Harnessing Intrinsic Cardiac Motion vs. External Mechanical Vibrations: A Comparison of MRI Cine-Tagging and MR Elastography for Liver Fibrosis Assessment.

Objective: This study aims to assess and compare the diagnostic accuracy of MRI cine-tagging and magnetic resonance elastography (MRE) for staging histologically confirmed liver fibrosis in patients with chronic liver disease.

Methods: MRI cine-tagging evaluates liver strain as the deformation induced by intrinsic cardiac motion on the left liver lobe, whereas MRE captures liver stiffness in response to externally applied vibrations from a mechanical driver. A head-to-head comparison of MRI cine-tagging and MRE was performed in 76 participants with biopsy-proven chronic liver disease. Spearman's rank correlation coefficients and areas under the receiver operating characteristic curve (AUC) were assessed. AUCs were compared using the Delong method.

Results: MRE-derived shear modulus increased, while strain obtained from tagged cine MRI decreased with higher fibrosis stages (ρ = 0.73 and ρ=-0.67, respectively; P < 0.0001). Both shear modulus and strain values exhibited significant differences across fibrosis stages (P < 0.0001) and correlated with each other (ρ=-0.44, P < 0.0001). MRE provided higher AUCs than MRI cine-tagging only for distinguishing stages ≤F3 vs. F4 (0.91 vs. 0.87, P = 0.043). There were no significant differences in AUCs for differentiating other dichotomized fibrosis stages, including stages F0 vs. ≥F1 (0.87 vs. 0.81, P = 0.083), ≤F1 vs. ≥F2 (0.84 vs. 0.84, P = 0.889), and ≤F2 vs. ≥F3 (0.89 vs. 0.86, P = 0.116).

Conclusion: MRI cine-tagging provided a similar diagnostic performance compared to MRE for staging liver fibrosis, except for the diagnosis of cirrhosis (F4). It is possible to assess liver strain as part of abdominal MRI screening, offering additional insight into the left lobe without the need for additional equipment.

Advances in knowledge: A head-to-head comparison of magnetic resonance elastography (MRE), the most accurate technique for the noninvasive staging of liver fibrosis, and MRI cine-tagging has not been performed yet. We found that MRI cine-tagging, having the advantage of not requiring any additional hardware, provides a similar diagnostic performance compared to MRE for staging liver fibrosis, except for the diagnosis of cirrhosis in patients with chronic liver disease.