MRI-derived, noninvasive tissue biomarker aids autoimmune hepatitis patient management
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An MRI-derived, noninvasive tissue biomarker improved autoimmune hepatitis management by distinguishing patients in biochemical remission as well as those at risk for relapse, according to a study published in eClinicalMedicine.
“[Multiparametric magnetic resonance (mpMR)] quantitative biomarkers have shown a positive impact on clinician-intended management plans as well as utility in characterizing the fibro-inflammatory status of those in various gradations of biochemical remission,” Michael A. Heneghan, MD, MMedSc, FRCPI, professor of hepatology at King’s College Hospital in London, and colleagues wrote. “By identifying differences between those in normal biochemical remission, [iron corrected T1 (cT1)] has shown promise in the phenotyping and risk stratification of individuals with this orphan disease who may not be identified using serum biochemistry and liver stiffness alone.”
Heneghan and colleagues enrolled 82 patients with autoimmune hepatitis from King’s College Hospital NHS Foundation Trust and Oxford University Hospitals NHS Trust in an observational cohort study. Participants (median age, 52 years; 77% women), all of whom were on monotherapy or combination therapy, underwent blood panel analysis, vibration-controlled transient elastography (VCTE) liver stiffness and non-contrast mpMR.
Investigators assessed cT1 measurements obtained with an MRI-derived noninvasive tissue biomarker (LiverMultiScan, Perspectum), other disease markers and imaging markers to risk-stratify patients in biochemical remission.
According to study results, cT1 significantly affected clinician-intended patient management (P < .0001). There also was a correlation between cT1 and alanine aminotransferase (P = .0005), aspartate aminotransferase (P < .001), immunoglobulin G (P = .0005) and liver stiffness (P < .0001).
Further, patients in deep biochemical remission had low cT1, while those in normal biochemical remission had high cT1 and were considered at higher risk for disease flare. Results showed that the best predictors of patients not in biochemical remission included cT1 measures of disease heterogeneity, alkaline phosphatase and bilirubin.
“Autoimmune hepatitis is difficult to diagnose and monitor because of the historic dependency on liver biopsies,” Rajarshi Banerjee, MD, PhD, MSc, MRCP, CEO of Perspectum, told Healio. “We now have the technology to see and map liver health without biopsies, and this is the first of many times we will see precision medicine made possible because of this.”
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Heneghan MA et al. EClinicalMedicine. 2022;doi:10.1016/j.eclinm.2022.101325.
LiverMultiScan detected earlier stages of treatable disease in patients with autoimmune hepatitis to allow tailored treatment. https://perspectum.com/news/livermultiscan-detected-earlier-stages-of-treatable-disease-in-patients-with-autoimmune-hepatitis-to-allow-tailored-treatment. Published March 21, 2022. Accessed March 24, 2022.
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