Multiparametric MRI Effective for Fatty Liver Assessment

A new study concludes that non-invasive multiparametric magnetic resonance imaging (MRI) liver scanning technology could halve the number of potential liver biopsies required.

Researchers at the University of Birmingham (UB; United Kingdom), the University of Oxford (United Kingdom), and other institutions conducted a study to investigate the performance and cost of the Perspectum Diagnostics LiverMultiScan multiparametric MRI device, which is designed to enable non-invasive and quantitative liver fat characterization, especially in non-alcoholic fatty liver disease (NAFLD).

For the study, 50 patients and six healthy volunteers underwent multiparametric MRI, blood sampling, and transient elastography within two weeks of liver biopsy. A summary of three biochemical liver characteristics, as well as the LiverMultiScan images, was then compared to histology as the gold standard. The results revealed that LiverMultiScan accurately identified patients with steatosis, stratified those with non-alcoholic steatohepatitis (NASH) or simple steatosis, and reliably excluded clinically significant liver disease. The study was published in the March 2018 issue of Alimentary Pharmacology and Therapeutics.

“Whilst liver biopsy remains an important part of advanced hepatology practice, clearly we need better non-invasive tools at our disposal to evaluate the nature and severity of liver disease,” said senior author Professor Gideon Hirschfield, MD, of the University of Birmingham. “In this work we were able to compare and contrast different approaches to this challenging problem, and show where scanning technology could help contribute to optimized diagnostic, prognostic and treatment pathways.”

LiverMultiScan uses MRI data to calculate images of proton density fat fraction, T2, and T1 in the liver, which have been shown to correlate with histological measures of steatosis, hemosiderosis, and fibrosis. The strong magnetic field in an MRI machine is used to excite water and fat molecules, which relax at different speeds. As they relax, they emit a signal, which is used to create the T1 and T2 MR images. T2 is influenced by iron deposits, which can therefore be used to assess hepatic iron overload, while T1 is influenced by the type and structural organization of a tissue.