Evidence map›Paper›PMID 29513767›Full record

ArticlePloS one2018

Association of gadolinium-enhanced magnetic resonance imaging with hepatic fibrosis and inflammation in primary sclerosing cholangitis.

Sarah Keller, Annette Aigner, Roman Zenouzi, Anne C Kim, Arnoud Meijer, Sören A Weidemann, Till Krech, Ansgar W Lohse, Gerhard Adam, Christoph Schramm and 1 more

Open access · goldAbstract readEvaluation Study
In one paragraph

Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.7field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 3 countries.

Sarah KellerDepartment of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.ORCID 0000-0001-7080-2082
Annette AignerInstitute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Roman Zenouzi1st Department of Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Anne C KimDepartment Stroke and Neurovascular Imaging, The Permanente Medical Group, San Francisco, California, United States of America.
Arnoud MeijerDepartment of Radiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
Sören A WeidemannInstitute of Pathology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Till KrechInstitute of Pathology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Ansgar W Lohse1st Department of Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Gerhard AdamDepartment of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Christoph Schramm1st Department of Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Jin YamamuraDepartment of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Universität Hamburg · DEColorado Permanente Medical Group · USLeiden University Medical Center · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate magnetic resonance imaging (MRI) parameters T2 signal, contrast enhancement (CE), and relative liver enhancement (RLE) of extracellular gadolinium-based contrast agent (GBCA)-enhanced MRI as a marker for hepatic fibrosis and inflammation in patients with primary sclerosing cholangitis (PSC).

methods3.0-Tesla MRI scans and liver biopsies of 40 patients (41.2 ± 17.1 years) were retrospectively reviewed. Biopsies were obtained within a mean time of 54 ± 55 days to MRI scans and specimens were categorized according to Ishak modified hepatic activity index (mHAI) and Scheuer staging of fibrosis. T2 signal (N = 40), CE alterations (N = 29), and RLE (N = 29) were assessed by two raters. Mixed-effects regression models were applied to estimate the association between histopathology and MRI parameters.

resultsNo significant association was observed between T2 signal or CE alterations with stages of fibrosis or mHAI grading. Regression models revealed significant positive associations of portal venous phase RLE with mHAI grade ≥ 7 points [β = 25.5; 95% CI (2.53; 48.62); p = 0.04] and delayed phase RLE with stages of fibrosis [stage 2: β = 35.13; 95% CI (11.35; 58.87); p = 0.007; stage 3/4: β = 69.24; 95% CI (45.77; 92.75); p < 0.001]. The optimal cut-off value of 66.6% delayed phase RLE distinguished fibrosis stages 0-2 from 3-4 with a sensitivity of 0.833 and specificity of 0.972. Inter-rater reliability (IRR) for quantification of RLE was 'excellent' (r = 0.90-0.98). IRR was 'substantial' for detection of T2 signal in the right liver lobe (RL) (Kappa = 0.77) and 'almost perfect' for T2 signal of the left liver lobe (LL) and CE of both lobes (Kappa = 0.87-1.0).

conclusionThe simple and reproducible method of RLE quantification on standard extracellular GBCA-enhanced MRI may provide a correlate measure of advanced stages of hepatic fibrosis and potentially also inflammation in PSC patients, if validated in larger cohorts.

Indexed as

Contrast MediaGadolinium DTPAAdultArea Under CurveBiopsyCholangitis, SclerosingDisease ProgressionFemaleHumansInflammationLiverLiver CirrhosisMagnetic Resonance ImagingMaleMiddle AgedReproducibility of ResultsContrast MediaGadolinium DTPA

Identifiers

PMID29513767
PMCPMC5841815
OpenAlexW2790824326

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.