Journal Article Epublish 1 citation
PubMed: 42754838 DOI: 10.1186/s12876-026-05213-6
Characterisation of liver disease using quantitative MRI: report of the imaging arm of the ELEGANCE study.
BMC Gastroenterol 26(1)
Authors: Yi-Chun Wang, Yu Jun Wong, Edward Jackson, Andrea Dennis, Sophie Riddell, Oi Fong Chong, Jeremy Wei Song Choo, Sulaiha Binte Ithnin, Pik Eu Jason Chang, Guan Huei Lee, Marianne Anastasia De Roza, Kalki R Chandrasekaran, Kok Kiong Ong, Patricia Ching Yen Chia, Kee Tung Tan, Ngiap Chuan Tan, Wei Lyn Yang, Xin Yi Yeap, Han Chong Toh, Cheryl Min En Chua, Jacelyn Siou Sze Chua, Jade Shu Qi Goh, Yu Ki Sim, Xin Hui Rachel Teo, Michael Brady, Pierce Kah Hoe Chow
Affiliations
- Perspectum Ltd. Gemini One, 5520 John Smith Drive Oxford, Oxford, OX4 2LL, UK.
- University of Oxford, Oxford, United Kingdom.
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore.
- Medical Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore.
- Perspectum Ltd. Gemini One, 5520 John Smith Drive Oxford, Oxford, OX4 2LL, UK.
- SingHealth Polyclinics, Singapore, Singapore.
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore.
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Centre for Digestive Health, National University, National University Hospital, Singapore, Singapore.
- Department of Gastroenterology and Hepatology, Sengkang General Hospital, Singapore, Singapore.
- Gastroenterology and Hepatology, Tan Tock Seng Hospital, Singapore, Singapore.
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
- Programme in Clinical and Translational Liver Cancer Research, National Cancer Centre Singapore, Singapore, Singapore.
- University of Oxford, Oxford, United Kingdom.
- Surgery Academic Clinical Program, SingHealth Duke-NUS Academic Medical Center, Singapore, Singapore.
- Department of Hepato-pancreato-biliary and Transplant Surgery, Division of Surgery and Surgical Oncology, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore.
Abstract
BACKGROUND
Evolving disease aetiology and rising prevalence of chronic liver disease are driving an increase in hepatocellular carcinoma (HCC). Non-contrast quantitative MRI (qMRI) has shown promising capability for characterising liver health and risk of liver related outcomes, but has not been evaluated in HCC surveillance or specifically examined in Asian populations. We explored the characteristics of qMRI in participants with chronic liver disease undergoing HCC surveillance as part of the prospective cohort study, ELEGANCE.
METHODS
Seven hundred sixty-nine participants underwent qMRI using LiverMultiScan to derive information relating to liver disease activity (iron-corrected T1, cT1), liver iron (from T2*) and liver fat content (through proton density fat fraction), as well as structural features of advancing disease such as, liver and spleen volumes, and the caudate to right lobe volume ratio.
RESULTS
Three hundred twenty-eight participants had hepatitis B (HBV); 161 metabolic dysfunction-associated steatotic liver disease (MASLD); and 273 had cirrhosis (any aetiology). In HBV, qMRI identified that more than 40% had concurrent SLD. In MASLD, qMRI suggested 31% had MASH. In all aetiologies, cirrhosis was associated with elevated cT1, reduced liver fat, spleen enlargement, and caudate hypertrophy. A model incorporating these features demonstrated strong discriminatory performance for cirrhosis, particularly within the MASLD cohort (AUC = 0.88). In an exploratory analysis the same score demonstrated statistical power to discriminate between those with and without a subsequent HCC diagnosis.
CONCLUSION
This study demonstrates the capability of qMRI for comprehensive characterisation of different liver disease aetiologies and the ability to identify those at highest risk of clinical outcomes.
MeSH
Liver Diseases, Liver, Gastrointestinal Diseases, Spleen