Comparison of the diagnostic accuracies of magnetic resonance elastography and transient elastography for hepatic fibrosis

Objectives: To compare the diagnostic accuracies of magnetic resonance elastography (MRE) and transient elastography (TE) for hepatic fibrosis. Materials and Methods: This retrospective study was approved by the institutional review board and included 113 patients (mean age, 63.1 +/- 12.2 years; 84 men and 29 women) with chronic liver disease who underwent liver biopsy or resection, histopathologic assessment (METAVIR scoring system), and TE within 6 months of MRE. Diagnostic accuracies of MRE and TE were compared using receiver operating characteristic curve analysis. Appropriate cutoff values of the two methods determined by maximum positive and minimum negative likelihood ratios were used to calculate the positive and negative predictive values for discriminating significant fibrosis (>= F2) from F0-F1 or cirrhosis (F4) from F0-F3. Results: Mean (95% confidence interval) area under the receiver operating characteristic curve values of MRE for cirrhosis (F4) (0.97 [0.93-0.99] vs. 0.93 [0.87-0.96]; P = 0.0308), clinically significant fibrosis (>= F2) (0.98 [0.94-0.99] vs. 0.87 [0.79-0.92]; P = 0.0003), and any fibrosis (>= F1) (0.97 [0.92-0.99] vs. 0.87 [0.76-0.93]; P = 0.0126) were significantly higher than those of TE. By using the cutoff values derived from the maximum positive likelihood ratio, the positive and negative predictive values for >= F2 were 98.8% and 83.9%, respectively, by MRE and 98.2% and 44.8%, respectively, by TE; and for F4, 97.0% and 86.3%, respectively, by MRE and 95.8% and 77.5%, respectively, by TE. Conclusion: MRE has better diagnostic accuracy than TE for staging hepatic fibrosis. (C) 2014 Elsevier Inc. All rights reserved.