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 21 June 2018

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News

MRI for the assessment of NAFLD

The current issue of Alimentary Pharmacology and Therapeutics performs an utility and cost evaluation of multiparametric magnetic resonance imaging for the assessment of non-alcoholic fatty liver disease.

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Validated diagnostic tools that are accurate, cost effective and acceptable to patients are required for disease stratification and monitoring in non-alcoholic fatty liver disease.

Professor Hirschfield and colleagues from the United Kingdom investigated the performance and cost of multiparametric magnetic resonance imaging alongside existing biomarkers in the assessment of non-alcoholic fatty liver disease.

Adult patients undergoing standard of care liver biopsy for non-alcoholic fatty liver disease were prospectively recruited at 2 London, United Kingdom, liver centers and underwent multiparametric magnetic resonance imaging, blood sampling and transient elastography withing 2 weeks of liver biopsy.

Non-invasive markers were compared to histology as the gold standard.

Data were obtained in 50 patients and 6 healthy volunteers.

Corrected T1 correlated with non-alcoholic fatty liver disease activity score.

Multiparametric magnetic resonance imaging could save £150,218 per 1000 patients
Alimentary Pharmacology and Therapeutics

The researchers found that corrected T1, enhanced liver fibrosis test and liver stiffness differentiated patients with simple steatosis and non-alcoholic steatohepatitis, with area under the receiver operating characteristic of 0.69, 0.87 and 0.82, respectively and healthy volunteers from patients with area under the receiver operating characteristic of 0.93, 0.81 and 0.89, respectively.

For the risk stratification of non-alcoholic fatty liver disease, multiparametric magnetic resonance imaging could save £150,218 per 1000 patients compared to biopsy.

Multiparametric magnetic resonance imaging did not discriminate between individual histological fibrosis stages in this population.

Professor Hirschfield's team comments, "Multiparametric magnetic resonance imaging accurately identified patients with steatosis, stratifies those with  non-alcoholic steatohepatitis or simple steatosis and reliably excludes clinically significant liver disease with superior negative predictive value to liver stiffness and enhanced liver fibrosis ."

"For the risk stratification of non-alcoholic fatty liver disease, multiparametric magnetic resonance imaging was cost effective and, combined with transient elastography, had the lowest cost per correct diagnosis."

Aliment Pharmacol Ther 2018: 47(5): 631–644

23 February 2018

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