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In This Article

  • Summary
  • Abstract
  • Introduction
  • Protocol
  • Representative Results
  • Discussion
  • Acknowledgements
  • Materials
  • References
  • Reprints and Permissions

Summary

The objective of this study was to develop a novel three-dimensional digital model for the early diagnosis of hepatic fibrosis, which includes the stiffness of each voxel in the patient's liver and can thus, be used to calculate the distribution ratio of the patient's liver at different fibrosis stages.

Abstract

Hepatic fibrosis is an early stage of liver cirrhosis, and there are no better non-invasive and convenient methods for the detection and evaluation of the disease. Despite the good progress made with the liver stiffness map (LSM) based on magnetic resonance elastography (MRE), there are still some limitations that need to be overcome, including manual focus determination, manual selection of regions of interest (ROIs), and discontinuous LSM data without structural information, which makes it impossible to evaluate the liver as a whole. In this study, we propose a novel three-dimensional (3D) digital model for the early diagnosis of hepatic fibrosis based on MRE.

MRE is a non-invasive imaging technique that employs magnetic resonance imaging (MRI) to measure the liver stiffness at the scanning site through human-computer interaction. Studies have indicated a significant positive correlation between the LSM obtained through MRE and the degree of hepatic fibrosis. However, for clinical purposes, a comprehensive and precise quantification of the degree of hepatic fibrosis is necessary. To address this, the concept of Liver Stiffness Distribution (LSD) was proposed in this study, which refers to the 3D stiffness volume of each liver voxel obtained by the alignment of 3D liver tissue images and MRE indicators. This provides a more effective clinical tool for the diagnosis and treatment of hepatic fibrosis.

Introduction

Hepatic fibrosis refers to the formation of excessive scar tissue in the liver, usually as a result of liver damage or disease1,2,3,4. It frequently arises as a consequence of chronic liver injury and is commonly associated with liver diseases, such as chronic viral hepatitis, non-alcoholic fatty liver disease, and alcoholic liver disease. If left untreated, hepatic fibrosis can progress to cirrhosis, a potentially life-threatening condition associated with significant morbidity and mortality.

Active research in t....

Protocol

This study utilized 3D-digital LSD modeling to reconstruct the liver of a typical patient with clinically confirmed hepatic fibrosis. The patient was recruited from a well-known liver disease treatment institution, "You An Hospital" in Beijing, China, and underwent routine upper abdominal magnetic resonance imaging (MRI) and MRE imaging after providing consent. The patient was chosen as the case study for this research method due to the confirmation of hepatic fibrosis staging through pathological examination and.......

Representative Results

By utilizing the information in the Description_Name field of DICOM files, the original MRI folder can be renamed to facilitate the rapid localization of the required imaging sequence during the analysis process in the imaging group. The MRI-IDEAL out-phase sequence is the type of MRI sequence used for providing clearer descriptions of liver tissue boundaries. This is because the MRI-IDEAL out-of-phase sequence can better differentiate the magnetization strength and angle of different tissues throug.......

Discussion

In clinical practice, it is challenging to accurately quantify and track the condition of early-stage hepatic fibrosis patients. The comparison shown in Figure 9 fully reflects the degree of hepatic fibrosis in the patient compared to a healthy liver; of course, this figure can also be a comparison between two different periods for the patient, used for evaluation of treatment efficacy. This precise quantification method is the core critical step of this study. Furthermore, the calculation m.......

Acknowledgements

This publication was supported by the fifth national traditional Chinese medicine clinical excellent talents research program organized by the National Administration of Traditional Chinese Medicine. The official network link is 'http://www.natcm.gov.cn/renjiaosi/zhengcewenjian/2021-11-04/23082.html. '

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Materials

NameCompanyCatalog NumberComments
MATLABMathWorks 2022BComputing and visualization 
MimicsMaterialiseMimics Research V20Model format transformation
Tools for 3D_LSDIntelligent EntropyHepaticFibrosis V1.0Beijing Intelligent Entropy Science & Technology Co Ltd.
Modeling for CT/MRI fusion

References

  1. Henderson, N. C., Rieder, F., Wynn, T. A. Fibrosis: from mechanisms to medicines. Nature. 587 (7835), 555-566 (2020).
  2. Parola, M., Pinzani, M. Liver fibrosis: Pathophysiology, pathogenetic targets and clinical issues.

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