Copyright
©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
Fibrosis in nonalcoholic fatty liver disease: Noninvasive assessment using computed tomography volumetry
Nobuhiro Fujita, Akihiro Nishie, Yoshiki Asayama, Kousei Ishigami, Yasuhiro Ushijima, Yukihisa Takayama, Daisuke Okamoto, Ken Shirabe, Tomoharu Yoshizumi, Kazuhiro Kotoh, Norihiro Furusyo, Tomoyuki Hida, Yoshinao Oda, Taisuke Fujioka, Hiroshi Honda
Nobuhiro Fujita, Akihiro Nishie, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Hiroshi Honda, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
Yoshiki Asayama, Department of Advanced Imaging and Interventional Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
Yukihisa Takayama, Department of Radiology Informatics and Network, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
Ken Shirabe, Tomoharu Yoshizumi, Department of Surgery and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
Kazuhiro Kotoh, Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
Norihiro Furusyo, Department of General Internal Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
Tomoyuki Hida, Yoshinao Oda, Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
Taisuke Fujioka, CT Application, Philips Electronics Japan Medical Systems, Minato-ku, Tokyo 108-8507, Japan
Author contributions: Fujita N and Nishie A designed and performed the research and wrote the paper; Asayama Y, Ishigami K, Ushijima Y, Takayama Y, Okamoto D, Shirabe K, Yoshizumi T, Kotoh K and Furusyo N provided clinical advice; Hida T and Oda Y provided pathological advice; Fujioka T provided technical advice; Honda H supervised the report.
Supported by a Grant-in-in-Aid for Scientific Research (C) (No. 26461796) from the Japanese Ministry of Education, Culture, Sports, Science, and Technology.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Kyushu University.
Informed consent statement: The requirements for informed consent were waived due to the retrospective design. The details of the study are published on the home page of Kyushu University.
Conflict-of-interest statement: One author (Fujioka T) is an employee of Philips Electronics Japan.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Akihiro Nishie, MD, PhD, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
anishie@radiol.med.kyushu-u.ac.jp
Telephone: +81-92-6425695 Fax: +81-92-6425708
Received: June 24, 2016
Peer-review started: June 28, 2016
First decision: August 22, 2016
Revised: September 2, 2016
Accepted: September 28, 2016
Article in press: September 28, 2016
Published online: October 28, 2016
Processing time: 124 Days and 2.7 Hours
AIM
To evaluate the diagnostic performance of computed tomography (CT) volumetry for discriminating the fibrosis stage in patients with nonalcoholic fatty liver disease (NAFLD).
METHODS
A total of 38 NAFLD patients were enrolled. On the basis of CT imaging, the volumes of total, left lateral segment (LLS), left medial segment, caudate lobe, and right lobe (RL) of the liver were calculated with a dedicated liver application. The relationship between the volume percentage of each area and fibrosis stage was analyzed using Spearman’s rank correlation coefficient. A receiver operating characteristic (ROC) curve analysis was performed to determine the accuracy of CT volumetry for discriminating fibrosis stage.
RESULTS
The volume percentages of the caudate lobe and the LLS significantly increased with the fibrosis stage (r = 0.815, P < 0.001; and r = 0.465, P = 0.003, respectively). Contrarily, the volume percentage of the RL significantly decreased with fibrosis stage (r = -0.563, P < 0.001). The volume percentage of the caudate lobe had the best diagnostic accuracy for staging fibrosis, and the area under the ROC curve values for discriminating fibrosis stage were as follows: ≥ F1, 0.896; ≥ F2, 0.929; ≥ F3, 0.955; and ≥ F4, 0.923. The best cut-off for advanced fibrosis (F3-F4) was 4.789%, 85.7% sensitivity and 94.1% specificity.
CONCLUSION
The volume percentage of the caudate lobe calculated by CT volumetry is a useful diagnostic parameter for staging fibrosis in NAFLD patients.
Core tip: This is a retrospective study to elucidate the morphological change in nonalcoholic fatty liver disease (NAFLD) using computed tomography (CT) volumetry and to evaluate the diagnostic performance of CT volumetry for discriminating the fibrosis stage in NAFLD. The volume percentages of the caudate lobe calculated by CT volumetry were significantly increased with the increase in fibrosis stage in NAFLD. The volume percentage of the caudate lobe is a useful diagnostic parameter for staging fibrosis in patients with NAFLD. The evaluation of liver volume using CT volumetry is useful for predicting the fibrosis stage in NAFLD.
