Researchers have determined that magnetic resonance elastography (MRE) can be an accurate, non-invasive tool to identify liver fibrosis in children.
Nonalcoholic fatty liver disease (NAFLD) is now the most common cause of chronic liver disease in children, and scarring of the liver, known as fibrosis, is a major determinant of clinical outcomes.
A generation ago, NAFLD was rare in children; it now affects 5 to 8 million children in the U.S. Moreover, NAFLD has become the most common cause of liver transplants in Americans under age 50. Due to the rapid increase in prevalence and severity of the disease, there is a growing interest in emerging imaging technologies that provide doctors with the information needed to care for patients, especially children, in a non-invasive manner.
"One of the challenges we face when evaluating a child with NAFLD is to determine the severity of their disease. A major component of that assessment is the staging of the amount of scar tissue seen from a liver biopsy. In MAGNET, we demonstrated that 2D MRE could be used to estimate hepatic stiffness (scarring) in these children," said co-author Jeffrey Schwimmer. "We also identified a roadmap to help navigate future use of MRE technology. Ultimately, MRE may be most useful for monitoring the progression or improvement in children with NAFLD."
Schwimmer said that the UC San Diego research team is now exploring the potential of 3D MRE. Further refinement of 2D and 3D MRE, they said, would help close the gap between where each technology is today and where it needs to be to be maximally useful for children.
According to the American Liver Foundation, NAFLD is a spectrum of diseases that begins with excess fat builds up in the cells of the liver. As the disease progresses, fibrosis increases, which may become cirrhosis, a permanent form of scarring that can lead to liver failure and need for transplantation. NAFLD affects nearly 25 percent of adults in the U.S., and 5 to 10 percent of all children. In children, the average age of diagnosis is 12.
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