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 27 May 2018

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Treatment response in NASH using advanced MRI

The most recent issue of the Alimentary Pharmacology & Therapeutics investigates a relationship between MRI-derived proton-density fat-fraction, total liver volume, total liver fat index, and histology in a NASH trial.

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Magnetic resonance imaging-derived measures of liver fat and volume are emerging as accurate, non-invasive imaging biomarkers in non-alcoholic steatohepatitis (NASH). 

Little is known about these measures in relation to histology longitudinally.

Professor Stephen Harrison and colleagues from California, USA examined any relationship between MRI-derived proton-density fat-fraction, total liver volume, total liver fat index, vs. histology in a NASH trial.

The research team performed a secondary analysis of a 24-week randomized, double-blind, placebo-controlled trial of 50 patients with biopsy-proven NASH randomized to oral ezetimibe 10 mg daily vs. placebo. 

Baseline and post-treatment anthropometrics, biochemical profiling, MRI and biopsies were obtained.

Total liver volume remained strongly correlated with total liver fat index 
Alimentary Pharmacology & Therapeutics
The team found that baseline mean proton-density fat-fraction correlated strongly with total liver fat index, and had good correlation with total liver volume. 

Mean total liver volume correlated strongly with total liver fat index. 

After 24 weeks, proton-density fat-fraction remained strongly correlated with total liver fat index, maintaining good correlation with total liver volume. 

The researchers found that total liver volume remained strongly correlated with total liver fat index. 

Patients with Grade 1 vs. 3 steatosis had lower proton-density fat-fraction, total liver volume, and total liver fat index. 

The team noted that changes in MRI-proton-density fat-fraction vs. total liver volume indicates that 10% reduction in MRI-proton-density fat-fraction predicts 257 mL reduction in total liver volume.

Professor Harrison's team concludes, "The MRI-proton-density fat-fraction and total liver volume strongly correlated with total liver fat index."

"Decreases in steatosis were associated with an improvement in hepatomegaly."

"Lower values of these measures reflect lower histologic steatosis grades."

"MRI-derived measures of liver fat and volume may be used as dynamic and more responsive imaging biomarkers in a NASH trial, than histology."

Aliment Pharmacol Ther 2017: 45(6): 844–854
06 March 2017

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