Quantitative multiparametric MRI as a non-invasive stratification tool in children and adolescents with autoimmune liver disease

Abstract Autoimmune hepatitis (AIH) and autoimmune sclerosing cholangitis (ASC) are two very closely related autoimmune liver diseases with overlapping clinical features and similar management strategies. The purpose of this study was to assess the utility of quantitative imaging markers to distingu...

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Autores principales:	Kamil Janowski, Elizabeth Shumbayawonda, Lin Cheng, Caitlin Langford, Andrea Dennis, Matt Kelly, Maciej Pronicki, Wieslawa Grajkowska, Malgorzata Wozniak, Piotr Pawliszak, Sylwia Chełstowska, Elzbieta Jurkiewicz, Rajarshi Banerjee, Piotr Socha
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a5ec93bb818648ec974d64986e5ca604
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spelling	oai:doaj.org-article:a5ec93bb818648ec974d64986e5ca6042021-12-02T16:24:22ZQuantitative multiparametric MRI as a non-invasive stratification tool in children and adolescents with autoimmune liver disease10.1038/s41598-021-94754-92045-2322https://doaj.org/article/a5ec93bb818648ec974d64986e5ca6042021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-94754-9https://doaj.org/toc/2045-2322Abstract Autoimmune hepatitis (AIH) and autoimmune sclerosing cholangitis (ASC) are two very closely related autoimmune liver diseases with overlapping clinical features and similar management strategies. The purpose of this study was to assess the utility of quantitative imaging markers to distinguish ASC from AIH in paediatrics. 66 participants (N = 52 AIH, N = 14 ASC) aged 14.4 ± 3.3 years scheduled to undergo routine biopsy and baseline serum liver biochemistry testing were invited to undergo MRI (non-contrast abdominal MRI and 3D fast spin-echo MRCP). Multiparametric MRI was used to measure fibro-inflammation with corrected T1 (cT1), while the biliary tree was modelled using quantitative MRCP (MRCP +). Mann–Whitney U tests were performed to compare liver function tests with imaging markers between patient groups (ASC vs AIH). Receiver operating characteristic curves and stepwise logistic regressions were used to identify the best combination of markers to discriminate between ASC and AIH. Correlations between liver function tests and imaging markers were performed using Spearman’s rank correlation. cT1 was significantly correlated with liver function tests (range 0.33 ≤ R ≤ 56, p < 0.05), as well as with fibrosis, lobular and portal inflammation (range 0.31 ≤ R ≤ 42, p < 0.05). 19 MRCP + metrics correlated significantly with liver function tests (range 0.29 ≤ R ≤ 0.43, p < 0.05). GGT and MRCP + metrics were significantly higher in ASC compared to those with AIH. The best multivariable model for distinguishing ASC from AIH included total number of ducts and the sum of relative severity of both strictures and dilatations AUC: 0.91 (95% CI 0.78–1). Quantitative MRCP metrics are a good discriminator of ASC from AIH.Kamil JanowskiElizabeth ShumbayawondaLin ChengCaitlin LangfordAndrea DennisMatt KellyMaciej PronickiWieslawa GrajkowskaMalgorzata WozniakPiotr PawliszakSylwia ChełstowskaElzbieta JurkiewiczRajarshi BanerjeePiotr SochaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kamil Janowski Elizabeth Shumbayawonda Lin Cheng Caitlin Langford Andrea Dennis Matt Kelly Maciej Pronicki Wieslawa Grajkowska Malgorzata Wozniak Piotr Pawliszak Sylwia Chełstowska Elzbieta Jurkiewicz Rajarshi Banerjee Piotr Socha Quantitative multiparametric MRI as a non-invasive stratification tool in children and adolescents with autoimmune liver disease
description	Abstract Autoimmune hepatitis (AIH) and autoimmune sclerosing cholangitis (ASC) are two very closely related autoimmune liver diseases with overlapping clinical features and similar management strategies. The purpose of this study was to assess the utility of quantitative imaging markers to distinguish ASC from AIH in paediatrics. 66 participants (N = 52 AIH, N = 14 ASC) aged 14.4 ± 3.3 years scheduled to undergo routine biopsy and baseline serum liver biochemistry testing were invited to undergo MRI (non-contrast abdominal MRI and 3D fast spin-echo MRCP). Multiparametric MRI was used to measure fibro-inflammation with corrected T1 (cT1), while the biliary tree was modelled using quantitative MRCP (MRCP +). Mann–Whitney U tests were performed to compare liver function tests with imaging markers between patient groups (ASC vs AIH). Receiver operating characteristic curves and stepwise logistic regressions were used to identify the best combination of markers to discriminate between ASC and AIH. Correlations between liver function tests and imaging markers were performed using Spearman’s rank correlation. cT1 was significantly correlated with liver function tests (range 0.33 ≤ R ≤ 56, p < 0.05), as well as with fibrosis, lobular and portal inflammation (range 0.31 ≤ R ≤ 42, p < 0.05). 19 MRCP + metrics correlated significantly with liver function tests (range 0.29 ≤ R ≤ 0.43, p < 0.05). GGT and MRCP + metrics were significantly higher in ASC compared to those with AIH. The best multivariable model for distinguishing ASC from AIH included total number of ducts and the sum of relative severity of both strictures and dilatations AUC: 0.91 (95% CI 0.78–1). Quantitative MRCP metrics are a good discriminator of ASC from AIH.
format	article
author	Kamil Janowski Elizabeth Shumbayawonda Lin Cheng Caitlin Langford Andrea Dennis Matt Kelly Maciej Pronicki Wieslawa Grajkowska Malgorzata Wozniak Piotr Pawliszak Sylwia Chełstowska Elzbieta Jurkiewicz Rajarshi Banerjee Piotr Socha
author_facet	Kamil Janowski Elizabeth Shumbayawonda Lin Cheng Caitlin Langford Andrea Dennis Matt Kelly Maciej Pronicki Wieslawa Grajkowska Malgorzata Wozniak Piotr Pawliszak Sylwia Chełstowska Elzbieta Jurkiewicz Rajarshi Banerjee Piotr Socha
author_sort	Kamil Janowski
title	Quantitative multiparametric MRI as a non-invasive stratification tool in children and adolescents with autoimmune liver disease
title_short	Quantitative multiparametric MRI as a non-invasive stratification tool in children and adolescents with autoimmune liver disease
title_full	Quantitative multiparametric MRI as a non-invasive stratification tool in children and adolescents with autoimmune liver disease
title_fullStr	Quantitative multiparametric MRI as a non-invasive stratification tool in children and adolescents with autoimmune liver disease
title_full_unstemmed	Quantitative multiparametric MRI as a non-invasive stratification tool in children and adolescents with autoimmune liver disease
title_sort	quantitative multiparametric mri as a non-invasive stratification tool in children and adolescents with autoimmune liver disease
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/a5ec93bb818648ec974d64986e5ca604
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Quantitative multiparametric MRI as a non-invasive stratification tool in children and adolescents with autoimmune liver disease

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