ABSTRACT
PURPOSE: To evaluate magnetic resonance elastography (MRE)-based liver stiffness measurement as a biomarker to predict the onset of cirrhosis in early-stage alcohol-related liver disease (ALD) patients, and the transition from compensated to decompensated cirrhosis in ALD. METHODS: Patients with ALD and at least one MRE examination between 2007 and 2020 were included in this study. Patient demographics, liver chemistries, MELD score (within 30 days of the first MRE), and alcohol abstinence history were collected from the electronic medical records. Liver stiffness and fat fraction were measured. Disease progression was assessed in the records by noting cirrhosis onset in early-stage ALD patients and decompensation in those initially presenting with compensated cirrhosis. Nomograms and cut-off values of liver stiffness, derived from Cox proportional hazards models were created to predict the likelihood of advancing to cirrhosis or decompensation. RESULTS: A total of 182 patients (132 men, median age 57 years) were included in this study. Among 110 patients with early-stage ALD, 23 (20.9%) developed cirrhosis after a median follow-up of 6.2 years. Among 72 patients with compensated cirrhosis, 33 (45.8%) developed decompensation after a median follow-up of 4.2 years. MRE-based liver stiffness, whether considered independently or adjusted for age, alcohol abstinence, fat fraction, and sex, was a significant and independent predictor for both future cirrhosis (Hazard ratio [HR] = 2.0-2.2, p = 0.002-0.003) and hepatic decompensation (HR = 1.2-1.3, p = 0.0001-0.006). Simplified Cox models, thresholds, and corresponding nomograms were devised for practical use, excluding non-significant or biased variables. CONCLUSIONS: MRE-based liver stiffness assessment is a useful predictor for the development of cirrhosis or decompensation in patients with ALD.
Subject(s)
Elasticity Imaging Techniques , Humans , Elasticity Imaging Techniques/methods , Male , Female , Middle Aged , Liver Diseases, Alcoholic/diagnostic imaging , Liver Diseases, Alcoholic/complications , Liver Cirrhosis/diagnostic imaging , Liver Cirrhosis/complications , Retrospective Studies , Disease Progression , Predictive Value of Tests , Liver/diagnostic imaging , Aged , AdultABSTRACT
Phase-modulator-generated laser for Raman transition is widely used in atom gravimeters to simplify a system and improve robustness. However, the induced additional sidebands (ASBs) lead to systematic errors in gravity measurement. This work presents a novel, to our knowledge, method to generate an optical single-sideband (OSSB) laser for Raman transition through phase modulation based on a Faraday anomalous dispersion atomic filter (FADOF). The experimental result indicates that it can reduce the additional sidebands with a signal-to-noise ratio (SNR, the intensity ratio of carrier and unwanted sidebands) of better than 50â dB, and the phase shift caused by ASBs is demonstrated to be effectively suppressed from 358.8 to 2.2â mrad. Furthermore, this system has already been applied on an atom gravimeter to achieve a primary gravity measurement. It shows that the FADOF-based Raman laser system is a new scheme for a compact atom absolute gravimeter.