Comparison of the diagnostic performance of 2D and 3D MR elastography in staging liver fibrosis

Mengsi Li, Hao Yang, Yong Liu, Linqi Zhang, Jingbiao Chen, Ying Deng, Yuanqiang Xiao, Jie Zhu, Zhuoya Yi, Bing Hu, Sichi Kuang, Bingjun He, Kevin J. Glaser, Meng Yin, Sudhakar K. Venkatesh, Richard L. Ehman, Jin Wang

Research output: Contribution to journalArticlepeer-review


Objectives: To compare the diagnostic performance and image quality of state-of-the-art 2D MR elastography (MRE) and 3D MRE in the basic application of liver fibrosis staging. Methods: This retrospective study assessed data from 293 patients who underwent 2D and 3D MRE examinations. MRE image quality was assessed with a qualitative 2-point grading system by evaluating artifacts. Two experienced analysts independently measured mean liver stiffness values. The interobserver agreement of liver stiffness measurement was assessed by the intraclass correlation coefficient (ICC). The area under the receiver operating characteristic curve (AUC) was used to assess the diagnostic performance of 2D and 3D MRE and blood-based markers for fibrosis staging using the pathology-proven liver fibrosis stage as the gold standard. Results: The image quality provided by 3D MRE was graded as significantly higher than that obtained with the 2D MRE method (p < 0.01). Interobserver agreement in liver stiffness measurements was higher for 3D MRE (ICC: 3D 0.979 vs 2D 0.955). The AUC values for discriminating ≥ F1, ≥ F2, ≥ F3, and F4 fibrosis for 3D MRE (0.89, 0.92, 0.95, and 0.93) were similar to those for 2D MRE (0.89, 0.91, 0.94, and 0.92). Both the 2D and 3D MRE methods provided superior accuracy to the blood-based biomarkers, including APRI, FIB-4, and Forns index, especially for ≥ F2, ≥ F3, and F4 fibrosis stages (all p < 0.01). Conclusions: While 3D MRE offers certain advantages and opportunities for new applications of MRE, current widely deployed 2D MRE technology has comparable performance in the basic application of detecting and staging liver fibrosis. Key Points: • 2D MRE and 3D MRE have comparable diagnostic performance in detecting and staging liver fibrosis. • 3D MRE has superior image quality and interobserver agreement compared to 2D MRE.

Original languageEnglish (US)
Pages (from-to)9468-9478
Number of pages11
JournalEuropean radiology
Issue number12
StatePublished - Dec 2021


  • 2D and 3D MRE
  • Fibrosis
  • MR elastography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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