Diagnostic Performance of Magnetic Resonance Elastography Versus Vibration‐Controlled Transient Elastography for Liver Fibrosis Staging in Steatotic Liver Disease
10 affiliations
- 1Goethe University Frankfurt, University Hospital Department of Radiology and Nuclear Medicine Frankfurt am Main Germany
- 2Goethe University Frankfurt, University Hospital Department of Pediatrics Frankfurt am Main Germany
- 3Goethe University Frankfurt, University Hospital Department of Internal Medicine I Frankfurt am Main Germany
- 4Goethe University Frankfurt, Faculty of Medicine Institute of Biostatistics and Mathematical Modeling Frankfurt am Main Germany
- 5Goethe University Frankfurt, University Hospital Department of Internal Medicine, Infectious Diseases Frankfurt am Main Germany
- 6University Hospital Jena, Institute of Diagnostic and Interventional Radiology, Section Neuroradiology Jena Germany
- 7Goethe University Frankfurt, University Hospital, Institute of Medical Virology Frankfurt am Main Germany
- 8Université de Paris, Center for Research on Inflammation, UMR 1149 National Institute for Health and Medical Research (INSERM), Team “From micro to macro in cancer development” Paris France
- 9King's College London School of Biomedical Engineering and Imaging Sciences London UK
- 10Goethe University Frankfurt, University Hospital Department of Cardiology and Angiology Frankfurt am Main Germany
Abstract
Gravitational magnetic resonance elastography (GT‐MRE) enables comprehensive biomechanical liver characterization and may overcome limitations of conventional elastography techniques. This study evaluated the diagnostic performance of two‐ and three‐dimensional (2D and 3D) GT‐MRE compared with 2D acoustic MRE (AC‐MRE) and vibration‐controlled transient elastography (VCTE) for liver fibrosis staging. In this prospective study, patients with suspected or known steatotic liver disease underwent GT‐MRE (2D and 3D, gradient‐echo sequences) and AC‐MRE (2D, spin‐echo echo‐planar imaging) at 1.5 T, plus VCTE with a median interval to MRE of 37 days (IQR, 20–124 days; range, 0–372 days). Statistical analyses included generalized additive models, ordinal logistic regression, and decision tree‐based classification. Diagnostic performance was assessed using cumulative receiver operating characteristic analysis and corresponding areas under the curve (AUCs). Ninety‐one participants (median age, 55 years [IQR, 45–64]; 41 women) were included, of whom 35 (38%) had histopathological correlation. In the biopsy‐confirmed subgroup, 3D GT‐MRE‐derived viscoelastic parameters showed promising exploratory performance for early fibrosis classification. Wave attenuation achieved AUCs of 0.91 for F0 versus ≥ F1 and 0.99 for ≤ F1 versus ≥ F2, while phase angle yielded an AUC of 0.88 for F0 versus ≥ F1, with numerically higher AUCs than conventional stiffness‐based metrics. For advanced fibrosis thresholds, all modalities performed well (AUC ≥ 0.84). Obuchowski measures for 3D‐derived parameters were 0.95–0.96. Internally cross‐validated multiparametric modeling achieved an accuracy of up to 92%. VCTE measurements plateaued beyond F3, whereas AC‐ and GT‐MRE metrics continued to increase with fibrosis severity. 3D GT‐MRE‐derived viscoelastic parameters showed promising performance for liver fibrosis classification and provided biomechanical information complementary to conventional stiffness measurements. Given the limited biopsy‐confirmed sample and marked class imbalance at F0, these findings require validation in larger independent cohorts before clinical implementation.
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BibTeX
@article{gruenewald2026diagnostic,
title = {{Diagnostic Performance of Magnetic Resonance Elastography Versus Vibration‐Controlled Transient Elastography for Liver Fibrosis Staging in Steatotic Liver Disease}},
author = {Leon David Gruenewald and Christian Booz and Jennifer Gotta and Philipp Reschke and Tommaso D'Angelo and Nicole Suarez Ziegengeist and Katerina Torgashov and Laura Hempfling and Scherwin Mahmoudi and Lisa Reisbeck and Renate Maria Hammerstingl and Stefan Zeuzem and Esra Görgülü and Anita Pathil‐Warth and Melis Onay and Eva Herrmann and Iulia Dahmer and Raja Idris and Maria Johanna Gobertina Tetuanui Vehreschild and Katharina Schregel and Christof Matthias Sommer and Sandra Ciesek and Katrin Eichler and Thomas Joseph Vogl and Ralph Sinkus and Sebastian Haberkorn and Vitali Koch},
journal = {Nmr in Biomedicine},
year = {2026},
month = nov,
doi = {10.1002/nbm.70429},
url = {https://doi.org/10.1002/nbm.70429},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Diagnostic Performance of Magnetic Resonance Elastography Versus Vibration‐Controlled Transient Elastography for Liver Fibrosis Staging in Steatotic Liver Disease
AU - Leon David Gruenewald
AU - Christian Booz
AU - Jennifer Gotta
AU - Philipp Reschke
AU - Tommaso D'Angelo
AU - Nicole Suarez Ziegengeist
AU - Katerina Torgashov
AU - Laura Hempfling
AU - Scherwin Mahmoudi
AU - Lisa Reisbeck
AU - Renate Maria Hammerstingl
AU - Stefan Zeuzem
AU - Esra Görgülü
AU - Anita Pathil‐Warth
AU - Melis Onay
AU - Eva Herrmann
AU - Iulia Dahmer
AU - Raja Idris
AU - Maria Johanna Gobertina Tetuanui Vehreschild
AU - Katharina Schregel
AU - Christof Matthias Sommer
AU - Sandra Ciesek
AU - Katrin Eichler
AU - Thomas Joseph Vogl
AU - Ralph Sinkus
AU - Sebastian Haberkorn
AU - Vitali Koch
PY - 2026
DA - 2026/11/03
JO - Nmr in Biomedicine
DO - 10.1002/nbm.70429
UR - https://doi.org/10.1002/nbm.70429
AB - Gravitational magnetic resonance elastography (GT‐MRE) enables comprehensive biomechanical liver characterization and may overcome limitations of conventional elastography techniques. This study evaluated the diagnostic performance of two‐ and three‐dimensional (2D and 3D) GT‐MRE compared with 2D acoustic MRE (AC‐MRE) and vibration‐controlled transient elastography (VCTE) for liver fibrosis staging. In this prospective study, patients with suspected or known steatotic liver disease underwent GT‐MRE (2D and 3D, gradient‐echo sequences) and AC‐MRE (2D, spin‐echo echo‐planar imaging) at 1.5 T, plus VCTE with a median interval to MRE of 37 days (IQR, 20–124 days; range, 0–372 days). Statistical analyses included generalized additive models, ordinal logistic regression, and decision tree‐based classification. Diagnostic performance was assessed using cumulative receiver operating characteristic analysis and corresponding areas under the curve (AUCs). Ninety‐one participants (median age, 55 years [IQR, 45–64]; 41 women) were included, of whom 35 (38%) had histopathological correlation. In the biopsy‐confirmed subgroup, 3D GT‐MRE‐derived viscoelastic parameters showed promising exploratory performance for early fibrosis classification. Wave attenuation achieved AUCs of 0.91 for F0 versus ≥ F1 and 0.99 for ≤ F1 versus ≥ F2, while phase angle yielded an AUC of 0.88 for F0 versus ≥ F1, with numerically higher AUCs than conventional stiffness‐based metrics. For advanced fibrosis thresholds, all modalities performed well (AUC ≥ 0.84). Obuchowski measures for 3D‐derived parameters were 0.95–0.96. Internally cross‐validated multiparametric modeling achieved an accuracy of up to 92%. VCTE measurements plateaued beyond F3, whereas AC‐ and GT‐MRE metrics continued to increase with fibrosis severity. 3D GT‐MRE‐derived viscoelastic parameters showed promising performance for liver fibrosis classification and provided biomechanical information complementary to conventional stiffness measurements. Given the limited biopsy‐confirmed sample and marked class imbalance at F0, these findings require validation in larger independent cohorts before clinical implementation.
SN - 0952-3480
SN - 1099-1492
ER -