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Current Medical Imaging


ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

Comparison of Liver Fibrosis and Function Indices with Extracellular Volume Using Dual-energy CT: A Retrospective Study

Author(s): Reiji Kokubo*, Kazuhiro Saito, Takafumi Yamada, Taro Tanaka, Yu Tajima and Kunihito Suzuki

Volume 18, Issue 11, 2022

Published on: 23 May, 2022

Article ID: e070422203236 Pages: 6

DOI: 10.2174/1573405618666220407100237

Price: $65


Background: Dual-Energy Computed Tomography (DECT) enables the direct measurement of iodine accumulation in the extracellular space.

Objective: To compare measures of liver fibrosis and function with Extracellular Volume (ECV) from iodine/water images using DECT.

Methods: Data was obtained from 119 consecutive patients who underwent abdominal DECT. A region of interest was set in the right lobe of the liver, pancreas, spleen, and aorta on iodine density images. ECV was calculated using the following formula: ECV = (1 − hematocrit) × [iodine concentration in the liver (or pancreas, spleen) / iodine concentration in the aorta]. The severity of liver fibrosis was estimated using the aminotransferase/platelet ratio index (APRI) and the Fibrosis-4 (FIB-4) index. Liver function was assessed by the Child-Pugh classification and albumin-bilirubin (ALBI) grade. Data were analyzed by the Spearman rank correlation coefficient, one-way analysis of variance, and post hoc analysis.

Results: The correlation between ECV and fibrosis indices (APRI and FIB-4) was only significant, with a weak magnitude for liver ECV quantification at the equilibrium phase (r=0.25 and r=0.20, respectively). The correlations between liver function index and ECV quantification were more robust than with fibrosis index. The highest correlations (r=0.50) were found between ALBI grade and liver ECV at the equilibrium phase. Liver ECV values at the equilibrium phase had a significant difference between ALBI grade 1 vs. 2 and grade 1 vs. 3.

Conclusion: Liver ECV quantification by DECT is more suitable for evaluating liver function than liver fibrosis severity.

Keywords: Dual-energy CT, extracellular volume fraction, liver fibrosis, liver functional reserve, aminotransferase/platelet ratio index (APRI), Fibrosis-4 (FIB-4) index, Child-Pugh classification, albumin bilirubin (ALBI) grade.

Graphical Abstract
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