LiverMultiScan can save £150 per patient
- February 12, 2018
- Liver Disease, LiverMultiScan, Press Releases, Research Studies
Digital liver scanning technology could halve the number of liver biopsies needed on the NHS
- Non-invasive LiverMultiScan aids diagnosis of fatty liver disease and could save valuable NHS resources on unnecessary biopsies.
- Test combines digital image processing and NHS Magnetic Resonance (MR) scanners to characterise liver tissue, giving doctors reliable information about the health of the whole liver.
Oxford, United Kingdom, Monday 12 February 2018. A study, published in the Journal Alimentary Pharmacology & Therapeutics, reveals that a new scanning technology called LiverMultiScan could almost halve the number of liver biopsies carried out in people with fatty liver disease. The authors conclude that 458 out of every 1,000 liver biopsies could be avoided if people are first assessed using LiverMultiScan.1
The study, which was conducted by researchers at The University of Birmingham and the University of Edinburgh, provides evidence that using the non-invasive LiverMultiScan as a first-line test can rule out the need for further liver tests, and could stop patients having unnecessary biopsies, saving valuable NHS resources and decreasing the overall cost of diagnosis. The researchers calculate a potential saving of around £150,000 per 1,000 patients.1
Liver biopsy is the current gold standard for assessing liver disease, however the rising burden of non-alcoholic fatty liver disease (NAFLD) calls for simpler and lower risk strategies for managing this clinical problem that meet the needs of clinicians and patients. In this study, funded by National Institute for Health Research (NIHR) and a grant from Innovate UK, the utility of LiverMultiScan– a test that combines digital image processing and trained experts to quantify and characterise tissue from a standard MRI scan of the liver – was assessed as an alternative method to help doctors to diagnose fatty liver disease. It is already used in the world’s largest liver imaging study, UK Biobank, and is available in the USA and Europe.
Professor Sir John Bell, Regius Professor of Medicine at the University of Oxford, and author of the UK’s Life Sciences Industrial Strategy comments, “It is clear that there is a rising burden of liver disease, particularly from non-alcoholic fatty liver disease. Our study is of importance to evaluating the best pathways to offer patients who need evaluation of their liver health. Whilst liver biopsy remains an important part of advanced Hepatology practice, clearly we need better non-invasive tools at our disposal to evaluate the nature and severity of liver disease. In this work we were able to compare and contrast different approaches to this challenging problem and show where LiverMultiScan could help contribute to optimised diagnostic, prognostic and treatment pathways”
Non-alcoholic fatty liver disease is on the increase – the prevalence is estimated at around 20-30% in the UK and these numbers are expected to grow.2 The UK Chief Medical Officer, Dame Sally Davies, has warned of the impact this will have on the nation’s health, and the drain on NHS resources.
Professor Gideon Hirschfield from the University of Birmingham was joint senior investigator of this study. He says, “It is clear that there is a rising burden of liver disease, particularly from non-alcoholic fatty liver disease. Our study is of importance to evaluating the best pathways to offer patients who need evaluation of their liver health. Whilst liver biopsy remains an important part of advanced Hepatology practice, clearly we need better non-invasive tools at our disposal to evaluate the nature and severity of liver disease. In this work we were able to compare and contrast different approaches to this challenging problem and show where LiverMultiScan could help contribute to optimised diagnostic, prognostic and treatment pathways”.
LiverMultiScan can be used to help doctors diagnose liver disease, even at the early stages, and can also help to predict those people whose liver disease is going to progress more quickly. In this study LiverMultiScan was superior for grading disease severity and excluding people at increased risk of disease progression, compared to the other tests evaluated. In practice this means that management of patients’ liver disease can be optimised, saving on healthcare resources and minimising risk to the patient.
Dr Rajarshi Banerjee, CEO of Perspectum Diagnostics, the company behind LiverMultiScan, comments, “A LiverMultiScan can help a patient see liver disease and act on it. Digital health will improve the way we practice medicine; in this case, a painless scan is clearly safer than a biopsy needle, and is far better suited to monitoring patients. We are proud to be leading the way in providing more patient-centric solutions for people with liver disease that helps them and their doctors make informed decisions about their care.”
- PJ Eddowes, N McDonald, N Davies, et al. Utility and cost evaluation of multiparametric magnetic resonance imaging for the assessment of non-alcoholic fatty liver disease. Alimentary Pharmacology & Therapeutics 2018. Available online here
- Non-alcoholic fatty liver disease (NAFLD): assessment and management. NICE Guideline published July 2016. https://www.nice.org.uk/guidance/ng49/chapter/context
About the study
The study was conducted to investigate the performance and cost of multiparametric MRI (LiverMultiScan) alongside existing biomarkers in the assessment of NAFLD. Adult patients undergoing standard of care liver biopsy for NAFLD were prospectively recruited at two UK liver centres (Birmingham and Edinburgh) and underwent multiparametric MRI, blood sampling and transient elastography within 2 weeks of liver biopsy. Non- invasive markers were compared to histology as the gold standard. Data were obtained in 50 patients and 6 healthy volunteers.
This work was supported by a grant from Innovate-UK (101679). The paper presents independent research supported by the NIHR Birmingham Biomedical Research Centre at the University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham. The role of Perspectum Diagnostics Ltd. was the provision of access to LiverMultiscan and blinded analysis of raw MRI data. All study investigations and data analysis were performed by the academic centres.
The National Institute for Health Research (NIHR): improving the health and wealth of the nation through research. Established by the Department of Health and Social Care, the NIHR:
funds high quality research to improve health
trains and supports health researchers
provides world-class research facilities
works with the life sciences industry and charities to benefit all
involves patients and the public at every step
For further information, visit the NIHR website (www.nihr.ac.uk).
LiverMultiScan™ is FDA 510(k) cleared in the U.S. and CE marked in Europe. It enables non-invasive and quantitative liver tissue characterisation to quickly and consistently quantify liver fat, as well as biomarkers which have been shown to correlates with iron and fibro-inflammation. It is a rapid and scalable technology that can be seamlessly integrated into existing MR examinations, without the need for contrast agent.
How it works
Patients undergo an MRI scan on a compatible scanner – this takes about 15 mins and no contrast agent is required.
The scans are sent electronically to a secure reporting laboratory to be quantified using a proprietary AI-based algorithm. The results are processed by clinical and imaging specialists.
The report is usually sent back to the referring doctor within 24 hours. It provides summary values of three biochemical characteristics of the liver as well as images that depict the health of the whole organ.
About fatty liver disease
Non-alcoholic fatty liver disease (NAFLD) is a major cause of liver disease and now accounts for over 60% of liver patients in Western countries. The World Gastroenterology Organization Global Guidelines classify NAFLD as a condition defined by excessive fat accumulation (steatosis) in the liver (> 5% of liver cells under a microscope).
Excess body weight causes liver fat deposition and chronic inflammation, which can lead to liver cirrhosis as well as diabetes, accelerated heart disease and early death (fatty liver disease (FLD) doubles the risk of heart attack). A subgroup of NAFLD patients (up to 25%) have liver cell injury and inflammation in addition to excessive fat, a condition designated as non-alcoholic steatohepatitis (NASH). Up to 40% of these patients will progress to cirrhosis, liver failure, and hepatocellular carcinoma (HCC).
NASH is widely considered to be the liver expression of the metabolic syndrome, that is, diseases related to diabetes mellitus type 2, insulin resistance, central obesity, hyperlipidemia, and hypertension.
There is already a worldwide epidemic of diabetes and obesity and the figure shows the expected increases of diabetes in different parts of the world, which will closely correlate with rates of NASH.
Kirsty Mearns, 07976 909312, firstname.lastname@example.org