Quantitative multiparametric magnetic resonance imaging can aid non-alcoholic steatohepatitis diagnosis in a Japanese cohort

Table 1 Participant demographics

	Total (n = 145), mean ± SD (% of cohort)	NASH	NAFL
Total cohort (n)	145	87	58
Sex (male)	88 (60.7%)	46	42a
Age	60.2 ± 13.1	60.9 ± 13.2	59 ± 12.9
BMI average	28.8 ± 4.7	29.9 ± 4.4	27.1 ± 4.8c
Normal BMI (≥ 18.5 ≤ 22.9)	21.4 ± 1.6 (n = 17)	n = 6	n = 12
Overweight (≥ 23.0 ≤ 27.9)	25.6 ± 1.1 (n = 43)	n = 26	n = 26
Obese (≥ 27.5)	32.1 ± 3.2 (n = 82)	n = 55	n = 20
Blood serum tests
AST (IU/L)	47.8 ± 27.5	56.4 ± 29.8	34.8 ± 17.1c
ALT (IU/L)	59.8 ± 49.3	71.3 ± 51.5	42.6 ± 41.4c
GGT	85.9 ± 78.4	97.8 ± 85.8	69.3 ± 62.9b
Total bilirubin (mg/dL)	0.86 ± 0.4	0.8 ± 0.3	0.9 ± 0.4
Platelets (× 104/μL)	19.4 ± 7.3	19.9 ± 7.5	18.8 ± 7
HbA1C (%)	6.5 ± 1.1	6.6 ± 1.0	6.5 ± 1.1
Fasting insulin (mU/mL)	20 ± 14.2	20.6 ± 11.6	19 ± 17.4
Fasting blood glucose (mg/dL)	124 ± 34.7	126.1 ± 32.5	120.8 ± 37.8
Albumin (g/dL)	4.3 ± 0.5	4.3 ± 0.4	4.2 ± 0.5
Non-invasive test
cT1	871 ± 102 (n = 143)	907 ± 90 (n = 87)	817 ± 96c (n = 56)
MR liver fat	11.4 ± 6.1 (n = 143)	13.6 ± 5.8 (n = 87)	8.1 ± 5.1c (n = 56)
CAP	294.3 ± 47.4 (n = 117)	309.1 ± 37.1 (n = 74)	268.9 ± 52.7c (n = 43)
VCTE-LSM	12.8 ± 9.5 (n = 117)	13 ± 8.4 (n = 74)	12.5 ± 11.1 (n = 43)
MRE	4.2 ± 1.7 (n = 144)	4.3 ± 1.5 (n = 88)	4.1 ± 1.9 (n = 56)
SE	9.3 ± 2.7 (n = 84)	9.6 ± 2.4 (n = 50)	8.8 ± 3.1 (n = 33)
Reported pre-existing conditions
Hypertensive	n = 71	n = 45	n = 26
Dyslipidaemic	n = 111	n = 72	n = 39
Reported as diabetic	n = 97	n = 59	n = 38

Non-alcoholic steatohepatitis (NASH) were patients with NASH clinical research network ≥ 4 with ballooning ≥ 1. Stars denote significance difference between those with NASH and non-alcoholic fatty liver these levels:

^aP < 0.05.

^bP < 0.01.

^cP < 0.001. MRE: Magnetic resonance elastography; CAP: Controlled-attenuation parameter; VCTE: Vibration-controlled transient elastography; cT1: Corrected T1; BMI: Body mass index; NASH: Non-alcoholic steatohepatitis; NAFL: Non-alcoholic fatty liver.

Table 2 Range of histology scores reported across the entire cohort

Histology scores from biopsy (n = 144)
	Score	Total	NASH	NAFL
Steatosis (Brunt)	0	13	0	13
	1	74	36	37
	2	35	30	5
	3	21	20	1
Lobular inflammation	0	13	0	1
	1	91	48	51
	2	35	35	9
	3	4	3	0
Ballooning	0	39	0	39
	1	72	55	16
	2	32	31	1
	3	0	0	0
Fibrosis (Kleiner)	0	5	1	0
	1	24	10	14
	2	27	16	11
	3	55	39	15
	4	31	19	12
NAS	0	0	0	0
	1	5	0	5
	2	23	0	22
	3	26	0	26
	4	25	25	1
	5	37	35	2
	6	16	16	0
	7	8	8	0
	8	2	2	0

NASH: Non-alcoholic steatohepatitis; NAFL: Non-alcoholic fatty liver.

Table 3 Spearman's correlation coefficients for all variables

	cT1, (n = 143)	MR liver fat (n = 143)	MRE (n = 144)	VCTE-LSM (n = 117)	CAP (n = 117)	2D SWE (n = 84)
Fibrosis	0.24, P < 0.01	-0.25, P <0.01	0.75, P < 0.001	0.69, P < 0.001	0.05, P = 0.58	0.72, P < 0.001
Steatosis	0.29, P < 0.001	0.70, P < 0.001	-0.23, P < 0.01	-0.09, P = 0.23	0.39, P < 0.001	-0.07, P = 0.53
Lobular inflammation	0.31, P < 0.001	0.28, P < 0.001	0.16, P < 0.01	0.15, P = 0.10	0.26, P < 0.01	0.16, P = 0.15
Ballooning	0.39, P < 0.001	0.29, P < 0.001	0.32, P < 0.01	0.29, P < 0.01	0.33, P < 0.001	0.34, P < 0.001
NAS	0.58, P < 0.001	0.64, P < 0.001	0.06, P = 0.44	0.13, P = 0.13	0.49, P < 0.001	0.16, P = 0.13

P < 0.05: Correlations with statistical significance. MRE: Magnetic resonance elastography; CAP: Controlled-attenuation parameter; VCTE: Vibration-controlled transient elastography; cT1: Corrected T1; SWE: Shear-Wave elastography; NASH: Non-alcoholic steatohepatitis; LSM: Liver stiffness measure.

Table 4 Inter-rater variability between the three pathologists for each histology metric

Histological metric	Pathologists	Kappa weighted	Lower CI	Upper CI	ASE	P value	Overall inter-rater variability (Krippendorff’s alpha)
Steatosis	1 vs 2	0.609	0.517	0.7	0.0467	< 0.0001	0.584
	1 vs 3	0.483	0.388	0.579	0.0489	< 0.0001
	2 vs 3	0.585	0.485	0.686	0.0513	< 0.0001
Lobular inflammation	1 vs 2	0.118	0.0631	0.173	0.0281	< 0.0001	0.109
	1 vs 3	0.0376	0.00574	0.0695	0.0163	0.02
	2 vs 3	0.179	0.0699	0.288	0.0556	0.001
Ballooning	1 vs 2	0.297	0.205	0.389	0..047	< 0.0001	0.398
	1 vs 3	0.459	0.344	0.573	0.0583	< 0.0001
	2 vs 3	0.27	0.18	0.36	0.0453	< 0.0001
Fibrosis	1 vs 2	0.719	0.65	0.788	0.0353	< 0.0001	0.398
	1 vs 3	0.571	0.496	0.647	0.0386	< 0.0001
	2 vs 3	0.597	0.521	0.672	0.0385	< 0.0001
NAS	1 vs 2	0.279	0.202	0.357	0.0398	< 0.0001	0.421
	1 vs 3	0.244	0.172	0.316	0.0366	< 0.0001
	2 vs 3	0.434	0.35	0.518	0.043	< 0.0001

CI: Confidence intervals.