Recommendations on the use of magnetic resonance imaging for collaborative multicenter studies in PSC

Recently, the MRI working group of the International PSC Study Group (IPSCSG) has published a position statement on the use of MRI regarding diagnosis and follow-up of PSC patients. These guidelines are intended for use by physicians in daily clinical routine. In addition, the group has outlined several areas of research, which need to be addressed in the near future. As PSC is a rare disease with the clinical outcome being determined by the development of end-stage liver disease and hepatobiliary malignancy. This article is protected by copyright. All rights reserved

European Radiology / The Efficacy of MRI in the diagnostic workup of cystic fibrosis-associated liver disease : A clinical observational cohort study

Purpose To identify independent imaging features and establish a diagnostic algorithm for diagnosis of cystic fibrosis (CF)-associated liver disease (CFLD) in CF patients compared to controls using gadoxetic acid-enhanced MRI. Methods A total of 90 adult patients were enrolled: 50 with CF, 40 controls. The CF group was composed of two subgroups: a retrospective test subgroup (n = 33) and a prospective validation subgroup (n = 17). Controls (patients with normal liver enzymes and only benign focal liver lesions) were divided accordingly (27:13). MRI variables, including quantitative and qualitative parameters, were used to distinguish CFLD from controls using clinical symptoms, laboratory tests and Debray criteria. Disease severity was classified according to Child-Pugh and Albumin-Bilirubin (ALBI) scores. Fifteen qualitative single-lesion CF descriptors were defined. Two readers independently evaluated the images. Univariate statistical analysis was performed to obtain significant imaging features that differentiate CF patients from controls. Through multivariate analysis using chi-squared automatic interaction detector (CHAID) methodology the most important descriptors were identified. Diagnostic performance was assessed by receiver-operating characteristic (ROC) analysis. Results Three independent imaging descriptors distinguished CFLD from controls: (1) presence of altered gallbladder morphology; (2) periportal tracking; and (3) periportal fat deposition. Prospective validation of the classification algorithm demonstrated a sensitivity of 94.1% and specificity of 84.6% for discriminating CFLD from controls. Disease severity was well associated with the imaging features. Conclusions A short unenhanced MRI protocol can identify the three cardinal imaging features of CFLD. The hepatobiliary phase of gadoxetic acid-enhanced MRI can define CFLD progression.(VLID)362009

Recommendations on the use of magnetic resonance imaging for collaborative multicenter studies in PSC

Recently, the MRI working group of the International PSC Study Group (IPSCSG) has published a position statement on the use of MRI regarding diagnosis and follow-up of PSC patients. These guidelines are intended for use by physicians in daily clinical routine. In addition, the group has outlined several areas of research, which need to be addressed in the near future. As PSC is a rare disease with the clinical outcome being determined by the development of end-stage liver disease and hepatobiliary malignancy. This article is protected by copyright. All rights reserved