Prognostic value of multiparametric magnetic resonance imaging, transient elastography and blood‐based fibrosis markers in patients with chronic liver disease

Ana., Jayaswal; Levick, Christina; Selvaraj, Emmanuel; Dennis, Andrea; Booth, J; Collier, Jane; Cobbold, Jeremy; Tunnicliffe, Elizabeth M.; Kelly, Catherine; Barnes, Eleanor; Neubauer, Stefan; Banerjee, Rajarshi; Pavlides, Michael

doi:10.1111/liv.14625

Cited by 52 publications

(61 citation statements)

References 45 publications

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“…When stratifying cT1 into groups (<840 , 840-990 , >990 ms), the risk of clinical events is increasing with increasing cT1. [36] Similarly, in a biopsy-confirmed mouse model of advanced NASH, hepatic pathology improved and NAFLD activity and expression of collagen genes (Col1a1 and Col4a1) were reduced upon Mastiha intake. [19] In our study, we showed that the Bray-Curtis dissimilarity index was significantly greater among patients with NAFLD that received the Mastiha, compared to the Placebo.…”

Section: Discussionmentioning

confidence: 99%

Effect of Mastiha supplementation on NAFLD: The MAST4HEALTH Randomised, Controlled Trial

Amerikanou

Kanoni

Kaliora

et al. 2021

Molecular Nutrition Food Res

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and On behalf of MAST4HEALTH consortium Scope: Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease with poor therapeutic strategies. Mastiha possesses antioxidant/anti-inflammatory and lipid-lowering properties. The authors investigate the effectiveness of Mastiha as a nonpharmacological intervention in NAFLD. Methods and Results: Ninety-eight patients with NAFLD in three countries (Greece, Italy, Serbia) are randomly allocated to either Mastiha or Placebo for 6 months, as part of a multicenter, randomized, double-blind, placebo-controlled, parallel-group clinical trial. The authors assess NAFLD severity via magnetic resonance imaging (MRI) scanning and LiverMultiScan technique and evaluate the effectiveness of Mastiha through medical, anthropometric, biochemical, metabolomic, and microbiota assessment. Mastiha is not superior to Placebo on changes in iron-corrected T1 (cT1) and Liver Inflammation Fibrosis score (LIF) in entire patient population; however, after BMI stratification (BMI ≤ 35 kg m -2 and BMI > 35 kg m -2 ), severely obese patients show an improvement in cT1 and LIF in Mastiha versus Placebo. Mastiha increases dissimilarity of gut microbiota, as shown by the Bray-Curtis index, downregulates Flavonifractor, a known inflammatory taxon and decreases Lysophosphatidylcholines-(LysoPC) 18:1, Lysophosphatidylethanolamines-(LysoPE) 18:1, and cholic acid compared to Placebo. Conclusion: Mastiha supplementation improves microbiota dysbiosis and lipid metabolite levels in patients with NAFLD, although it reduces parameters of liver inflammation/fibrosis only in severely obese patients.

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Section: Discussionmentioning

confidence: 99%

Effect of Mastiha supplementation on NAFLD: The MAST4HEALTH Randomised, Controlled Trial

Amerikanou

Kanoni

Kaliora

et al. 2021

Molecular Nutrition Food Res

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“…MRI scanning was performed using Liver MultiScan image acquisition protocols [24][25][26]. For LMS-IDEAL PDFF measurements, four sets of transverse images of the liver were acquired at the level of the portal vein.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

“…These developments have resulted in a technique, referred to here as LMS-IDEAL, that quantifies liver fat in a standardised way across different manufacturers and field strengths. LMS-IDEAL is integrated in the multiparametric MRI technology, Liver MultiScan 1 (Perspectum, UK), a diagnostic aid to quantitatively characterise liver tissue in terms of fat, iron, fibrosis and inflammation [24][25][26]. Liver MultiScan's standardised measurements allow data from larger cohorts, comprising participants from different studies, locations and scanners to be combined in a single analysis.…”

Section: Introductionmentioning

confidence: 99%

Comparison between magnetic resonance and ultrasound-derived indicators of hepatic steatosis in a pooled NAFLD cohort

Beyer¹,

Hutton²,

Andersson³

et al. 2021

PLoS ONE

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Background & aims MRI-based proton density fat fraction (PDFF) and the ultrasound-derived controlled attenuation parameter (CAP) are non-invasive techniques for quantifying liver fat, which can be used to assess steatosis in patients with non-alcoholic fatty liver disease (NAFLD). This study compared both of these techniques to histopathological graded steatosis for the assessment of fat levels in a large pooled NAFLD cohort. Methods This retrospective study pooled N = 581 participants from two suspected NAFLD cohorts (mean age (SD) 56 (12.7), 60% females). Steatosis was graded according to NASH-CRN criteria. Liver fat was measured non-invasively using PDFF (with Liver MultiScan’s Iterative Decomposition of water and fat with Echo Asymmetry and Least-squares estimation method, LMS-IDEAL, Perspectum, Oxford) and CAP (FibroScan, Echosens, France), and their diagnostic performances were compared. Results LMS-IDEAL and CAP detected steatosis grade ≥ 1 with AUROCs of 1.00 (95% CI, 0.99–1.0) and 0.95 (95% CI, 0.91–0.99), respectively. LMS-IDEAL was superior to CAP for detecting steatosis grade ≥ 2 with AUROCs of 0.77 (95% CI, 0.73–0.82] and 0.60 (95% CI, 0.55–0.65), respectively. Similarly, LMS-IDEAL outperformed CAP for detecting steatosis grade ≥ 3 with AUROCs of 0.81 (95% CI, 0.76–0.87) and 0.63 (95% CI, 0.56–0.70), respectively. Conclusion LMS-IDEAL was able to diagnose individuals accurately across the spectrum of histological steatosis grades. CAP performed well in identifying individuals with lower levels of fat (steatosis grade ≥1); however, its diagnostic performance was inferior to LMS-IDEAL for higher levels of fat (steatosis grades ≥2 and ≥3). Trial registration ClinicalTrials.gov (NCT03551522); https://clinicaltrials.gov/ct2/show/NCT03551522. UMIN Clinical Trials Registry (UMIN000026145); https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000026145.

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“…12 patients presented with a diagnosed underlying liver disease. MpMRI was performed in all patients and 21% of individuals (29/135) had pre-operative liver cT1 values greater than the upper limit of normal (795 ms) defined for the general population [34,35].…”

Section: Resultsmentioning

confidence: 99%

“…In the subset of patients where at least 10% of the liver volume was removed (n = 77), the median length of stay for patients with pre-operative cT1 above the upper limit of normal (�795ms) was 1.5 days longer than those presenting with cT1 within the normal range (Fig 4). Other variables (presence of comorbidities, resection volume greater than 50%, preoperative bilirubin level above normal (20 μmol/L), total lesion volume above 100ml, age over 60 years, Bilirubin (μmol/L) 10 [8][9][10][11][12][13][14][15][16][17][18][19] Albumin (μmol/L) 39 [36][37][38][39][40] AST (U/L) 26 [22][23][24][25][26][27][28][29][30][31][32] ALT (U/L) 23 [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] ALP…”

Section: Pre-operative Multiparametric Mri Correlates With Length Of mentioning

confidence: 99%

Quantitative magnetic resonance imaging predicts individual future liver performance after liver resection for cancer

et al. 2020

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The risk of poor post-operative outcome and the benefits of surgical resection as a curative therapy require careful assessment by the clinical care team for patients with primary and secondary liver cancer. Advances in surgical techniques have improved patient outcomes but identifying which individual patients are at greatest risk of poor post-operative liver performance remains a challenge. Here we report results from a multicentre observational clinical trial (ClinicalTrials.gov NCT03213314) which aimed to inform personalised pre-operative risk assessment in liver cancer surgery by evaluating liver health using quantitative multiparametric magnetic resonance imaging (MRI). We combined estimation of future liver remnant (FLR) volume with corrected T1 (cT1) of the liver parenchyma as a representation of liver health in 143 patients prior to treatment. Patients with an elevated preoperative liver cT1, indicative of fibroinflammation, had a longer post-operative hospital stay compared to those with a cT1 within the normal range (6.5 vs 5 days; p = 0.0053). A composite score combining FLR and cT1 predicted poor liver performance in the 5 days immediately following surgery (AUROC = 0.78). Furthermore, this composite score correlated with the regenerative performance of the liver in the 3 months following resection. This study highlights the utility of quantitative MRI for identifying patients at increased risk of poor post-operative liver performance and a longer stay in hospital. This approach has the potential to inform the assessment of individualised patient risk as part of the clinical decision-making process for liver cancer surgery.

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Prognostic value of multiparametric magnetic resonance imaging, transient elastography and blood‐based fibrosis markers in patients with chronic liver disease

Abstract: Prognostic value of multiparametric magnetic resonance imaging, transient elastography and blood-based fibrosis markers in patients with chronic liver disease.

Cited by 52 publications

References 45 publications

Effect of Mastiha supplementation on NAFLD: The MAST4HEALTH Randomised, Controlled Trial

Effect of Mastiha supplementation on NAFLD: The MAST4HEALTH Randomised, Controlled Trial

Comparison between magnetic resonance and ultrasound-derived indicators of hepatic steatosis in a pooled NAFLD cohort

Quantitative magnetic resonance imaging predicts individual future liver performance after liver resection for cancer

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