SFMR:s företagsstipendium: Salem Alsaqal

Quantification of Gadoxetic Acid-Enhanced MRI Enables the Detection of Metabolic Dysfunction Associated Steatohepatitis

Purpose:

There is a need for non-invasive biomarkers to differentiate between metabolic dysfunction associated steatohepatitis (MASH) and metabolic dysfunction associated steatotic liver (MASL) within the spectrum of metabolic dysfunction associated steatotic liver disease (MASLD), also known as nonalcoholic fatty liver disease. Gadoxetic acid-enhanced MRI (GA-MRI) has the ability to quantify hepatocellular function and potentially identifying dysfunction. The purpose of this study was to evaluate the ability of various parameters obtained using GA-MRI to differentiate between MASH and MASL and between fibrosis stages and to assess the repeatability.

Materials and methods:

Sixty-eight participants with biopsy proven MASLD (40 men and 28 women; mean 54.5 years; 53 with MASH and 15 with MASL) were prospectively included. Contrast enhancement index (CEI), relative enhancement (RE), and relative enhancement (RE) were calculated using signal intensity data from GA-MRI sequences before and 20 minutes after the intravenous injection of GA. Thirty participants underwent a second MRI within 2-4 weeks to assess the repeatability.

Results:

CEI, RE, and RE could differentiate MASH from MAFL with an AUROC of 0.68, 0.73, and 0.78, respectively. These parameters were also correlated to the histopathological activity grade (0-4) with Spearman’s correlation coefficient of -0.30, -0.34, and -0.39, respectively and to the histopathological fibrosis stage (0-4) with Spearman’s correlation coefficient of - 0.30, -0.29, and -0.28, respectively. The ICC for repeatability of these parameters ranged between 0.83 and 0.88.

Conclusion:

MASH can be differentiated from MAFL and fibrosis stages can be detected using highly repeatable parameters obtained using a routine clinical protocol of GA-MRI.