Magnetic resonance‐based biomarkers in nonalcoholic fatty liver disease and nonalcoholic steatohepatitis

Abstract

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Aktualisierte S2k-Leitlinie nicht-alkoholische Fettlebererkrankung der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – April 2022 – AWMF-Registernummer: 021–025

“…Die klinische Bedeutung ist jedoch gegenwärtig aufgrund der geringen Verfügbarkeit und der Anforderungen an Hard- und Software auf Zentren mit entsprechender Expertise begrenzt. Die prädiktive Bedeutung der mittels MR-Techniken charakterisierten Steatosedynamik in Therapiestudien ist noch nicht abschließend definiert 125 156 .…”

“…Die Magnetresonanzspektroskopie (MRS) hat in der Literatur die höchste Genauigkeit für die Fettbeurteilung, ist jedoch gegenwärtig aufgrund fehlender Vereinheitlichung der Methodik und hohen Anforderungen an Hard-und Software auf Forschungszentren begrenzt. Ähnliches gilt derzeit für die MR-Elastographie zur Beurteilung der Leberfibrose [125,126]. Die MR-basierte Quantifizierung des Leberfettgehalts mittels "proton density fat-fraction" (PDFF) wird aufgrund der hohen Genauigkeit, einfachen Nachverarbeitung und besseren Verfügbarkeit zunehmend als beste Methode anerkannt [127].…”

Updated S2k Clinical Practice Guideline on Non-alcoholic Fatty Liver Disease (NAFLD) issued by the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS) – April 2022 – AWMF Registration No.: 021–025

“…However, clinical use is currently limited to centers due to low availability and hard- and software requirements. The predictive importance of the steatosis dynamics characterized by means of MR techniques in therapy studies has not yet been finally defined 124 154 .…”

“…According to the literature, magnetic resonance spectroscopy (MRS) has the highest accuracy for fat assessment but is currently limited to research centers due to a lack of standardization of the methodology and high demands on hardware and software. The same is currently true for MR elastography regarding the detection and staging of liver fibrosis [124,125]. The MR-based quantification of liver fat content using the "proton density fat fraction" (PDFF) is increasingly recognized as the best method by virtue of its high accuracy, easy post-processing and better availability [126].…”

Diagnostic and Therapy of Nonalcoholic Fatty Liver Disease: A Narrative Review

“…It should be noted that the information is based on the relative triglyceride content but cannot provide any information about the histological distribution [14]. Due to the diagnostic precision, MR-based methods appear to be suitable as a reference standard for diagnostic and interventional studies [15]. However, the clinical significance is currently limited to centers due to the low availability and the requirements for hardware and software.…”