however, their role in distinguishing between the certain fibrosis groups needs further studies. Full article
(This article belongs to the Special Issue Imaging Diagnosis of Liver Diseases)
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15 pages, 4777 KiB  
Article
Comparison of Vendor-Independent Software Tools for Liver Proton Density Fat Fraction Estimation at 1.5 T
by Zita Zsombor, Boglárka Zsély, Aladár D. Rónaszéki, Róbert Stollmayer, Bettina K. Budai, Lőrinc Palotás, Viktor Bérczi, Ildikó Kalina, Pál Maurovich Horvat and Pál Novák Kaposi
Diagnostics 2024, 14(11), 1138; https://doi.org/10.3390/diagnostics14111138 - 30 May 2024
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Abstract
(1) Background: Open-source software tools are available to estimate proton density fat fraction (PDFF). (2) Methods: We compared four algorithms: complex-based with graph cut (GC), magnitude-based (MAG), magnitude-only estimation with Rician noise modeling (MAG-R), and multi-scale quadratic pseudo-Boolean optimization with graph cut (QPBO). [...] Read more.
(1) Background: Open-source software tools are available to estimate proton density fat fraction (PDFF). (2) Methods: We compared four algorithms: complex-based with graph cut (GC), magnitude-based (MAG), magnitude-only estimation with Rician noise modeling (MAG-R), and multi-scale quadratic pseudo-Boolean optimization with graph cut (QPBO). The accuracy and reliability of the methods were evaluated in phantoms with known fat/water ratios and a patient cohort with various grades (S0–S3) of steatosis. Image acquisitions were performed at 1.5 Tesla (T). (3) Results: The PDFF estimates showed a nearly perfect correlation (Pearson r = 0.999, p < 0.001) and inter-rater agreement (ICC = from 0.995 to 0.999, p < 0.001) with true fat fractions. The absolute bias was low with all methods (0.001–1%), and an ANCOVA detected no significant difference between the algorithms in vitro. The agreement across the methods was very good in the patient cohort (ICC = 0.891, p < 0.001). However, MAG estimates (−2.30% ± 6.11%, p = 0.005) were lower than MAG-R. The field inhomogeneity artifacts were most frequent in MAG-R (70%) and GC (39%) and absent in QPBO images. (4) Conclusions: The tested algorithms all accurately estimate PDFF in vitro. Meanwhile, QPBO is the least affected by field inhomogeneity artifacts in vivo. Full article
(This article belongs to the Special Issue Imaging Diagnosis of Liver Diseases)
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12 pages, 1605 KiB  
Article
Assessing the Utility of Acoustic Radiation Force Impulse in the Evaluation of Non-Alcoholic Fatty Liver Disease with Severe Obesity or Steatosis
by Yeo Wool Kang, Yang Hyun Baek, Jong Hoon Lee, Young Hoon Roh, Hee Jin Kwon, Sang Yi Moon, Min Kook Son and Jin Sook Jeong
Diagnostics 2024, 14(11), 1083; https://doi.org/10.3390/diagnostics14111083 - 22 May 2024
Cited by 1 | Viewed by 1244
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) encompasses a heterogeneous spectrum ranging from simple steatosis to fibrosis and cirrhosis. Fibrosis, associated with long-term overall mortality and liver-related events, requires evaluation. Traditionally, liver biopsy has been the gold standard for diagnosing fibrosis. However, its invasive [...] Read more.
Background: Non-alcoholic fatty liver disease (NAFLD) encompasses a heterogeneous spectrum ranging from simple steatosis to fibrosis and cirrhosis. Fibrosis, associated with long-term overall mortality and liver-related events, requires evaluation. Traditionally, liver biopsy has been the gold standard for diagnosing fibrosis. However, its invasive nature, potential complications, and sampling variability limit widespread use. Consequently, various non-invasive tests have been developed as alternatives for diagnosing fibrosis in NAFLD patients. Aim: This study aimed to compare the accuracy of non-invasive tests (NITs) and evaluate the diagnostic accuracy of acoustic radiation force impulse (ARFI), one of the point shear wave techniques, compared to conventional methods, assessing its effective role in diagnosis. Methods: This is a retrospective study; a total of 136 patients diagnosed with fatty liver disease through ultrasonography were enrolled. The anthropometric data of the patients were collected on the day of admission and blood tests, measurements of ARFI, and a point shear test were conducted using abdominal ultrasound; a biopsy was performed the following day. In addition, we calculated the aspartate aminotransferase-to-platelet ratio index (APRI) index based on four factors (FIB-4) and the NAFLD fibrosis score (NFS). Subsequently, we assessed the diagnostic accuracy of NITs within various subgroups based on the extent of obesity, steatosis, or NAFLD activity score. Results: ARFI has been shown to have the highest diagnostic value among various NITs, with AUROC values of 0.832, 0.794, 0.767, and 0.696 for ARFI, APRI, FIB-4, and NFS, respectively. In the morbidly obese subgroup, the AUROC values of ARFI, APRI, FIB-4, and NFS were 0.805, 0.769, 0.736, and 0.674. In the group with severe steatosis or non-alcoholic steatohepatitis (NASH), the AUROC values were 0.679, 0.596, 0.661, and 0.612, respectively, for severe steatosis and 0.789, 0.696, 0.751, and 0.691, respectively, for NASH. Conclusions: In conclusion, ARFI is not affected by various factors and maintains diagnostic accuracy compared to serum NITs. Therefore, we can recommend ARFI as a valuable diagnostic test to screen for advanced fibrosis in patients with NAFLD. Full article
(This article belongs to the Special Issue Imaging Diagnosis of Liver Diseases)
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