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Diagnostics
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Recent Advances in Liver Diseases Diagnosis
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Recent Advances in Liver Diseases Diagnosis

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (15 February 2023) | Viewed by 18079

Special Issue Editor

Prof. Dr. Armand Abergel

E-Mail Website
Guest Editor
Department of Digestive and Hepatobiliary Medecine, CHU Clermont-Ferrand, Clermont-Ferrand, France
Interests: hepatology; liver diseases

Special Issue Information

Dear Colleagues,

The main goal of this Special Issue is to publish review articles presenting recent advances on non-invasive diagnosis and treatment of liver diseases. Potential topics include (but are not limited to) the following thematic areas:

(1) Steatosis, noninvasive diagnosis;

(2) Radiomics: Is it useful in the differential diagnosis of liver tumors?

(3) Noninvasive diagnosis of Wilson disease and alpha-1 antitrypsin deficiency;

(4) Hyperferritinemia: the role of MRI and genetics in the diagnosis and treatment;

(5)  Screening of fibrosis in the general population. Where do we stand in 2022?

(6) New tools in the diagnosis and treatment of hepatitis B;

(7) Predictive response to immunotherapy in patients with hepatocellular carcinoma: is there any hope?

(8) Microbiota in liver diseases.

The submission deadline has been set to 1 March 2022. You may send your manuscript at any time between now and the deadline.

Prof. Dr. Armand Abergel
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (7 papers)

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Research

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12 pages, 1135 KiB  
Article
Autoantibodies Associated with Autoimmune Liver Diseases in a Healthy Population: Evaluation of a Commercial Immunoblot Test
by Awais Ahmad, Charlotte Dahle, Johan Rönnelid, Christopher Sjöwall and Stergios Kechagias
Diagnostics 2022, 12(7), 1572; https://doi.org/10.3390/diagnostics12071572 - 28 Jun 2022
Cited by 2 | Viewed by 1946
Abstract
Autoantibodies constitute important tools for diagnosing the autoimmune liver diseases (AILD) autoimmune hepatitis and primary biliary cholangitis. The EUROLINE immunoblot assay, detecting multiple specificities, is widely used, but the clinical importance of weakly positive findings is unclear. The manufacturer’s recommended cut-off was evaluated [...] Read more.
Autoantibodies constitute important tools for diagnosing the autoimmune liver diseases (AILD) autoimmune hepatitis and primary biliary cholangitis. The EUROLINE immunoblot assay, detecting multiple specificities, is widely used, but the clinical importance of weakly positive findings is unclear. The manufacturer’s recommended cut-off was evaluated by investigating AILD-associated autoantibodies in 825 blood donors and 60 confirmed AILD cases. Positive findings were followed up with immunofluorescence microscopy on rat tissue, anti-M2-ELISA, alternative immunoblot assay, and liver function tests. Thirty-six (4.4%) blood donors were positive with EUROLINE. The most common specificities were LC-1 (1.6%), gp210 (1.3%), and AMA-M2 (1.1%). In general, the positive results were higher in patients than in blood donors, whereas anti-LC-1 was higher in blood donors. The liver function tests were slightly elevated in 2 of the 36 immunoblot positive blood donors. The majority of the positive EUROLINE findings could not be confirmed with the follow-up tests. The EUROLINE-Autoimmune Liver Diseases-(IgG) immunoblot detected autoantibodies in 4.4% of blood donors without signs of AILD. Our findings indicate that the recommended cut-off can be raised for most specificities without loss of diagnostic sensitivity. The prevalence of anti-LC-1 among blood donors indicates a problem with the antigen source. Full article
(This article belongs to the Special Issue Recent Advances in Liver Diseases Diagnosis)
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11 pages, 835 KiB  
Article
Detection of Incomplete Irreversible Electroporation (IRE) and Microwave Ablation (MWA) of Hepatocellular Carcinoma (HCC) Using Iodine Quantification in Dual Energy Computed Tomography (DECT)
by Wolf Bäumler, Lukas Philipp Beyer, Lukas Lürken, Philipp Wiggermann, Christian Stroszczynski, Marco Dollinger and Andreas Schicho
Diagnostics 2022, 12(4), 986; https://doi.org/10.3390/diagnostics12040986 - 14 Apr 2022
Cited by 2 | Viewed by 1667
Abstract
Early detection of local tumor progression (LTP) after irreversible electroporation (IRE) and microwave ablation (MWA) of hepatocellular carcinoma (HCC) remains challenging. The goal of this study was to identify cases with insufficient ablation and prevent HCC recurrencies by measuring iodine uptake using dual-energy [...] Read more.
Early detection of local tumor progression (LTP) after irreversible electroporation (IRE) and microwave ablation (MWA) of hepatocellular carcinoma (HCC) remains challenging. The goal of this study was to identify cases with insufficient ablation and prevent HCC recurrencies by measuring iodine uptake using dual-energy computed tomography (DECT). In 54 HCC-patients, the volumetric iodine concentration (VIC) of the central and peripheral ablation area was evaluated by DECT within 24 h after IRE or MWA. Follow-up was performed with CT and/or MRI at 6 weeks, 3, 6, 9, and 12 months, respectively. In both groups, LTP was solely detected in the peripheral area (IRE: n = 4; MWA: n = 4) and LTP patients showed significantly higher VIC values in the peripheral zone than patients without LTP (IRE: * p = 0.0005; MWA: * p = 0.000). In IRE-LTP patients, no significant difference between the VIC values of non-ablated liver tissue and the peripheral zone was detected (p = 0.155). The peripheral zones of IRE patients without LTP (* p = 0.000) and MWA patients, irrespective of the presence of LTP (LTP: * p = 0.005; without LTP: * p = 0.000), showed significantly lower VIC values than non-ablated liver parenchyma. Higher BCLC tumor stages were indicative for LTP (* p = 0.008). The study suggests that elevated iodine uptake in the peripheral ablation zone could help identify LTP after IRE and MWA of HCC. Full article
(This article belongs to the Special Issue Recent Advances in Liver Diseases Diagnosis)
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13 pages, 4587 KiB  
Article
Segmental Distribution of Hepatocellular Carcinoma in Cirrhotic Livers
by Matteo Renzulli, Nicolò Brandi, Anna Pecorelli, Luigi Vincenzo Pastore, Alessandro Granito, Giuseppe Martinese, Francesco Tovoli, Mario Simonetti, Elton Dajti, Antonio Colecchia and Rita Golfieri
Diagnostics 2022, 12(4), 834; https://doi.org/10.3390/diagnostics12040834 - 29 Mar 2022
Cited by 8 | Viewed by 2027
Abstract
Background: To evaluate the segmental distribution of hepatocellular carcinoma (HCC) according to Couinaud’s anatomical division in cirrhotic patients. Methods: Between 2020 and 2021, a total of 322 HCC nodules were diagnosed in 217 cirrhotic patients who underwent computed tomography (CT) or magnetic resonance [...] Read more.
Background: To evaluate the segmental distribution of hepatocellular carcinoma (HCC) according to Couinaud’s anatomical division in cirrhotic patients. Methods: Between 2020 and 2021, a total of 322 HCC nodules were diagnosed in 217 cirrhotic patients who underwent computed tomography (CT) or magnetic resonance imaging (MRI) for the evaluation of suspicious nodules (>1 cm) detected during ultrasound surveillance. For each patient, the segmental position of the HCC nodule was recorded according to Couinaud’s description. The clinical data and nodule characteristics were collected. Results: A total of 234 (72.7%) HCC nodules were situated in the right lobe whereas 79 (24.5%) were detected in the left lobe (p < 0.0001) and only 9 nodules were in the caudate lobe (2.8%). HCC was most common in segment 8 (n = 88, 27.4%) and least common in segment 1 (n = 9, 2.8%). No significant differences were found in the frequencies of segmental or lobar involvement considering patient demographic and clinical characteristics, nodule dimension, or disease appearance. Conclusions: The intrahepatic distribution of HCC differs among Couinaud’s segments, with segment 8 being the most common location and segment 1 being the least common. The segmental distribution of tumour location was similar to the normal liver volume distribution, supporting a possible correlation between HCC location and the volume of hepatic segments and/or the volumetric distribution of the portal blood flow. Full article
(This article belongs to the Special Issue Recent Advances in Liver Diseases Diagnosis)
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10 pages, 8978 KiB  
Article
Assessment of Liver Fat: Dual-Energy CT versus Conventional CT with and without Contrast
by Jack Junchi Xu, Mikkel Ranum Boesen, Sofie Lindskov Hansen, Peter Sommer Ulriksen, Søren Holm, Lars Lönn and Kristoffer Lindskov Hansen
Diagnostics 2022, 12(3), 708; https://doi.org/10.3390/diagnostics12030708 - 14 Mar 2022
Cited by 7 | Viewed by 3417
Abstract
We assessed the correlation between liver fat percentage using dual-energy CT (DECT) and Hounsfield unit (HU) measurements in contrast and non-contrast CT. This study included 177 patients in two patient groups: Group A (n = 125) underwent whole body non-contrast DECT and [...] Read more.
We assessed the correlation between liver fat percentage using dual-energy CT (DECT) and Hounsfield unit (HU) measurements in contrast and non-contrast CT. This study included 177 patients in two patient groups: Group A (n = 125) underwent whole body non-contrast DECT and group B (n = 52) had a multiphasic DECT including a conventional non-contrast CT. Three regions of interest were placed on each image series, one in the left liver lobe and two in the right to measure Hounsfield Units (HU) as well as liver fat percentage. Linear regression analysis was performed for each group as well as combined. Receiver operating characteristic (ROC) curve was generated to establish the optimal fat percentage threshold value in DECT for predicting a non-contrast threshold of 40 HU correlating to moderate-severe liver steatosis. We found a strong correlation between fat percentage found with DECT and HU measured in non-contrast CT in group A and B individually (R2 = 0.81 and 0.86, respectively) as well as combined (R2 = 0.85). No significant difference was found when comparing venous and arterial phase DECT fat percentage measurements in group B (p = 0.67). A threshold of 10% liver fat found with DECT had 95% sensitivity and 95% specificity for the prediction of a 40 HU threshold using non-contrast CT. In conclusion, liver fat quantification using DECT shows high correlation with HU measurements independent of scan phase. Full article
(This article belongs to the Special Issue Recent Advances in Liver Diseases Diagnosis)
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Review

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11 pages, 1333 KiB  
Review
Radiomics, a Promising New Discipline: Example of Hepatocellular Carcinoma
by Thomas Lévi-Strauss, Bettina Tortorici, Olivier Lopez, Philippe Viau, Dann J. Ouizeman, Baptiste Schall, Xavier Adhoute, Olivier Humbert, Patrick Chevallier, Philippe Gual, Lionel Fillatre and Rodolphe Anty
Diagnostics 2023, 13(7), 1303; https://doi.org/10.3390/diagnostics13071303 - 30 Mar 2023
Cited by 1 | Viewed by 1584
Abstract
Radiomics is a discipline that involves studying medical images through their digital data. Using “artificial intelligence” algorithms, radiomics utilizes quantitative and high-throughput analysis of an image’s textural richness to obtain relevant information for clinicians, from diagnosis assistance to therapeutic guidance. Exploitation of these [...] Read more.
Radiomics is a discipline that involves studying medical images through their digital data. Using “artificial intelligence” algorithms, radiomics utilizes quantitative and high-throughput analysis of an image’s textural richness to obtain relevant information for clinicians, from diagnosis assistance to therapeutic guidance. Exploitation of these data could allow for a more detailed characterization of each phenotype, for each patient, making radiomics a new biomarker of interest, highly promising in the era of precision medicine. Moreover, radiomics is non-invasive, cost-effective, and easily reproducible in time. In the field of oncology, it performs an analysis of the entire tumor, which is impossible with a single biopsy but is essential for understanding the tumor’s heterogeneity and is known to be closely related to prognosis. However, current results are sometimes less accurate than expected and often require the addition of non-radiomics data to create a performing model. To highlight the strengths and weaknesses of this new technology, we take the example of hepatocellular carcinoma and show how radiomics could facilitate its diagnosis in difficult cases, predict certain histological features, and estimate treatment response, whether medical or surgical. Full article
(This article belongs to the Special Issue Recent Advances in Liver Diseases Diagnosis)
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18 pages, 555 KiB  
Review
Wilson Disease and Alpha1-Antitrypsin Deficiency: A Review of Non-Invasive Diagnostic Tests
by Olivier Guillaud, Jérôme Dumortier, Eduardo Couchonnal-Bedoya and Mathias Ruiz
Diagnostics 2023, 13(2), 256; https://doi.org/10.3390/diagnostics13020256 - 10 Jan 2023
Cited by 2 | Viewed by 2553
Abstract
Wilson disease and alpha1-antitrypsin deficiency are two rare genetic diseases that may impact predominantly the liver and/or the brain, and the liver and/or the lung, respectively. The early diagnosis of these diseases is important in order to initiate a specific treatment, when available, [...] Read more.
Wilson disease and alpha1-antitrypsin deficiency are two rare genetic diseases that may impact predominantly the liver and/or the brain, and the liver and/or the lung, respectively. The early diagnosis of these diseases is important in order to initiate a specific treatment, when available, ideally before irreversible organ damage, but also to initiate family screening. This review focuses on the non-invasive diagnostic tests available for clinicians in both diseases. These tests are crucial at diagnosis to reduce the potential diagnostic delay and assess organ involvement. They also play a pivotal role during follow-up to monitor disease progression and evaluate treatment efficacy of current or emerging therapies. Full article
(This article belongs to the Special Issue Recent Advances in Liver Diseases Diagnosis)
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15 pages, 1063 KiB  
Review
Screening for Liver Fibrosis in the General Population: Where Do We Stand in 2022?
by Clémence M. Canivet and Jérôme Boursier
Diagnostics 2023, 13(1), 91; https://doi.org/10.3390/diagnostics13010091 - 28 Dec 2022
Cited by 11 | Viewed by 3908
Abstract
Approximately 30% of the worldwide population has at least one risk factor for liver disease. Identifying advanced liver disease before the occurrence of complications remains a difficult challenge in clinical practice, where diagnosis comes too late for many patients, at the time of [...] Read more.
Approximately 30% of the worldwide population has at least one risk factor for liver disease. Identifying advanced liver disease before the occurrence of complications remains a difficult challenge in clinical practice, where diagnosis comes too late for many patients, at the time of liver decompensation or palliative hepatocellular carcinoma, with poor short-term prognosis. Noninvasive, blood- or elastography-based tests of liver fibrosis (NITs) have been developed for the early diagnosis of advanced liver fibrosis. Recent population-based studies evaluating the screening of liver fibrosis with these NITs have provided important information on at-risk groups that should be targeted. New measures based on the sequential use of NITs help to better organize the referral of at-risk patients to the liver specialist. However, energizing these measures will require increased awareness of both chronic liver diseases and the use of NITs among non-specialists. Full article
(This article belongs to the Special Issue Recent Advances in Liver Diseases Diagnosis)
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