The diagnostic value of normalized ADC using spleen as reference organ in assessment liver fibrosis

Abstract Background To investigate the value of liver ADC normalization using spleen as a reference organ in liver fibrosis assessment compared to Fibroscan. A total of 60 participants were included, 30 HCV positive patients and 30 in control group. We calculated mean spleen apparent diffusion coeff...

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Main Authors: Mai A. Mostafa, Omnia Kamal, Aya Yassin, Mona A. Nagi, Osama A. Ahmed, Hagar A. Ahmed
Format: Article
Language:English
Published: SpringerOpen 2020-06-01
Series:The Egyptian Journal of Radiology and Nuclear Medicine
Subjects:
Online Access:http://link.springer.com/article/10.1186/s43055-020-00212-3
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author Mai A. Mostafa
Omnia Kamal
Aya Yassin
Mona A. Nagi
Osama A. Ahmed
Hagar A. Ahmed
author_facet Mai A. Mostafa
Omnia Kamal
Aya Yassin
Mona A. Nagi
Osama A. Ahmed
Hagar A. Ahmed
author_sort Mai A. Mostafa
collection DOAJ
description Abstract Background To investigate the value of liver ADC normalization using spleen as a reference organ in liver fibrosis assessment compared to Fibroscan. A total of 60 participants were included, 30 HCV positive patients and 30 in control group. We calculated mean spleen apparent diffusion coefficient (ADC), liver mean ADC, and normalized liver ADC (defined as the ratio of liver ADC to spleen ADC) which were compared between cirrhotic patients and the control group. Data was analyzed, and ROC was used to evaluate the performance of nADC. Results No significant difference between spleen ADC values of patient and control groups or in-between different fibrosis stages. A negative correlation between liver ADC and nADC values with increasing fibrosis stages. We also found that the mean liver ADC and nADC value in patients with hepatic fibrosis were significantly lower than that of control group (1.53 × 10−3 mm2/s vs 1.65 × 10−3 mm2/s). After analysis with ROC, nADC shows higher diagnostic performance compared to liver ADC. nADC area under the curve (AUC) was 0.878 for detection of stage ≥ F2 with sensitivity and specificity of 87% and 80% respectively while ADC AUC was 0.548 with sensitivity and specificity of 62% and 72% respectively (p = 0.021); ≥ F3 AUC of nADC was 0.891 with sensitivity and specificity of 88.7% and 80% respectively while ADC AUC is 0.603 with sensitivity and specificity of 72% and 72% respectively (p = 0.023), and F4 stage nADC AUC was 0.879 for with sensitivity and specificity of 90% and 80% respectively, while ADC AUC was 0.648 with sensitivity and specificity of 80% and 72% respectively (p = 0.054). Conclusion Normalized liver ADC using the spleen as reference organs increases the diagnostic performance of MR in evaluation liver fibrosis compared to ADC alone.
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spelling doaj.art-476970b88a7f46058071e3eee9ce72ba2022-12-22T01:32:07ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622020-06-0151111010.1186/s43055-020-00212-3The diagnostic value of normalized ADC using spleen as reference organ in assessment liver fibrosisMai A. Mostafa0Omnia Kamal1Aya Yassin2Mona A. Nagi3Osama A. Ahmed4Hagar A. Ahmed5Radiology Department, Faculty of Medicine, Ain Shams UniversityRadiology Department, Faculty of Medicine, Ain Shams UniversityRadiology Department, Faculty of Medicine, Ain Shams UniversityRadiology Department, Faculty of Medicine, Ain Shams UniversityInternal Medicine Department, Faculty of Medicine, Ain Shams UniversityInternal Medicine Department, Faculty of Medicine, Ain Shams UniversityAbstract Background To investigate the value of liver ADC normalization using spleen as a reference organ in liver fibrosis assessment compared to Fibroscan. A total of 60 participants were included, 30 HCV positive patients and 30 in control group. We calculated mean spleen apparent diffusion coefficient (ADC), liver mean ADC, and normalized liver ADC (defined as the ratio of liver ADC to spleen ADC) which were compared between cirrhotic patients and the control group. Data was analyzed, and ROC was used to evaluate the performance of nADC. Results No significant difference between spleen ADC values of patient and control groups or in-between different fibrosis stages. A negative correlation between liver ADC and nADC values with increasing fibrosis stages. We also found that the mean liver ADC and nADC value in patients with hepatic fibrosis were significantly lower than that of control group (1.53 × 10−3 mm2/s vs 1.65 × 10−3 mm2/s). After analysis with ROC, nADC shows higher diagnostic performance compared to liver ADC. nADC area under the curve (AUC) was 0.878 for detection of stage ≥ F2 with sensitivity and specificity of 87% and 80% respectively while ADC AUC was 0.548 with sensitivity and specificity of 62% and 72% respectively (p = 0.021); ≥ F3 AUC of nADC was 0.891 with sensitivity and specificity of 88.7% and 80% respectively while ADC AUC is 0.603 with sensitivity and specificity of 72% and 72% respectively (p = 0.023), and F4 stage nADC AUC was 0.879 for with sensitivity and specificity of 90% and 80% respectively, while ADC AUC was 0.648 with sensitivity and specificity of 80% and 72% respectively (p = 0.054). Conclusion Normalized liver ADC using the spleen as reference organs increases the diagnostic performance of MR in evaluation liver fibrosis compared to ADC alone.http://link.springer.com/article/10.1186/s43055-020-00212-3MRI DWIHepatitis C virusLiver fibrosisLiver cirrhosisFibroscan
spellingShingle Mai A. Mostafa
Omnia Kamal
Aya Yassin
Mona A. Nagi
Osama A. Ahmed
Hagar A. Ahmed
The diagnostic value of normalized ADC using spleen as reference organ in assessment liver fibrosis
The Egyptian Journal of Radiology and Nuclear Medicine
MRI DWI
Hepatitis C virus
Liver fibrosis
Liver cirrhosis
Fibroscan
title The diagnostic value of normalized ADC using spleen as reference organ in assessment liver fibrosis
title_full The diagnostic value of normalized ADC using spleen as reference organ in assessment liver fibrosis
title_fullStr The diagnostic value of normalized ADC using spleen as reference organ in assessment liver fibrosis
title_full_unstemmed The diagnostic value of normalized ADC using spleen as reference organ in assessment liver fibrosis
title_short The diagnostic value of normalized ADC using spleen as reference organ in assessment liver fibrosis
title_sort diagnostic value of normalized adc using spleen as reference organ in assessment liver fibrosis
topic MRI DWI
Hepatitis C virus
Liver fibrosis
Liver cirrhosis
Fibroscan
url http://link.springer.com/article/10.1186/s43055-020-00212-3
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