In a Clinical Trial, Hepatic MR Elastography Delivers Encouraging Results

Researchers at Mayo Clinic were able to show that magnetic resonance elastography (MRE), a modality that looks at tissue stiffness, can identify early signs of hepatic fibrosis. MRE can possibly become one day a noninvasive diagnostic technology of choice for liver fibrosis, replacing the percutaneous liver biopsy that we have to do nowadays.
From a statement by Mayo Clinic:

The study, which included 113 patients, will be presented Nov. 3 at The Liver Meeting, an annual gathering of the American Association for the Study of Liver Disease, in San Francisco. Study participants had undergone liver biopsy in the year preceding the study and had a wide variety of liver diseases, including nonalcoholic and alcoholic fatty liver disease, hepatitis C, hepatitis B, autoimmune hepatitis, primary biliary cirrhosis and primary sclerosing cholangitis. Patients ranged in age from 19 to 78, and their body weight ranged from normal to severely obese.
“Results showed that elastography was highly accurate in detecting moderate-to-severe hepatic fibrosis even with the variety in age, types of liver disease and body size,” says Dr. Talwalkar. Among the study’s findings:
* The detection of cirrhosis by MRE when compared to liver biopsy results was 88 percent accurate.
* Patients with nonalcoholic fatty liver disease and no significant inflammation or fibrosis were identified with 97 percent accuracy.
“Using MRE, we can confidently avoid liver biopsies for patients with no evidence of advanced fibrosis, as well as for patients with cirrhosis,” says Dr. Talwalkar.
Liver biopsies, conducted by extracting tissue samples with a needle, can underestimate the degree of hepatic fibrosis about 20 to 30 percent of the time because of the patchy distribution of fibrosis that occurs in the liver. Another drawback is that since liver biopsy is invasive, patients may be reluctant to have a biopsy performed and sometimes delay the procedure when liver disease is first suspected, says Dr. Talwalkar.

Here’s a video of Dr. Jayant Talwalkar explaining the technology:

Press release: Mayo Clinic’s New Imaging Technology Accurately Identifies a Broad Spectrum of Liver Disease …
Image: Elastograms of a normal liver (top) and a fibrotic liver, validated by biopsy.
Flashback: MR Elastography for Liver Fibrosis