Title: Reliability Assessment of CT Enhancement Rate and Extracellular Volume in Liver
Fibrosis Prediction
Version: 2 Date: 20 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The key terms like “fEES” and the calculation methods should be explained more clearly. A
concise definition or a diagram could help make the concepts more digestible.
-Provide more detailed references to specific studies or meta-analyses that directly compare
imaging biomarkers (such as ECV and VP-ER) with liver biopsy results in fibrosis staging. This
could offer a clearer context for the study's novelty and importance.
-Include a power analysis or discuss the rationale behind the chosen sample size, ensuring the
study has adequate power to detect significant relationships.
-Discuss how potential confounders, such as comorbidities or medications, were controlled for
or acknowledged in the study design and analysis.
-Mention the inter-observer or intra-observer reliability of ROI placement to assure readers of
the consistency and accuracy of the imaging measurements.
-Provide more detailed context for the AUC values, explaining their diagnostic relevance in
more clinical terms.
-More critical analysis of why VP-ER had a lower AUC than ECV, and why previous studies
may have found different results, would add depth to the discussion. For example, factors like
the phase of CT imaging or patient characteristics (e.g., comorbidities) may influence diagnostic
performance.
-Provide more details on the inherent limitations of liver biopsy, such as sampling errors or
variability between pathologists, which may affect the comparison between imaging biomarkers
and biopsy findings.
Title: Reliability Assessment of CT Enhancement Rate and Extracellular Volume in Liver
Fibrosis Prediction
Version: 2 Date: 20 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The key terms like “fEES” and the calculation methods should be explained more clearly. A
concise definition or a diagram could help make the concepts more digestible.
-Provide more detailed references to specific studies or meta-analyses that directly compare
imaging biomarkers (such as ECV and VP-ER) with liver biopsy results in fibrosis staging. This
could offer a clearer context for the study's novelty and importance.
-Include a power analysis or discuss the rationale behind the chosen sample size, ensuring the
study has adequate power to detect significant relationships.
-Discuss how potential confounders, such as comorbidities or medications, were controlled for
or acknowledged in the study design and analysis.
-Mention the inter-observer or intra-observer reliability of ROI placement to assure readers of
the consistency and accuracy of the imaging measurements.
-Provide more detailed context for the AUC values, explaining their diagnostic relevance in
more clinical terms.
-More critical analysis of why VP-ER had a lower AUC than ECV, and why previous studies
may have found different results, would add depth to the discussion. For example, factors like
the phase of CT imaging or patient characteristics (e.g., comorbidities) may influence diagnostic
performance.
-Provide more details on the inherent limitations of liver biopsy, such as sampling errors or
variability between pathologists, which may affect the comparison between imaging biomarkers
and biopsy findings.
Please review this paper.
user
Title: Reliability Assessment of CT Enhancement Rate and Extracellular Volume in Liver
Fibrosis Prediction
Version: 2 Date: 20 Dec 2024
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The key terms like “fEES” and the calculation methods should be explained more clearly. A
concise definition or a diagram could help make the concepts more digestible.
-Provide more detailed references to specific studies or meta-analyses that directly compare
imaging biomarkers (such as ECV and VP-ER) with liver biopsy results in fibrosis staging. This
could offer a clearer context for the study's novelty and importance.
-Include a power analysis or discuss the rationale behind the chosen sample size, ensuring the
study has adequate power to detect significant relationships.
-Discuss how potential confounders, such as comorbidities or medications, were controlled for
or acknowledged in the study design and analysis.
-Mention the inter-observer or intra-observer reliability of ROI placement to assure readers of
the consistency and accuracy of the imaging measurements.
-Provide more detailed context for the AUC values, explaining their diagnostic relevance in
more clinical terms.
-More critical analysis of why VP-ER had a lower AUC than ECV, and why previous studies
may have found different results, would add depth to the discussion. For example, factors like
the phase of CT imaging or patient characteristics (e.g., comorbidities) may influence diagnostic
performance.
-Provide more details on the inherent limitations of liver biopsy, such as sampling errors or
variability between pathologists, which may affect the comparison between imaging biomarkers
and biopsy findings.
assistant