Evidence map›Paper›PMID 30051141›Full record

ArticleEuropean radiology2019

The development and validation of magnetic resonance elastography for fibrosis staging in primary sclerosing cholangitis.

Kartik S Jhaveri, Hooman Hosseini-Nik, Nima Sadoughi, Harry Janssen, Jordan J Feld, Sandra Fischer, Ravi Menezes, Angela C Cheung

Abstract read
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In one paragraph

Article in European radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
–field-weighted citation impact
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

13 citing papers in PubMed.

  1. Review
  2. Article
  3. Pathogenesis, Non-Invasive Assessments and Treatment of Hepatic Fibrosis in Autoimmune Liver Diseases.Liver international : official journal of the International Association for the Study of the Liver · 2025
    Review
  4. Review
  5. Review
  6. Article
  7. Observational
  8. Article
  9. Review
  10. Review
  11. Article
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  13. Review
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

8 authors.

Kartik S JhaveriJoint Department of Medical Imaging, University of Toronto, University Health Network and Mount Sinai Hospital, 610 University Ave, 3-957, Toronto, Ontario, M5G 2M9, Canada. kartik.jhaveri@uhn.ca.
Hooman Hosseini-NikJoint Department of Medical Imaging, University of Toronto, University Health Network and Mount Sinai Hospital, 610 University Ave, 3-957, Toronto, Ontario, M5G 2M9, Canada.
Nima SadoughiJoint Department of Medical Imaging, University of Toronto, University Health Network and Mount Sinai Hospital, 610 University Ave, 3-957, Toronto, Ontario, M5G 2M9, Canada.
Harry JanssenToronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Jordan J FeldToronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Sandra FischerDepartment of Laboratory Medicine and Pathology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Ravi MenezesJoint Department of Medical Imaging, University of Toronto, University Health Network and Mount Sinai Hospital, 610 University Ave, 3-957, Toronto, Ontario, M5G 2M9, Canada.
Angela C CheungToronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo develop and internally validate MR elastography (MRE) quantified liver stiffness (LS) cut-off values for distinguishing early/moderate fibrosis from cirrhosis in primary sclerosing cholangitis (PSC) against non-invasive fibrosis test of vibration-controlled transient elastography (VCTE).

methodsSixty-seven patients were enrolled prospectively at a tertiary care centre to undergo MRE and VCTE. MRE-quantified LS was calculated using three region-of-interest (ROI) methods: Trace, Average and Maximum. Each ROI method was compared with the reference standard of VCTE. Internal validation was performed with bootstrapping. Univariable and multivariable linear regression determined independent predictors for MRE-quantified LS and final Mayo Risk Score (MRS).

resultsMRE-quantified LS by Trace ROI method had the highest sensitivity [87.5%; 95% confidence interval (CI), 66.0-96.8] and specificity (96.1%; 95%CI, 89.6-99.0) for distinguishing cirrhosis; and was the strongest predictor of final MRS (β, 0.44; 95% CI, 0.27-0.61). Alkaline phosphatase twice the normal upper limit (β, 1.55; 95% CI, 0.95-2.17), abnormal bilirubin (β, 1.27; 95% CI, 0.41-2.14) and thrombocytopaenia (β, 0.79; 95% CI, 0.12-1.46) were independent predictors of LS.

conclusionsMRE has a higher correlation with MRS than VCTE; and though MRE is possibly influenced by severe cholestasis and portal hypertension, MRE-quantified LS is an independent predictor of worse MRS. KEY POINTS: • MRE is valid and reliable in assessing cirrhosis in PSC, and MRE-quantified Liver stiffness (LS) score was the strongest predictor of final Mayo Risk Score (MRS). • Trace ROI performs best for distinguishing moderate fibrosis from cirrhosis and has the highest correlation with Mayo Risk Score (MRS). • Cholestasis, hyperbilirubinaemia and portal hypertension may influence MRE LS score.

Indexed as

AdultCholangitis, SclerosingCholestasisElasticity Imaging TechniquesFemaleHumansHypertension, PortalLinear ModelsLiver CirrhosisMaleMiddle AgedRetrospective StudiesSensitivity and SpecificitySeverity of Illness IndexBile ductsElasticity imaging techniquesLiver cirrhosisMagnetic resonance imagingPrimary sclerosing cholangitis

Identifiers

PMID30051141

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Registered trials

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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.