Agreement Between Magnetic Resonance Imaging Proton Density Fat Fraction Measurements and Pathologist-Assigned Steatosis Grades of Liver Biopsies From Adults With Nonalcoholic Steatohepatitis.
TL;DR: Based on data from a phase 2 randomized controlled trial of adults with NASH, PDFF estimated by MRI scanners of different field strength and at different sites, accurately classifies grades and changes in hepatic steatosis when histologic analysis of biopsies is used as a reference.
About: This article is published in Gastroenterology.The article was published on 2017-09-01 and is currently open access. It has received 193 citations till now. The article focuses on the topics: Steatosis.
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TL;DR: The current state of the noninvasive assessment of liver disease in NAFLD is summarized, and an expert synthesis of how these nonin invasive tools could be utilized in clinical practice is provided.
780 citations
TL;DR: In this article, the authors provide the latest update to the EASL Clinical Practice Guidelines on the use of non-invasive tests for the evaluation of liver disease severity and prognosis.
428 citations
TL;DR: NGM282 produced rapid and significant reductions in liver fat content with an acceptable safety profile in patients with non-alcoholic steatohepatitis.
317 citations
TL;DR: In this paper, the authors discuss the role and utility of MRI-PDFF as a quantitative and noninvasive imaging-based biomarker in early-phase NASH trials, including potential sample size reduction.
266 citations
Cites methods from "Agreement Between Magnetic Resonanc..."
...In addition, MRI-PDFF has been successfully applied in the setting of several clinical trials.(32,37,48,49) Although MRI-PDFF is a useful tool, it is best suited for the following scenarios as a treatment endpoint in NASH trials....
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TL;DR: MRI proton-density fat fraction is currently the most accurate and precise imaging biomarker to quantify liver steatosis and is the most appropriate noninvasive end point for steatotic reduction in clinical trials and therapy response assessment.
Abstract: Hepatic steatosis is a frequently encountered imaging finding that may indicate chronic liver disease, the most common of which is non-alcoholic fatty liver disease. Non-alcoholic fatty liver disease is implicated in the development of systemic diseases and its progressive phenotype, non-alcoholic steatohepatitis, leads to increased liver-specific morbidity and mortality. With the rising obesity epidemic and advent of novel therapeutics aimed at altering metabolism, there is a growing need to quantify and monitor liver steatosis. Imaging methods for assessing steatosis range from simple and qualitative to complex and highly accurate metrics. Ultrasound may be appropriate in some clinical instances as a screening modality to identify the presence of abnormal liver morphology. However, it lacks sufficient specificity and sensitivity to constitute a diagnostic modality for instigating and monitoring therapy. Newer ultrasound techniques such as quantitative ultrasound show promise in turning qualitative assessment of steatosis on conventional ultrasound into quantitative measurements. Conventional unenhanced CT is capable of detecting and quantifying moderate to severe steatosis but is inaccurate at diagnosing mild steatosis and involves the use of radiation. Newer CT techniques, like dual energy CT, show potential in expanding the role of CT in quantifying steatosis. MRI proton-density fat fraction is currently the most accurate and precise imaging biomarker to quantify liver steatosis. As such, proton-density fat fraction is the most appropriate noninvasive end point for steatosis reduction in clinical trials and therapy response assessment.
160 citations
References
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TL;DR: A strong scoring system and NAS for NAFLD and NASH with reasonable inter‐rater reproducibility that should be useful for studies of both adults and children with any degree ofNAFLD are presented.
8,253 citations
TL;DR: Prevalence of nonalcoholic fatty liver disease and NASH is higher than estimated previously and Hispanics and patients with diabetes are at greatest risk for both NAFLD and NASh.
1,910 citations
Saint Louis University1, University of California, San Diego2, Virginia Commonwealth University3, Columbia University4, Johns Hopkins University5, Duke University6, Indiana University – Purdue University Indianapolis7, Case Western Reserve University8, University of California, San Francisco9, Virginia Mason Medical Center10, Cleveland Clinic11, Washington University in St. Louis12, National Institutes of Health13
TL;DR: Obeticholic acid improved the histological features of non-alcoholic steatohepatitis, but its long-term benefits and safety need further clarification.
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TL;DR: In this article, several methods of estimating error rates in discriminant analysis are evaluated by sampling methods, and two methods in most common use are found to be significantly poorer than some new methods that are proposed.
Abstract: Several methods of estimating error rates in Discriminant Analysis are evaluated by sampling methods. Multivariate normal samples are generated on a computer which have various true probabilities of misclassification for different combinations of sample sizes and different numbers of parameters. The two methods in most common use are found to be significantly poorer than some new methods that are proposed.
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TL;DR: The similarities and differences in the epidemiology of NAFLD in different regions of the world are discussed and the potential role of genetics and insulin resistance in disease progression is also presented.
Abstract: NAFLD is a clinical syndrome characterized by predominant macrovesicular steatosis of the liver. The clinical and histological phenotypes of NAFLD extend from a nonalcoholic fatty liver to NASH. Although the prevalence of NAFLD is increasing globally, and it is set to become the predominant cause of chronic liver disease in many parts of the world, the epidemiology and demographic characteristics of NAFLD vary worldwide. Indeed, the condition is associated with obesity and insulin resistance in most cases in the Western world, but the disease manifests at a lower BMI in Asian countries and many patients do not seem to have insulin resistance as determined using conventional methods. The similarities and differences in the epidemiology of NAFLD in different regions of the world are discussed and the potential role of genetics and insulin resistance in disease progression is also presented.
1,381 citations