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Magnitude MRI accurate biomarker for liver PDFF, steatosis in children with NAFLD

In the MRI Rosetta Stone Project, the use of magnitude-based MRI accurately measured liver proton density fat fraction, or PDFF, and steatosis grade in children with nonalcoholic fatty liver disease, according to study results recently published in Hepatology.

“Currently, diagnosis of NAFLD requires a liver biopsy, which is not always available or performed,” researcher Jeffrey B. Schwimmer, MD, professor of clinical pediatrics at University of California, San Diego Medical Center, and director of the Fatty Liver Clinic at Rady Children’s Hospital in San Diego, said in a press release. “This leads to both misdiagnosis and missed diagnoses, hampering patient care and progress in clinical research. Thus, a noninvasive method for diagnosing and/or evaluating NAFLD has the potential to impact millions of children.”

Schwimmer and colleagues used magnitude-based MRI to measure liver PDFF, a known biomarker of liver fat content, in 174 children (mean age, 14 years) with and without NAFLD and compared it with standard liver biopsy, which all children underwent, according to the research.

The researchers found that liver PDFF was strongly correlated with steatosis grade (0.725) among the patients (P < .01). The correlation was stronger in girls compared with boys (0.86 vs. 0.7; P < .01) and weakest in children with stage 2, 3 or 4 fibrosis (0.61) compared with children with no fibrosis (0.76) or stage 1 fibrosis (0.78).

Overall, MRI-estimated liver PDFF was 56% accurate in predicting steatosis grade among the patients (OR = 3.27; 95% CI, 3.17-3.41), according to the research.

“Advanced magnitude MRI can be used to estimate PDFF in children, which correlates well with standard analysis of liver biopsies,” Schwimmer said. “We are especially excited about the promise of the technology for following children with NAFLD over time. However, further refinements will be needed before this or any other MRI technique can be used to diagnose NAFLD in an individual child.”

Disclosure: One researcher reported receiving grants from GE Healthcare.