Magnetic resonance imaging and transient elastography in the management of Nonalcoholic Fatty Liver Disease (NAFLD)

ABSTRACT

Introduction: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease and cirrhosis worldwide and the second most common cause of liver transplantation in major medical centers. Because liver steatosis and fibrosis severity are related to disease morbidity and mortality, the extent of disease, and disease progression, they need to be assessed and monitored. In addition, innovation with new drug developments requires disease staging and monitoring in both phase 2 and 3 clinical trials. Currently, disease assessment in both clinical practice and research is mostly performed by liver biopsy, an invasive, procedure with risks. Noninvasive, highly accurate tests are needed that could be used in clinical trials as surrogate endpoints and in clinical practice for monitoring patients.

Area Covered: We discuss noninvasive tests, transient elastography (TE) with controlled attenuation parameter (CAP), magnetic resonance imaging (MRI), and MR elastography (MRE), summarize the available evidence of their usefulness for assessing steatosis and fibrosis. Therefore they could be used as clinical trials outcomes and in disease monitoring in clinical practice.

Expert Commentary: TE with CAP, MRI and MRE are highly accurate noninvasive diagnostic tools for quantifying hepatic steatosis and fibrosis. Therefore they could be used as clinical trials outcomes and in disease monitoring in clinical practice.

KEYWORDS:

• Nonalcoholic fatty liver disease
• nonalcoholic steatohepatitis
• magnetic resonance imaging proton density fat fraction
• magnetic resonance elastography
• transient elastography
• controlled attenuation parameter

Declaration of interest

M Noureddin has been on the advisory board or a speaker for EchoSense, OWL and Abbott.

Research support: Gilead, Galmed, Galectin, Conatus and Shire. W Ayoub has been a speaker for: Grifols, Intercept. Advisory board: BMS, Gilead, Intercept, Alexion, AbbVie. E Mena: discloses research support for: Galmed, Conatus, Shire, Merck and Gilead, consultant and advisory to: Gilead, Abbvie, Merck, Bayer, Grifalos, speaker bureau for: Gilead, Abbvie, Merck, Bayer, Grifalos and stocks in Gilead and Galecctin. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.