Researchers exploring ways to use MRI instead of invasive biopsy to monitor liver changes

Nonalcoholic fatty liver disease is the leading cause of chronic liver disease worldwide, affecting 30 percent of the global population. This can progress to nonalcoholic steatohepatitis, or NASH, one of the leading reasons for people to need liver transplantation.

A recent study by Penn State College of Medicine’s Jonathan Stine, MD, MSc, shows a promising new way to measure response to treatment in people with early-phase NASH, currently done using more invasive liver biopsy techniques.

In the Stine group’s analysis, a biomarker called magnetic resonance imaging proton density fat fraction (MRI-PDFF) has shown promise as a non-invasive marker of treatment response in early-phase NASH trials.

Previous trials had individually shown that a 30 percent reduction or more in MRI-PDFF was associated with histologic response. Stine’s group, comprising researchers from Penn State, University of California – San Diego, University of Chicago and University of Virginia, did a collaborative systematic review and meta-analysis across seven such clinical trials.

In aggregate, the Stine group evaluated data from those seven trials and demonstrated that those who showed response via MRI-PDFF had higher odds of histologic response than did those who were MRI-PDFF non-responders.

The researchers concluded that MRI-PDFF offers an accurate and reliable biomarker for assessment of treatment response in early-phase NASH trials. Further research is needed to define the role of MRI-PDFF in clinical trials of drugs with different mechanisms of action, including antifibrotics, and to clarify the role of MRI-PDFF in late-phase clinical trials and clinical care.

The study was published in late August in the journal Clinical Gastroenterology and Hepatology.

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