Multiparametric MRI identifies hallmarks of NASH

WASHINGTON — Multiparametric magnetic resonance imaging identified and stratified patients with nonalcoholic fatty liver disease and nonalcoholic steatohepatitis at a population level, according to a study presented at Digestive Disease Week 2018.

“We’re trying to find a noninvasive way to identify these patients at risk for disease progression,” Stephen A. Harrison, MD, medical director of Pinnacle Clinical Research, San Antonio, said during his presentation. The way we estimated this NAFLD and NASH prevalence was using multiparametric MRI, specifically corrected T1 and proton density fat fraction.”

Harrison and colleagues investigated the efficacy of multiparametric MRI for NAFLD and NASH assessment using two large cohorts: the UK Biobank study and a U.S. prevalence study. The researchers compared the results of each study and then combined the results to estimate NASH prevalence in the United Kingdom.

The U.K. cohort included 2,825 participants and the U.S. cohort included 402 participants from the San Antonio area, all of whom received multiparametric MRI to estimate liver fat fraction. High-risk patients with PDFF of 5% or higher also underwent biopsy.

Of the U.S. participants with biopsies, 99% with PDFF of 5% or higher and Liver Inflammation and Fibrosis (LIF) score of 2 or higher had NAFLD and 56% had NASH. No participants with PDFF less than 5% and LIF score less than 2 had NASH and only 2% had NAFLD.

The researchers projected their estimates onto the UK cohort and found an estimated NASH prevalence of 11.8% in the general population.

“Multiparametric MRI with LiverMultiscan [Perspectum Diagnostics] can identify histological hallmarks of NASH, specifically fatty liver disease,” Harrison concluded. – by Talitha Bennett

Reference:

Harrison SA, et al. Abstract 354. Presented at: Digestive Disease Week; June 2-5, 2018; Washington, D.C.

Disclosure: Harrison reports he received consulting fees from Axcella, Bristol-Myers Squibb, Cirius Therapeutics, CymaBay, Echosens, Genfit, Gilead, HistoIndex, Intercept, Madrigal, NGM Biopharma, Perspectum Diagnostics, Pfizer and Second Genome; and his spouse has consulted for and has ownership interest in Cirius Therapeutics and Madrigal. Please see the DDW faculty disclosure index for a list of all other authors’ relevant financial disclosures.