MASLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, California, USA.
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Aliment Pharmacol Ther. 2024 Aug;60(4):484-491. doi: 10.1111/apt.18118. Epub 2024 Jun 11.
Magnetic resonance elastography (MRE) and vibration-controlled transient elastography (VCTE) have the potential to assess disease progression; however, repeatability data in people with cirrhosis are lacking. We aimed to assess the effect of disease severity on measurement variability and contribute to the evidentiary basis for the qualification of repeating liver stiffness measurements (LSM) in practice and research.
This prospective study included 49 adult participants (58.3% female) with cirrhosis who underwent same-day repeat LSM examinations. The primary outcome was the same-day, same-operator repeatability coefficient% (RC%) and the within-case coefficient of variation (wCV) for each modality. Secondary outcomes include the intra-class correlation coefficient (ICC). The relationship between measurement variability (interquartile for VCTE, standard deviation for MRE) and disease severity (mean liver stiffness) was evaluated by linear regression with the coefficient of determination R reported.
Same-day repeat MRE and VCTE exams were prospectively conducted in 33 and 45 participants, respectively. The RC% appeared 82% higher for VCTE versus MRE (38% vs. 21%), with consistent findings in head-to-head analyses. The wCV for VCTE and MRE was 14% and 8% respectively, indicating VCTE has 75% higher within-subject measurement variation than MRE. ICC was excellent for LSM by VCTE (0.92) and MRE (0.96). Measurement variability increased with mean liver stiffness for VCTE (R = 0.78) and MRE (R = 0.93).
Both VCTE and MRE demonstrated increased measurement variability with disease severity. However, MRE outperformed VCTE in terms of technical repeatability in patients with cirrhosis. These repeatability estimates may improve the qualification of NITs in practice.
磁共振弹性成像（MRE）和振动控制瞬态弹性成像（VCTE）具有评估疾病进展的潜力；然而，在肝硬化患者中缺乏重复性数据。我们旨在评估疾病严重程度对测量变异性的影响，并为实践和研究中重复肝脏硬度测量（LSM）的资格提供证据基础。
这项前瞻性研究纳入了 49 名成年肝硬化患者（58.3%为女性），他们在同一天接受了重复 LSM 检查。主要结局是每种模态的同一天、同操作者重复性系数%（RC%）和个体内变异系数（wCV）。次要结局包括组内相关系数（ICC）。通过线性回归评估测量变异性（VCTE 的四分位间距，MRE 的标准差）与疾病严重程度（平均肝硬度）之间的关系，并报告决定系数 R。
分别对 33 名和 45 名参与者进行了 MRE 和 VCTE 的重复检查。VCTE 的 RC%比 MRE 高 82%（38%比 21%），且在头对头分析中结果一致。VCTE 和 MRE 的 wCV 分别为 14%和 8%，表明 VCTE 的个体内测量变异性比 MRE 高 75%。VCTE 的 ICC 为 0.92，MRE 的 ICC 为 0.96，均为优秀。VCTE（R=0.78）和 MRE（R=0.93）的测量变异性随平均肝硬度增加而增加。
VCTE 和 MRE 均表现出随疾病严重程度增加的测量变异性。然而，在肝硬化患者中，MRE 在技术重复性方面优于 VCTE。这些重复性估计可能会提高实践中 NITs 的资格。
