際際滷

際際滷Share a Scribd company logo

Monitoring liver fibrosis with quantitaive B-Mode ultrasound

Download as PPTX, PDF
U
Upenn Ultrasound Research

This study evaluated quantitative ultrasound features for assessing hepatic fibrosis in a rat model of cirrhosis induced by diethylnitrosamine (DEN). Rats received DEN (n=12) or served as controls (n=4). Ultrasound images were analyzed for echo-intensity and heterogeneity at 0, 10, and 13 weeks. Both features increased significantly with time in DEN rats compared to controls. Histological analysis found DEN rats developed METAVIR grades F2-F4 fibrosis while controls were F0. Echo-intensity and heterogeneity correlated strongly with METAVIR grade. Ultrasound could non-invasively track fibrotic changes and distinguish fibrosis grades, suggesting potential for assessing liver fibrosis.

1 of 16
Download to read offline
Quantitative Assessment of Diethylnitrosamine-induced Hepatic Fibrosis by Non-Invasive Ultrasound Laith R Sultan MD, Julia C DSouza BSE, Susan M Schultz RDMS, Tong Wu PhD, Terrence Gade MD PhD,Sean D Carlin PhD, Stephen J Hunt MD PhD, Chandra M Sehgal PhD
All authors have no financial disclosures
Cirrhosis: Diagnosis Cirrhosis and liver disease represent the 12th leading cause of death overall, and 5th leading cause of death for 45 - 54 year olds in US Liver biopsy is the gold standard for assessing fibrosis and cirrhosis Shortcomings of liver biopsy: Invasive Sampling error: Complications
Objective To evaluate fibrotic changes in a preclinical model using B-mode ultrasound Approach: Quantitative, computer-extracted features Diethylnitrosamine (DEN)-induced rat model
Experimental Design Arms: DEN (n=12) Control (n=4)
Materials & Methods Image and Statistical Analysis Sampling: 6 image acquisitions throughout liver 4 - 6 ROIs/image Echo-intensity = mean brightness of ROIs Heterogeneity = variance of 1st order histogram Intragroup (temporal progression): ANOVA with subsequent t-tests between three timepoints Intergroup (DEN vs control): Two-sided t-tests at each timepoint
Preparation of H&E and trichrome stains METAVIR grading by veterinary pathologist Spearman correlation between sonographic parameters and METAVIR score Materials & Methods Pathologic Validation
DENControl 10 weeks0 weeks 13 weeks Results Echointensity * * * p = 0.001 0w 10w 13w Control 38.1 38.2 38.4 DEN 38.1 56.5 59.6 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 Echointensity
Echo-intensity: 10 weeks (p = 0.0013), 13 weeks (p = 0.0002) DENControl 10 weeks0 weeks 13 weeks Results Heterogeneity ** * * ** p = 0.005 0w 10w 13w Control 275.3 247.8 245.5 DEN 246.6 524.9 480.7 0.0 100.0 200.0 300.0 400.0 500.0 600.0 700.0 Heterogeneity
DEN rats: METAVIR grades F2-F4 Control rats: F0 F3 F4F2 Results Histology
Results Correlation of 13w sonographic data with METAVIR score Echointensity vs. Fibrosis grade Heterogeneity vs. Fibrosis grade Rho = 0.8242 p = 0.0003 Rho = 0.8287 p = 0.0002
Different grades of fibrosis show separate populations based on echointensity and heterogeneity Results Population grouping of METAVIR grades by sonographic measures F 4 F 0 F 2 F 3
Limitations Limited data for intermediate stages of fibrosis Image and sacrifice at earlier time points Similarities in characterization of F2/F3 lesions Further characterization with additional computerized features
Conclusion B-mode US tracks fibrotic changes in a rat model. Sonographic features correlate to histology. Potential role for B-mode US for the non-invasive measurement of liver fibrosis.
Future Directions Preclinical correlation of sonographic features to HCC development Rat model comparison to fibroscan results Comparison of biopsy-proven METAVIR fibrosis scoring with clinical ultrasound measurements
Thank you! Contact: lsultan@pennmedicine.upenn.edu julia.dsouza@uphs.upenn.edu Stephen.hunt@uphs.upenn.edu Chandra.sehgal@uphs.upenn.edu Penn Ultrasound Research Lab Penn Small Animal Imaging Facility

More Related Content

Monitoring liver fibrosis with quantitaive B-Mode ultrasound

  • 1. Quantitative Assessment of Diethylnitrosamine-induced Hepatic Fibrosis by Non-Invasive Ultrasound Laith R Sultan MD, Julia C DSouza BSE, Susan M Schultz RDMS, Tong Wu PhD, Terrence Gade MD PhD,Sean D Carlin PhD, Stephen J Hunt MD PhD, Chandra M Sehgal PhD
  • 2. All authors have no financial disclosures
  • 3. Cirrhosis: Diagnosis Cirrhosis and liver disease represent the 12th leading cause of death overall, and 5th leading cause of death for 45 - 54 year olds in US Liver biopsy is the gold standard for assessing fibrosis and cirrhosis Shortcomings of liver biopsy: Invasive Sampling error: Complications
  • 4. Objective To evaluate fibrotic changes in a preclinical model using B-mode ultrasound Approach: Quantitative, computer-extracted features Diethylnitrosamine (DEN)-induced rat model
  • 6. Materials & Methods Image and Statistical Analysis Sampling: 6 image acquisitions throughout liver 4 - 6 ROIs/image Echo-intensity = mean brightness of ROIs Heterogeneity = variance of 1st order histogram Intragroup (temporal progression): ANOVA with subsequent t-tests between three timepoints Intergroup (DEN vs control): Two-sided t-tests at each timepoint
  • 7. Preparation of H&E and trichrome stains METAVIR grading by veterinary pathologist Spearman correlation between sonographic parameters and METAVIR score Materials & Methods Pathologic Validation
  • 8. DENControl 10 weeks0 weeks 13 weeks Results Echointensity * * * p = 0.001 0w 10w 13w Control 38.1 38.2 38.4 DEN 38.1 56.5 59.6 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 Echointensity
  • 9. Echo-intensity: 10 weeks (p = 0.0013), 13 weeks (p = 0.0002) DENControl 10 weeks0 weeks 13 weeks Results Heterogeneity ** * * ** p = 0.005 0w 10w 13w Control 275.3 247.8 245.5 DEN 246.6 524.9 480.7 0.0 100.0 200.0 300.0 400.0 500.0 600.0 700.0 Heterogeneity
  • 10. DEN rats: METAVIR grades F2-F4 Control rats: F0 F3 F4F2 Results Histology
  • 11. Results Correlation of 13w sonographic data with METAVIR score Echointensity vs. Fibrosis grade Heterogeneity vs. Fibrosis grade Rho = 0.8242 p = 0.0003 Rho = 0.8287 p = 0.0002
  • 12. Different grades of fibrosis show separate populations based on echointensity and heterogeneity Results Population grouping of METAVIR grades by sonographic measures F 4 F 0 F 2 F 3
  • 13. Limitations Limited data for intermediate stages of fibrosis Image and sacrifice at earlier time points Similarities in characterization of F2/F3 lesions Further characterization with additional computerized features
  • 14. Conclusion B-mode US tracks fibrotic changes in a rat model. Sonographic features correlate to histology. Potential role for B-mode US for the non-invasive measurement of liver fibrosis.
  • 15. Future Directions Preclinical correlation of sonographic features to HCC development Rat model comparison to fibroscan results Comparison of biopsy-proven METAVIR fibrosis scoring with clinical ultrasound measurements

Editor's Notes

  • #4: The most common serious complication of liver biopsy is intraperitoneal hemorrhage, although hematoma and hemobilia can also occur. Other potential complications of liver biopsy include right upper abdominal pain, right shoulder pain, bile peritonitis or pneumothorax. lobar difference between METAVIR grades in up to 24.2% of cases1
  • #7: Intragroup (temporal progression): ANOVA Intergroup (DEN vs control): Two-sided t-tests at each timepoint
  • #8: Collaboration with colleagues in the vet school certified veterinary pathologist blinded to the imaging results graded the histology
  • #9: Echo-intensity: Mean liver echo-intensity increased from 42.9 at baseline to 56.4 at 10 weeks (p = 0.0013) reaching the level of 59.9 at 13 weeks (p = 0.0002) from DEN starting time.
  • #10: Echo-intensity: Mean liver echo-intensity increased from 42.9 at baseline to 56.4 at 10 weeks (p = 0.0013) reaching the level of 59.9 at 13 weeks (p = 0.0002) from DEN starting time.
  • #14: Have an animal model that is useful for studying fibrosis US can be used to track changes Quantitative texturized computer analysis captures the fibrotic changes in an animal model
  • #15: Have an animal model that is useful for studying fibrosis US can be used to track changes Quantitative texturized computer analysis captures the fibrotic changes in an animal model
  • #16: Have an animal model that is useful for studying fibrosis US can be used to track changes Quantitative texturized computer analysis captures the fibrotic changes in an animal model
AboutCopyright
息 2025 際際滷