A new non-invasive method of risk assessment in liver disease

In a recent study, an interdisciplinary research team from MedUni Vienna showed that functional magnetic resonance imaging (MRI) can be used as a non-invasive method to predict complications in chronic liver disease. The researchers combined a simple risk stratification system developed at MedUni Vienna – the Liver Functional Imaging Index (FLIS) – with the spleen diameter. This new non-invasive method can be used in addition to invasive research. The results of the study were recently published in the famous Journal of Hepatology.

For their study, an interdisciplinary team of researchers from the Department of Biomedical Imaging and Imaging Therapy and the Department of Medicine III at MedUni Vienna analyzed patients with liver cirrhosis outpatient at Vienna University Hospital. The Functional Liver Imaging Assessment (FLIS), developed by MedUni Vienna, has been confirmed as extremely useful as a supplement to and / or replacement of existing invasive procedures for assessing severity and risk of mortality. In a recent study, scientists first combined FLIS and spleen diameter to perfect a new non-invasive method. This combination gave them more data for risk assessment in patients with advanced chronic liver disease.

Spleen diameter as a risk marker

FLIS is estimated by functional magnetic resonance imaging imaging (fMRI) using a liver-specific contrast agent and plotted on a scale of 0 to 6. The study found that patients with advanced liver disease and low FLIS (0-3 points) or high FLIS (4-6 points) but large spleen (> 13 cm in diameter) had an increased risk of developing liver complications by 3 , 2 times. compared with patients with high FLIS (4–6 points) and small spleen (≤13 cm). In addition, regardless of spleen size, patients with low FLIS (0–3 points) had an 8.5-fold increased risk of death compared with patients with high FLIS (4–6 points) and small spleens (≤13 cm).

Using a combination of FLIS and spleen size, researchers have drawn attention to a long-known fact in medicine that patients with chronic liver disease often have high blood pressure y Cardiovascular system upstream of the liver (portal hypertension). This contributes to the development of complications and leads to enlargement of the spleen: the more severe the liver disease, the more pronounced portal hypertension– and even more so the spleen.

The findings of the study will now be confirmed by multicenter clinical trials, i.e. clinical trials held in parallel in different institutions. According to the authors of the current analysis Nina Bastatti and Lucian Beer from the Department of Biomedical Imaging and Therapy under the auspices of the Vienna Medical University, fMRI using a specific contrast agent for liver and spleen size can already be used in clinical practice.