Multiparametric Magnetic Resonance Imaging (MRI) as a Safe, Non-invasive Method for Assessing Liver Health
Liver disease is a growing problem, particularly lifestyle-driven non-alcoholic fatty liver disease (NAFLD) and its inflammatory sub-type, non-alcoholic steatohepatitis (NASH). Definitive staging of NAFLD and NASH currently requires liver biopsy, which is invasive, costly, and subject to sampling errors. Cost-effective and accurate non-invasive liver tests are urgently required for the diagnosis, staging, and monitoring of fatty liver disease.
One such non-invasive technique is multiparametric MRI, which can characterize liver tissue by providing measures of hepatic fat, iron, and fibro-inflammatory changes to help guide diagnosis of liver disease. Unlike conventional MRI, this “multiparametric” MRI uses a series of images to calculate quantitative parametric maps, and, by combining multiple parametric maps, a comprehensive picture of liver tissue in health and disease is revealed. LiverMultiScan is an example of a test that harnesses the power of multiparametric MRI to give clinicians and patients more information about liver disease.
With this technique, a physician can comprehensively examine the patient’s liver by seeing the whole liver in the context of fat, inflammation, and fibrosis, whereas a biopsy only samples 1/50,000th of the liver mass. In some cases, such as in autoimmune hepatitis, there can be major regional differences in the degree of liver disease. In the image to the left, a biopsy may be sampling healthy tissue or a diseased part of the liver depending on the location of the sample. Seeing the whole liver with rich visual and quantitative output is a clear advantage, particularly in patchy or regionally heterogeneous disease, and when communicating with patients.
What’s more, MRI doesn’t use radiation, and the test can be repeated to monitor the patient’s liver over time. The images below show an example of improvement in liver health over seven weeks of ledipasvir/sofosbuvir therapy (which clears the virus) in a patient with Hepatitis C. Repeated scans may enable physicians to be more responsive to patients’ treatment plans, especially in acute inflammatory conditions such as autoimmune hepatitis.
Using LiverMultiScan is simple. Patients have a quick and painless MRI performed at any radiology center where the technology is available, no needles or infusion of contrast agent is necessary, and the imaging data are sent securely through the Cloud to a central reading laboratory where they are analyzed by imaging and clinical specialists and quickly returned to the physician with quantified metrics and parametric maps. The output is an easily understandable report with normal reference ranges for all measured metrics.
Key features of multiparametric MRI:
· Quantifies iron, fat and fibro-inflammatory levels in the liver
· Aids in the diagnosis of liver disease non-invasively
Suitable for use in obese patients
· Requires no contrast agent
· Requires no additional hardware purchase from imaging center
· Works with leading MRI manufacturers, regardless of field strength
Where possible, patients favor non-invasive tests as an alternative to liver biopsy because of the pain and other risks associated with biopsy such as bleeding, infection, and possible damage to other organs. Physicians, too, strongly support the development of non-invasive, accurate liver testing options for their patients.
In the future, multiparametric MRI technology has the potential to replace biopsy in many cases, thereby providing safe and cost-effective solutions for physicians and patients.
About the Author
Prof. Stefan Neubauer is Founder and Chief Medical Officer of Perspectum Diagnostics, developer of LiverMultiScan, a non-invasive liver imaging technology. He is also head of the Division of Cardiovascular Medicine and Director of the Centre for Clinical Magnetic Resonance Research at the University of Oxford. He is a world-leading imaging scientist with 25 years’ experience in the field and a senior Cardiologist. Recipient of the 2010 European Magnetic Resonance Award and the 2013 Society for Cardiovascular Magnetic Resonance Gold Medal, he has pioneered the development and implementation of many cutting-edge MRI techniques in Medicine.
