This article is more than 5 years old. Information may no longer be current.

MRE measures liver stiffness in pediatric patients with NAFLD

Magnetic resonance elastography showed potential as a noninvasive measurement of hepatic stiffness in pediatric patients with nonalcoholic fatty liver disease, according to results of the recent MRI Assessment Guiding NAFLD Evaluation and Treatment study, or MAGNET.

“In MAGNET, we performed a dual-center study of MRE in children with NAFLD and compared MRE-measured hepatic stiffness to liver histology fibrosis stage,” Jeffrey B. Schwimmer, MD, from the University of California, San Diego School of Medicine, and colleagues wrote. “Overall, the correlation between MRE estimated hepatic shear stiffness and liver fibrosis stage was good. Notably, MRE did not perform as well in children with NAFLD compared to previously reported studies in adults.”

The study comprised 90 children with NAFLD. Mean patient age was 13.1 years (range, 8-18 years) and 73% were boys. MRE readings were performed manually at two separate sites and once through automated analysis.

Researchers determined that three patients with steatosis of less than 5% did not have NAFLD. However, they did categorize the other patients as having NAFLD (n = 38), borderline zone 1 nonalcoholic steatohepatitis (n = 17), borderline zone 3 NASH (n = 15) or definite NASH (n = 17). Fibrosis stages included stage 0 (n = 54), stage 1 (n = 24), stage 2 (n = 6), stage 3 (n = 5) and stage 4 (n = 1)

Median 2D MRE hepatic stiffness values were 2.35 kPa (range, 1.81-9.67) from Reading Center 1, 2.35 kPa (range, 1.85-10.46) from Reading Center 2 and 2.31 kPa (range, 1.74-9.65) from the automated analysis performed.

Stiffness values were similar between Reading Center 1 and 2, but lower from the automated analysis compared with the Reading centers. All three MRE analyses were significantly correlated overall with stages of fibrosis (P < .001).

The researchers found significant correlation between alanine aminotransferase values and MRE stiffness values for Reading Center 1 (P = .0008), Reading Center 2 (P < .0001) and automated analysis (P = .0033). Only the results from Reading Center 2 presented significant correlation between NASH and MRE stiffness values (P = .01).

“We demonstrated that MRE could be used to estimate hepatic stiffness in children with NAFLD,” the researchers wrote. “However, the results of this study did not show the degree of diagnostic performance reported in adult-based studies. This may be due, in part, to technical difficulties in children, which might be addressed with improved pediatric MRE sequences that do not require breath holding. Further technical development of MRE and other non-invasive quantitative imaging biomarkers of fibrosis in children with NAFLD remains a major need.” – by Talitha Bennett

Disclosures: Healio.com/Hepatology was unable to determine relevant financial disclosures at the time of publication.