MRI-derived biomarkers pinpoint NASH patients at high risk of progression

The quantitative magnetic resonance imaging (MRI)-derived biomarkers cT1 and liver fat demonstrate good performance for identifying patients with nonalcoholic steatohepatitis (NASH) who have the highest risk of disease progression, as reported in a study.

Researchers looked at data from five clinical studies involving a total of 543 participants suspected of nonalcoholic fatty liver disease (NAFLD). They determined the diagnostic accuracy of the MRI biomarkers to stratify NASH patients.

There was a stepwise increase in cT1 and MRI liver fat observed with increasing NAFLD severity. Of note, patients with high-risk NASH had markedly higher cT1.

The diagnostic accuracy (AUROC) of identifying patients with NASH was 0.78 (95 percent confidence interval [CI], 0.74–0.82) for cT1, 0.78 (95 percent CI, 0.73–0.82) for liver fat, and 0.82 (95 percent CI, 0.78–0.85) for the combined cT1 and liver fat.

In terms of the diagnostic accuracy for identifying patients with high-risk NASH, cT1 had a good performance (AUROC, 0.78, 95 percent CI, 0.74–0.82) and showed superiority to MRI liver fat (AUROC, 0.69, 95 percent CI, 0.64–0.74). CT1’s diagnostic accuracy did not substantially improve when combined with liver fat (AUROC, 0.79, 95% CI, 0.75–0.83).

The findings highlight the important clinical utility of MRI cT1 and liver fat to help guide the appropriate use of interventions in NAFLD and NASH clinical care pathways.