MRI-guided Biopsy to Correlate Tissue Specimens with MR Elastography Stiffness Readings in Liver Transplants

Ryan B. Perumpail; Josh Levitsky; Yi Wang; Victoria S. Lee; Jennifer Karp; Ning Jin; Guang Yu Yang; Bradley D. Bolster; Saurabh Shah; Sven Zuehlsdorff; Albert A. Nemcek; Andrew C. Larson; Frank H. Miller; Reed A. Omary

doi:10.1016/j.acra.2012.05.011

MRI-guided Biopsy to Correlate Tissue Specimens with MR Elastography Stiffness Readings in Liver Transplants

Ryan B. Perumpail, Josh Levitsky, Yi Wang, Victoria S. Lee, Jennifer Karp, Ning Jin, Guang Yu Yang, Bradley D. Bolster, Saurabh Shah, Sven Zuehlsdorff, Albert A. Nemcek, Andrew C. Larson, Frank H. Miller, Reed A. Omary^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

Rationale and Objectives: Magnetic resonance elastography (MRE) can noninvasively measure the stiffness of liver tissue and display this information in anatomic maps. Magnetic resonance imaging (MRI) guidance has not previously been used to biopsy segments of heterogeneous stiffness identified on MRE. Dedicated study of MRE in post-liver transplant patients is also limited. In this study, the ability of real-time MRI to guide biopsies of segments of the liver with different MRE stiffness values in the same post-transplant patient was assessed. Materials and Methods: MRE was performed in 9 consecutive posttransplant patients with history of hepatitis C. Segments of highest and lower stiffness on MRE served as targets for subsequent real-time MRI-guided biopsy using T2-weighted imaging. The ability of MRI-guided biopsy to successfully obtain tissue specimens was assessed. The Wilcoxon signed-rank test was used to compare mean stiffness differences for highest and lower MRE stiffness segments, with α = 0.05. Results: MRI guidance allowed successful sampling of liver tissue for all (18/18) biopsies. There was a statistically significant difference in mean MRE stiffness values between highest (4.61 ± 1.99 kPa) and lower stiffness (3.03 ± 1.75 kPa) (P = .0039) segments biopsied in the 9 posttransplant patients. Conclusion: Real-time MRI can guide biopsy in patients after liver transplantation based on MRE stiffness values. This study supports the use of MRI guidance to sample tissue based on functional information.

Original language	English (US)
Pages (from-to)	1121-1126
Number of pages	6
Journal	Academic radiology
Volume	19
Issue number	9
DOIs	https://doi.org/10.1016/j.acra.2012.05.011
State	Published - Sep 2012

Funding

The authors acknowledge the assistance of Dr. Richard Ehman (Mayo Clinic, Rochester, MN) who provided access to prototype hardware and software for MRE and assisted with manuscript preparation. RBP was funded by the Northwestern University Medical Student Research Program Grant. RAO was partially funded by NIH R01 CA126809 . Partial support by NIH R01 EB001981 .

Keywords

Image-guided biopsy
Liver biopsy
Liver transplantation
MRI guidance
Magnetic resonance elastography

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.acra.2012.05.011

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Perumpail, R. B., Levitsky, J., Wang, Y., Lee, V. S., Karp, J., Jin, N., Yang, G. Y., Bolster, B. D., Shah, S., Zuehlsdorff, S., Nemcek, A. A., Larson, A. C., Miller, F. H., & Omary, R. A. (2012). MRI-guided Biopsy to Correlate Tissue Specimens with MR Elastography Stiffness Readings in Liver Transplants. Academic radiology, 19(9), 1121-1126. https://doi.org/10.1016/j.acra.2012.05.011

@article{23c1af60c0d94e02befd456135856511,

title = "MRI-guided Biopsy to Correlate Tissue Specimens with MR Elastography Stiffness Readings in Liver Transplants",

abstract = "Rationale and Objectives: Magnetic resonance elastography (MRE) can noninvasively measure the stiffness of liver tissue and display this information in anatomic maps. Magnetic resonance imaging (MRI) guidance has not previously been used to biopsy segments of heterogeneous stiffness identified on MRE. Dedicated study of MRE in post-liver transplant patients is also limited. In this study, the ability of real-time MRI to guide biopsies of segments of the liver with different MRE stiffness values in the same post-transplant patient was assessed. Materials and Methods: MRE was performed in 9 consecutive posttransplant patients with history of hepatitis C. Segments of highest and lower stiffness on MRE served as targets for subsequent real-time MRI-guided biopsy using T2-weighted imaging. The ability of MRI-guided biopsy to successfully obtain tissue specimens was assessed. The Wilcoxon signed-rank test was used to compare mean stiffness differences for highest and lower MRE stiffness segments, with α = 0.05. Results: MRI guidance allowed successful sampling of liver tissue for all (18/18) biopsies. There was a statistically significant difference in mean MRE stiffness values between highest (4.61 ± 1.99 kPa) and lower stiffness (3.03 ± 1.75 kPa) (P = .0039) segments biopsied in the 9 posttransplant patients. Conclusion: Real-time MRI can guide biopsy in patients after liver transplantation based on MRE stiffness values. This study supports the use of MRI guidance to sample tissue based on functional information.",

keywords = "Image-guided biopsy, Liver biopsy, Liver transplantation, MRI guidance, Magnetic resonance elastography",

author = "Perumpail, {Ryan B.} and Josh Levitsky and Yi Wang and Lee, {Victoria S.} and Jennifer Karp and Ning Jin and Yang, {Guang Yu} and Bolster, {Bradley D.} and Saurabh Shah and Sven Zuehlsdorff and Nemcek, {Albert A.} and Larson, {Andrew C.} and Miller, {Frank H.} and Omary, {Reed A.}",

note = "Funding Information: The authors acknowledge the assistance of Dr. Richard Ehman (Mayo Clinic, Rochester, MN) who provided access to prototype hardware and software for MRE and assisted with manuscript preparation. RBP was funded by the Northwestern University Medical Student Research Program Grant. RAO was partially funded by NIH R01 CA126809 . Partial support by NIH R01 EB001981 .",

year = "2012",

month = sep,

doi = "10.1016/j.acra.2012.05.011",

language = "English (US)",

volume = "19",

pages = "1121--1126",

journal = "Academic radiology",

issn = "1076-6332",

publisher = "Elsevier USA",

number = "9",

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TY - JOUR

T1 - MRI-guided Biopsy to Correlate Tissue Specimens with MR Elastography Stiffness Readings in Liver Transplants

AU - Perumpail, Ryan B.

AU - Levitsky, Josh

AU - Wang, Yi

AU - Lee, Victoria S.

AU - Karp, Jennifer

AU - Jin, Ning

AU - Yang, Guang Yu

AU - Bolster, Bradley D.

AU - Shah, Saurabh

AU - Zuehlsdorff, Sven

AU - Nemcek, Albert A.

AU - Larson, Andrew C.

AU - Miller, Frank H.

AU - Omary, Reed A.

N1 - Funding Information: The authors acknowledge the assistance of Dr. Richard Ehman (Mayo Clinic, Rochester, MN) who provided access to prototype hardware and software for MRE and assisted with manuscript preparation. RBP was funded by the Northwestern University Medical Student Research Program Grant. RAO was partially funded by NIH R01 CA126809 . Partial support by NIH R01 EB001981 .

PY - 2012/9

Y1 - 2012/9

N2 - Rationale and Objectives: Magnetic resonance elastography (MRE) can noninvasively measure the stiffness of liver tissue and display this information in anatomic maps. Magnetic resonance imaging (MRI) guidance has not previously been used to biopsy segments of heterogeneous stiffness identified on MRE. Dedicated study of MRE in post-liver transplant patients is also limited. In this study, the ability of real-time MRI to guide biopsies of segments of the liver with different MRE stiffness values in the same post-transplant patient was assessed. Materials and Methods: MRE was performed in 9 consecutive posttransplant patients with history of hepatitis C. Segments of highest and lower stiffness on MRE served as targets for subsequent real-time MRI-guided biopsy using T2-weighted imaging. The ability of MRI-guided biopsy to successfully obtain tissue specimens was assessed. The Wilcoxon signed-rank test was used to compare mean stiffness differences for highest and lower MRE stiffness segments, with α = 0.05. Results: MRI guidance allowed successful sampling of liver tissue for all (18/18) biopsies. There was a statistically significant difference in mean MRE stiffness values between highest (4.61 ± 1.99 kPa) and lower stiffness (3.03 ± 1.75 kPa) (P = .0039) segments biopsied in the 9 posttransplant patients. Conclusion: Real-time MRI can guide biopsy in patients after liver transplantation based on MRE stiffness values. This study supports the use of MRI guidance to sample tissue based on functional information.

AB - Rationale and Objectives: Magnetic resonance elastography (MRE) can noninvasively measure the stiffness of liver tissue and display this information in anatomic maps. Magnetic resonance imaging (MRI) guidance has not previously been used to biopsy segments of heterogeneous stiffness identified on MRE. Dedicated study of MRE in post-liver transplant patients is also limited. In this study, the ability of real-time MRI to guide biopsies of segments of the liver with different MRE stiffness values in the same post-transplant patient was assessed. Materials and Methods: MRE was performed in 9 consecutive posttransplant patients with history of hepatitis C. Segments of highest and lower stiffness on MRE served as targets for subsequent real-time MRI-guided biopsy using T2-weighted imaging. The ability of MRI-guided biopsy to successfully obtain tissue specimens was assessed. The Wilcoxon signed-rank test was used to compare mean stiffness differences for highest and lower MRE stiffness segments, with α = 0.05. Results: MRI guidance allowed successful sampling of liver tissue for all (18/18) biopsies. There was a statistically significant difference in mean MRE stiffness values between highest (4.61 ± 1.99 kPa) and lower stiffness (3.03 ± 1.75 kPa) (P = .0039) segments biopsied in the 9 posttransplant patients. Conclusion: Real-time MRI can guide biopsy in patients after liver transplantation based on MRE stiffness values. This study supports the use of MRI guidance to sample tissue based on functional information.

KW - Image-guided biopsy

KW - Liver biopsy

KW - Liver transplantation

KW - MRI guidance

KW - Magnetic resonance elastography

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MRI-guided Biopsy to Correlate Tissue Specimens with MR Elastography Stiffness Readings in Liver Transplants

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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