DWI - histology: a possible means of determining degree of liver fibrosis?

// Niklas Verloh 1 , Kirsten Utpatel 2 , Michael Haimerl 1 , Florian Zeman 3 , Claudia Fellner 1 , Marc Dahlke 4 , Philipp Renner 4 , Timo Seyfried 5 , Martina Muller 6 , Christian Stroszczynski 1 , Matthias Evert 2 and Philipp Wiggermann 1 1 Department of Radiology, University Hospital Regensburg, Regensburg, Germany 2 Department of Pathology, University Regensburg, Regensburg, Germany 3 Center for Clinical Trials, University Hospital Regensburg, Regensburg, Germany 4 Department of Surgery, University Hospital Regensburg, Regensburg, Germany 5 Department of Anaesthesia, University Hospital Regensburg, Regensburg, Germany 6 Department of Gastroenterology, University Hospital Regensburg, Regensburg, Germany Correspondence to: Niklas Verloh, email: niklas.verloh@ukr.de Keywords: magnetic resonance imaging; liver; abdomen; fibrosis; histology Received: November 17, 2017      Accepted: March 12, 2018      Published: April 13, 2018 ABSTRACT Objectives: The aim of this study was to determine the diagnostic value of diffusion-weighted MRI of the liver at 3T to classify liver fibrosis/cirrhosis. Methods: 62 patients who underwent both histopathological examination and diffusion-weighted imaging of the liver via 3T MRI within a period of 3 months were included in the study. The Ishak score (1-6) was used to determine the degree of fibrosis: No liver fibrosis (NLF; Ishak 0, n = 16), mild liver fibrosis (MLF; Ishak 1-2, n = 23), advanced liver fibrosis (ALF; Ishak 3-5, n = 12), and liver cirrhosis (LC; Ishak 6, n = 11). Results: The corresponding ADC values for the individual patient groups were as follows: NLF: 1123 (SD 95.8); MLF: 1032 (SD 77.6); ALF: 962 (SD 68.8); LC: 1015 (SD 60.2) mm2/s. There is a significant difference between NLF and MLF (p = 0.004) and between MLF and ALF (p = 0.022). A significant difference between patients with ALF and LC (p = 0.117) could not be found. Conclusion: Liver fibrosis/cirrhosis lowers the ADC values of the liver parenchyma in 3T MRI. However, the degree of fibrosis can only be conditionally determined on the basis of ADC values.