{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T04:09:41Z","timestamp":1793246981403,"version":"4.5.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T00:00:00Z","timestamp":1573430400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T00:00:00Z","timestamp":1573430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"crossref","award":["RE 4161\/1-1"],"award-info":[{"award-number":["RE 4161\/1-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"crossref","award":["RE 4161\/1-2"],"award-info":[{"award-number":["RE 4161\/1-2"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"crossref","award":["SFB 1340\/1 Matrix in Vision"],"award-info":[{"award-number":["SFB 1340\/1 Matrix in Vision"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"crossref","award":["SFB 1340\/1 Matrix in Vision"],"award-info":[{"award-number":["SFB 1340\/1 Matrix in Vision"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"crossref","award":["SFB 1340\/1 Matrix in Vision"],"award-info":[{"award-number":["SFB 1340\/1 Matrix in Vision"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"crossref","award":["SFB 1340\/1 Matrix in Vision"],"award-info":[{"award-number":["SFB 1340\/1 Matrix in Vision"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n              <jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>To determine the diagnostic performance, cut-off values, and optimal drive frequency range for staging hepatic fibrosis using tomoelastography by multifrequency MR elastography of the liver and spleen.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This prospective study consecutively enrolled a total of 61 subjects between June 2014 and April 2017: 45 patients with chronic liver disease and proven stage of fibrosis and 16 healthy volunteers. Tomoelastography was performed at 1.5 T using six drive frequencies from 35 to 60 Hz. Cut-off values and AUC were calculated. Shear wave speed (in m\/s) of the liver and spleen was assessed separately and in combination as a surrogate of stiffness.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>For compound multifrequency processing of the liver, cut-off and AUC values by fibrosis stage were as follows: F1, 1.52 m\/s and 0.89; F2, 1.55 m\/s and 0.94; F3, 1.67 m\/s and 0.98; and F4, 1.72 m\/s and 0.98. Diagnostic performance of the best single drive frequencies (45 Hz, 55 Hz, 60 Hz) was similar (mean AUC = 0.95, respectively). Combined analysis of the liver and spleen slightly improved performance at 60 Hz in F4 patients (mean AUC = 0.97 vs. 0.95, <jats:italic>p<\/jats:italic> = 0.03). Full-field-of-view elastograms displayed not only the liver and spleen but also small anatomical structures including the pancreas and major vessels.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Tomoelastography provides full-field-of-view elastograms with unprecedented detail resolution and excellent diagnostic accuracy for staging hepatic fibrosis. Our analysis of single-frequency tomoelastography suggests that scan time can be further reduced in future studies, making tomoelastography easier to implement in clinical routine.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p><jats:italic>\u2022 Tomoelastography provides full-field-of-view elastograms of the abdomen with unprecedented detail resolution and excellent diagnostic accuracy for staging hepatic fibrosis.<\/jats:italic><\/jats:p>\n                <jats:p><jats:italic>\u2022 Diagnostic performance of single-frequency tomoelastography at higher frequencies (45 Hz, 55 Hz, 60 Hz) and compound multifrequency processing are equivalent for staging hepatic fibrosis.<\/jats:italic><\/jats:p>\n                <jats:p><jats:italic>\u2022 Combined assessment of hepatic and splenic stiffness slightly improves diagnostic performance for staging hepatic fibrosis.<\/jats:italic><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00330-019-06471-7","type":"journal-article","created":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T11:02:56Z","timestamp":1573470176000},"page":"1719-1729","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Diagnostic performance of tomoelastography of the liver and spleen for staging hepatic fibrosis"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9741-6736","authenticated-orcid":false,"given":"Rolf","family":"Reiter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiko","family":"Tzsch\u00e4tzsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Schwahofer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Haas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Bayerl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Muche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dieter","family":"Klatt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreyan","family":"Majumdar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meltem","family":"Uyanik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Hamm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Braun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingolf","family":"Sack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Asbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,11]]},"reference":[{"key":"6471_CR1","doi-asserted-by":"crossref","unstructured":"Guo J, B\u00fcning C, Schott E et al (2015) In vivo abdominal magnetic resonance elastography for the assessment of portal hypertension before and after transjugular intrahepatic portosystemic shunt implantation. Invest Radiol 50:347\u2013351","DOI":"10.1097\/RLI.0000000000000136"},{"key":"6471_CR2","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1002\/mrm.24674","volume":"71","author":"S Hirsch","year":"2014","unstructured":"Hirsch S, Guo J, Reiter R et al (2014) MR elastography of the liver and the spleen using a piezoelectric driver, single-shot wave-field acquisition, and multifrequency dual parameter reconstruction. Magn Reson Med 71:267\u2013277","journal-title":"Magn Reson Med"},{"key":"6471_CR3","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1002\/jmri.24165","volume":"39","author":"S Hirsch","year":"2014","unstructured":"Hirsch S, Guo J, Reiter R et al (2014) Towards compression-sensitive magnetic resonance elastography of the liver: sensitivity of harmonic volumetric strain to portal hypertension. J Magn Reson Imaging 39:298\u2013306","journal-title":"J Magn Reson Imaging"},{"key":"6471_CR4","doi-asserted-by":"crossref","unstructured":"Talwalkar JA, Yin M, Venkatesh S et al (2009) Feasibility of in vivo MR elastographic splenic stiffness measurements in the assessment of portal hypertension. AJR Am J Roentgenol 193:122\u2013127","DOI":"10.2214\/AJR.07.3504"},{"key":"6471_CR5","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1148\/radiol.13130128","volume":"269","author":"VY Leung","year":"2013","unstructured":"Leung VY, Shen J, Wong VW et al (2013) Quantitative elastography of liver fibrosis and spleen stiffness in chronic hepatitis B carriers: comparison of shear-wave elastography and transient elastography with liver biopsy correlation. Radiology 269:910\u2013918","journal-title":"Radiology"},{"key":"6471_CR6","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.jacr.2017.02.011","volume":"14","author":"JM Horowitz","year":"2017","unstructured":"Horowitz JM, Kamel IR, Arif-Tiwari H et al (2017) ACR appropriateness criteria \u00ae chronic liver disease. J Am Coll Radiol 14:103\u2013117","journal-title":"J Am Coll Radiol"},{"key":"6471_CR7","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1016\/j.cgh.2014.09.046","volume":"13","author":"S Singh","year":"2015","unstructured":"Singh S, Venkatesh SK, Wang Z et al (2015) Diagnostic performance of magnetic resonance elastography in staging liver fibrosis: a systematic review and meta-analysis of individual participant data. Clin Gastroenterol Hepatol 13:440\u2013451","journal-title":"Clin Gastroenterol Hepatol"},{"key":"6471_CR8","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1016\/j.cgh.2007.06.012","volume":"5","author":"M Yin","year":"2007","unstructured":"Yin M, Talwalkar JA, Glaser KJ et al (2007) Assessment of hepatic fibrosis with magnetic resonance elastography. Clin Gastroenterol Hepatol 5:1207\u20131213","journal-title":"Clin Gastroenterol Hepatol"},{"key":"6471_CR9","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1053\/j.gastro.2008.03.076","volume":"135","author":"L Huwart","year":"2008","unstructured":"Huwart L, Sempoux C, Vicaut E et al (2008) Magnetic resonance elastography for the noninvasive staging of liver fibrosis. Gastroenterology 135:32\u201340","journal-title":"Gastroenterology"},{"key":"6471_CR10","doi-asserted-by":"publisher","first-page":"1665","DOI":"10.1016\/j.jbiomech.2014.02.034","volume":"47","author":"R Reiter","year":"2014","unstructured":"Reiter R, Freise C, J\u00f6hrens K et al (2014) Wideband MRE and static mechanical indentation of human liver specimen: sensitivity of viscoelastic constants to the alteration of tissue structure in hepatic fibrosis. J Biomech 47:1665\u20131674","journal-title":"J Biomech"},{"key":"6471_CR11","doi-asserted-by":"crossref","unstructured":"Hirsch S, Braun J, Sack I (2017) Magnetic resonance elastography, 1st edn. Wiley, Weinheim","DOI":"10.1002\/9783527696017"},{"key":"6471_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.media.2016.01.001","volume":"30","author":"H Tzsch\u00e4tzsch","year":"2016","unstructured":"Tzsch\u00e4tzsch H, Guo J, Dittmann F et al (2016) Tomoelastography by multifrequency wave number recovery from time-harmonic propagating shear waves. Med Image Anal 30:1\u201310","journal-title":"Med Image Anal"},{"key":"6471_CR13","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1148\/radiol.2018170601","volume":"286","author":"P Kennedy","year":"2018","unstructured":"Kennedy P, Wagner M, Cast\u00e9ra L et al (2018) Quantitative elastography methods in liver disease: current evidence and future directions. Radiology 286:738\u2013763","journal-title":"Radiology"},{"key":"6471_CR14","doi-asserted-by":"publisher","unstructured":"Reiter R, Wetzel M, Hamesch K et al (2018) Comparison of non-invasive assessment of liver fibrosis in patients with alpha1-antitrypsin deficiency using magnetic resonance elastography (MRE), acoustic radiation force impulse (ARFI) Quantification, and 2D-shear wave elastography (2D-SWE). PLoS One. https:\/\/doi.org\/10.1371\/journal.pone.0196486","DOI":"10.1371\/journal.pone.0196486"},{"key":"6471_CR15","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.1016\/j.ultrasmedbio.2015.12.026","volume":"42","author":"S Ipek-Ugay","year":"2016","unstructured":"Ipek-Ugay S, Tzsch\u00e4tzsch H, Hudert C et al (2016) Time harmonic elastography reveals sensitivity of liver stiffness to water ingestion. Ultrasound Med Biol 42:1289\u20131294","journal-title":"Ultrasound Med Biol"},{"key":"6471_CR16","doi-asserted-by":"publisher","first-page":"976","DOI":"10.1002\/mrm.26484","volume":"78","author":"F Dittmann","year":"2017","unstructured":"Dittmann F, Tzsch\u00e4tzsch H, Hirsch S et al (2017) Tomoelastography of the abdomen: tissue mechanical properties of the liver, spleen, kidney, and pancreas from single MR elastography scans at different hydration states. Magn Reson Med 78:976\u2013983","journal-title":"Magn Reson Med"},{"key":"6471_CR17","doi-asserted-by":"publisher","first-page":"1208","DOI":"10.1016\/j.acra.2012.05.009","volume":"19","author":"MA Fischer","year":"2012","unstructured":"Fischer MA, Raptis DA, Montani M et al (2012) Liver fat quantification by dual-echo MR imaging outperforms traditional histopathological analysis. Acad Radiol 19:1208\u20131214","journal-title":"Acad Radiol"},{"key":"6471_CR18","doi-asserted-by":"crossref","unstructured":"Desmet VJ, Gerber M, Hoofnagle JH, Manns M, Scheuer PJ (1994) Classification of chronic hepatitis: diagnosis, grading and staging. Hepatology 19:1513\u20131520","DOI":"10.1002\/hep.1840190629"},{"key":"6471_CR19","doi-asserted-by":"publisher","first-page":"837","DOI":"10.2307\/2531595","volume":"44","author":"ER DeLong","year":"1988","unstructured":"DeLong ER, DeLong DM, Clarke-Pearson DL (1988) Comparing the areas under two or more correlated receiver operating characteristic curves\u00a0: a nonparametric approach. Biometrics 44:837\u2013845","journal-title":"Biometrics"},{"key":"6471_CR20","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1148\/radiol.10092489","volume":"257","author":"P Asbach","year":"2010","unstructured":"Asbach P, Klatt D, Schlosser B et al (2010) Viscoelasticity-based staging of hepatic fibrosis with multifrequency MR elastography. Radiology 257:80\u201386","journal-title":"Radiology"},{"key":"6471_CR21","doi-asserted-by":"publisher","first-page":"1356","DOI":"10.1002\/jmri.23585","volume":"35","author":"R Rustogi","year":"2012","unstructured":"Rustogi R, Horowitz J, Harmath C et al (2012) Accuracy of MR elastography and anatomic MR imaging features in the diagnosis of severe hepatic fibrosis and cirrhosis. J Magn Reson Imaging 35:1356\u20131364","journal-title":"J Magn Reson Imaging"},{"key":"6471_CR22","doi-asserted-by":"crossref","unstructured":"Guo Y, Parthasarathy S, Goyal P, McCarthy RJ, Larson AC, Miller FH (2014) Magnetic resonance elastography and acoustic radiation force impulse for staging hepatic fibrosis: a meta-analysis. Abdom Imaging 40:818\u2013834","DOI":"10.1007\/s00261-014-0137-6"},{"key":"6471_CR23","doi-asserted-by":"publisher","first-page":"1431","DOI":"10.1007\/s00330-015-3949-z","volume":"26","author":"S Singh","year":"2016","unstructured":"Singh S, Venkatesh SK, Loomba R et al (2016) Magnetic resonance elastography for staging liver fibrosis in non-alcoholic fatty liver disease: a diagnostic accuracy systematic review and individual participant data pooled analysis. Eur Radiol 26:1431\u20131440","journal-title":"Eur Radiol"},{"key":"6471_CR24","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1097\/RLI.0000000000000529","volume":"54","author":"CA Hudert","year":"2018","unstructured":"Hudert CA, Tzsch\u00e4tzsch H, Rudolph B et al (2018) Tomoelastography for the evaluation of pediatric nonalcoholic fatty liver disease. Invest Radiol 54:198\u2013203","journal-title":"Invest Radiol"},{"key":"6471_CR25","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.1002\/mrm.26769","volume":"79","author":"F Dittmann","year":"2017","unstructured":"Dittmann F, Reiter R, Guo J et al (2017) Tomoelastography of the prostate using multifrequency MR elastography and externally placed pressurized-air drivers. Magn Reson Med 79:1325\u20131333","journal-title":"Magn Reson Med"},{"key":"6471_CR26","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1097\/RLI.0000000000000511","volume":"54","author":"SR Marticorena Garcia","year":"2019","unstructured":"Marticorena Garcia SR, Grossmann M, Bruns A et al (2019) Tomoelastography paired with T2* magnetic resonance imaging detects lupus nephritis with normal renal function. Invest Radiol 54:89\u201397","journal-title":"Invest Radiol"}],"container-title":["European Radiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-019-06471-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00330-019-06471-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-019-06471-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,10]],"date-time":"2020-11-10T00:18:53Z","timestamp":1604967533000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s00330-019-06471-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,11]]},"references-count":26,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["6471"],"URL":"https:\/\/doi.org\/10.1007\/s00330-019-06471-7","relation":{},"ISSN":["0938-7994","1432-1084"],"issn-type":[{"value":"0938-7994","type":"print"},{"value":"1432-1084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,11]]},"assertion":[{"value":"16 July 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 August 2019","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 September 2019","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 November 2019","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The scientific guarantor of this publication is Rolf Reiter, MD.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor"}},{"value":"The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Meltem Uyanik, MS, from the Richard and Loan Hill Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA, kindly provided statistical advice and is one of the co-authors of this manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was obtained from all subjects in this study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Some study subjects (healthy volunteers) have been previously reported (Reiter R, Wetzel M, Hamesch K, et al (2018) Comparison of non-invasive assessment of liver fibrosis in patients with alpha1-antitrypsin deficiency using magnetic resonance elastography (MRE), acoustic radiation force impulse (ARFI) Quantification, and 2D-shear wave elastography (2D-SWE). PLOS ONE. DOI:10.1371\/journal.pone.0196486.) The same MR elastography raw data were acquired for all healthy volunteers in both studies; however, there are differences in the analyzed frequency range (30\u201360 Hz vs 35\u201360 Hz) and the postprocessing pipeline. There is no subject overlap in the patient population as our prior study only investigated patients with alpha1-antitrypsin deficiency\u2013based liver fibrosis without biopsy.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"value":"\u2022 prospective\u2022 diagnostic accuracy study and experimental\u2022 performed at one institution","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}