First European guidance on the use of multiparametric MRI in fatty liver disease
- September 4, 2020
Oxford, September 4th, 2020. The first European guidance using multiparametric MRI (mpMRI), including cT1® , to assess the risk of liver fibrosis and inflammation in patients suspected of NAFLD has been published, helping to improve clinical management and treatment monitoring.
Non-alcoholic fatty liver disease (NAFLD) is the excessive accumulation of fat in the liver due to poor diet and sedentary lifestyle, affecting more than 25% of the adult population worldwide. For many people the condition will not advance, and the only necessary intervention is lifestyle modification. However, for others, NAFLD can progress into a more serious condition, called non-alcoholic steatohepatitis (NASH), which can cause fibrosis, cirrhosis and end-stage liver disease.
There are currently no approved drugs to reverse NASH symptoms, so early identification of NAFLD patients who are likely to develop NASH is essential while symptoms can still be reversed with lifestyle changes. Liver biopsy is still the reference standard to measure fibrosis and discriminate between NAFLD and NASH, but in addition to being invasive and painful for the patient, it also carries a risk of bleeding complications and variability in results. Non-invasive, mpMRI methods, such as LiverMultiScan, offer quantitative and accurate assessment of tissue characteristics associated with NAFLD and NASH. These patient-friendly techniques measure liver fat using proton density fat-fraction (PDFF), iron using T2*, and fibrosis and inflammation using cT1 (corrected T1). MR elastography, another non-invasive technique, can also detect and quantify fibrosis, but with the drawbacks of requiring additional hardware and being unreliable in patients with high iron.
This new guidance proposes the use of mpMRI, including cT1, to stratify suspected NAFLD patients. For example, only patients with elevated cT1 values would be referred for comprehensive evaluation and monitoring, potentially reducing the number of unnecessary biopsies. A recent study has already shown how cT1 can be used to identify chronic liver disease patients at greatest risk of poor outcomes. Furthermore, as new NASH drugs come to market, their adoption into clinical protocols may be accelerated by inclusion of cT1 in clinical trials.