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Real‐World Assessment of Liver Corrected T1 and Magnetic Resonance Elastography in Predicting Liver Disease Progression

Year: 2025

Type: article

Abstract: BACKGROUND: Clinical guidelines emphasise identifying patients at risk of chronic liver disease progression. To avoid biopsy drawbacks, noninvasive imaging tests (NITs) have become part of standard-of-care. We assessed the real-world clinical profile, referral trends, and use of magnetic resonance imaging (MRI)-based tests, multiparametric MRI (mpMRI) and magnetic resonance elastography (MRE), as part of chronic liver disease management. METHODS: Patients referred for abdominal imaging as part of standard-of-care were eligible for inclusion irrespective of liver aetiology or referral pathway. Liver fibrosis was assessed using MRE and disease severity using mpMRI (disease activity [iron-corrected T1, cT1], liver fat content [LFC] and iron). T-tests were used for group comparisons; Kaplan-Meier analyses for disease progression and area under the receiver operating characteristic (AUC) for diagnostic accuracy. RESULTS: ) were referred for liver imaging. The majority (66%) had steatotic liver disease (SLD). Of those with low MRE (73%) and low FIB-4 (42%), 36% had elevated cT1 (> 875 ms). Those with MRE > 5 kPa had cT1 > 875 ms. During follow-up, those with low MRE (< 3.14 kPa) but elevated cT1 (> 800 ms) had significant disease worsening (HR: 3.1, p = 0.0035) compared to all others. In the SLD group, cT1 (AUC: 0.71) outperformed LFC (AUC: 0.64) and MRE (AUC: 0.53) in predicting disease progression. CONCLUSION: Regardless of aetiology, patients with low fibrosis risk (MRE) but high disease activity (cT1) face a three-times higher risk of progression. Integrating both biomarkers into standard care, especially for SLD, can guide management adjustments.

Source: Liver International

DOI: 10.1111/liv.70280