New noninvasive way to assess hepatic fibrosis

Step aside invasive and costly liver biopsies. It looks as if there’s a new noninvasive way to accurately assess hepatic fibrosis in children with chronic liver disease, even in those who are obese.

The method is magnetic resonance elastography (MRE). A new study led by researchers at the Cincinnati Children’s Hospital Medical Center finds that it detects chronic diseases such as nonalcoholic fatty liver disease (NAFLD).

The finding is timely because the problem of chronic liver disease in children is a growing one, due in large part to what has been an increasing rate of childhood obesity.

Obesity has traditionally complicated detection of liver problems by making imaging methods, such as ultrasound-based transient elastography and acoustic radiation force imaging, less than reliable. Experts have been using MRE successfully to assess hepatic fibrosis in adults, but thresholds applicable to children have not existed until now.

The researchers included 35 participants aged between 4 and 20 years. They evaluated the participants for chronic liver disease using both MRE and liver biopsy.

Their study demonstrated that MRE was highly accurate in detecting more advanced fibrosis in children with chronic liver disease, including severely obese patients. Only 1 participant required sedation, and no adverse events occurred.

According to the American Liver Foundation, NAFLD affects almost 1 in every 10 children in the United States, and more than 1 in every 3 obese children have it. Males are affected twice as often as females, and Hispanics are at greater risk than non-Hispanic whites or blacks. 

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