MRI to predict liver damage

Sure would be nice to have a quick, easy way to track ones' liver status. jerrym
News > 2007 > October > Liver Fibrosis Predicted by MRI
Liver Fibrosis Predicted by MRI
25th October 2007 - Moderate to severe chronic liver disease can be predicted with the use of diffusion-weighted MRI (DWI), according to a recent study conducted by researchers at New York University Medical Center in New York, NY.

"Due to the increased incidence of chronic hepatitis in the United States, particularly hepatitis C, there is a strong need for non-invasive methods to replace or supplement liver biopsy, which is relatively invasive and limited by interobserver variability and sampling error," said Bachir Taouli, MD, lead author of the study. "DWI appears promising in that purpose, although it needs validation in larger series," he said.

The study included 23 patients with chronic hepatitis and 7 volunteers. The researchers compared apparent diffusion coefficients (ADCs) or the quantification of water diffusion in a tissue between patients who had stage 2 or greater versus stage 1 or less fibrosis and stage 3 or greater versus stage 2 or less fibrosis. In liver fibrosis and cirrhosis, decreased ADC (i.e. restricted water diffusion) is possibly related to increased collagen deposition and decreased perfusion. The study showed that hepatic ADC was a significant predictor of stage 2 or greater and stage 3 or greater liver fibrosis.

"At this point, this is an experimental method that needs to be tested in a larger series. It should also be compared with other methods such as FibroTest (a score based on a combination of basic serum markers) or FibroScan (an ultrasound based method to measure liver stiffness) in order to be validated," said Dr. Taouli. "However, diffusion imaging does show potential for decreasing the number of biopsies and decreasing the number of antifibrogenic drug trials," he said.

"We did not expect to have such good results in terms of detection of significant fibrosis, partly because this is an investigational study and we did not have any prior experience with such application," said Dr. Taouli.

"This preliminary study was funded by a grant from the Society of Gastrointestinal Radiologists and we are now in the process of applying for extramural funding from National Institutes of Health," said Dr. Taouli. "The goal is to validate diffusion and perfusion imaging as a replacement of liver biopsy in chronic viral hepatitis," he said.

Article adapted by Medical News Today from original press release.

[alagirl]

I've never been real excited by non-invasive measures only because they always find something different than expected when they open me up.  So I guess I don't trust other methods so much.  NOT that this stops me from having all of these tests done, they seem to throw me through the machines a good bit trying to "visualize" one thing or the other.  

I was told a couple of weeks ago that the doctor saw something he didn't like in my intestines during my last MRI of the liver.  "Sh*t?" I asked, helpfully.  The nurse didn't think it was very funny.  I KNOW there is nothing wrong there because they've scoped me twice in the last two years and I've had a barium enema, which has to be the single cruelest medical intervention ever.  Clean as... well anyway.  There was nothing bad going on.

So now they want to do it again.  Another scope.  On account of the MRI.  Yeah, I'll do it.  But I'm not real worried about it.

[merryBe]

yes folks now we have one more non-definitive test based on 23 people to go along with the 6 other non-definitive tests we can charge you or your insurance 1-3 grand for...and then, when all is said and done....we will do the test that really parts the sheets and without which most insurances won't agree to treat anyway.

Look, if you have a GOOD reason to not have a biopsy like your a bleeder or something, well fine,
but if not, you had better bite the bullet cause 3 tests missed everything when I was really at stage
3 or 4.......if thats not enough to make people stop with the anal probes and get down to business nothing ever will be.

I'm all in favor of new non-invasive gizmos...PROVIDED they WORK...and peoples livers aren't being destroyed under the idiot guises of "all is well in Z-Emerald City", while in reality behind the curtain, goims and gents, we have half our scans being read by still pimply 30 somethings still in training.....(for redeployment some day soon to someplace where da engish shes no so recommedable by the sy=la-ble.. If you follow. the machine is only as good as the person on it....that's half the problem...

the other half is, I can walk around the elephant all day, but there's nothing quite as revealing as removing the blindfolds to see if in fact we have an elephant or not!

[merryBe]

OMG, you mean..shudder...they found shiet in yer pooop shoot?????
How wierd is that!!????  (rolleyes)

[copyman]

have you heard of the fibroSCAN. this NON-invasive test is just as good if not better then the biopsy and will be at more locations next year when fda approves it. in trials it has proven to be as accurate as a bx if not better.

[merryBe]

I've read conflictin things on fibroscan...like some stages it reads better than others.
that may chage if they find a new contrast that's safe with the machine...but right now, even having it would not mean I would have gotten treatment as the biopsy is the quickest way to say for certain treatment should proceed. Gandolinium is up against big time legals so they're probably backing off of contrast being as there's so many probs...like kidney failure..etc.

whether you have nodules.bridging etc.like I have, or the beginning of fibrosis, don't you want to know for certain so you will TAKE the treatment seriously, and 2 so you will know for certain.

I would liken the progress to say, and MRi vs a back xray...one can see you have discs, but barely, the other can tell you 10 times more and if they are ruptured how many fissures there are.......big difference. So if a machine can't read early stage, or half what it is designed to read.......is that really progress? Just thinking out loud here. I'm sure they'll improve with time.
right now, the gold standard is still biopsy as someone here put it.

[alagirl]

For me, the fibroscan isn't necessary because 1) I had a liver biopsy a year and a half ago (before I had hepc and I'm fine although unfortunately I had too much iron in my liver at the time) and I am treating within three or four months of being exposed to and acquiring hepc.  I was more just making a general statement.  I've had a good bit of surgery unfortunately and many times what they find is much worse than what they "see" on scans.  Or alternately, they see something that is nothing.  This is the second colonoscopy I'm having for what I am willing to bet is actually just food traveling through my system.  (That's what it was the first time).  I don't get them not having you clean your system out, then doing an MRI of the liver and extrapolating findings in your intestines out for further study when you weren't properly cleaned for intestinal tests.