Pioneering Technology From Mayo Could Better Diagnose Liver Issues

Magnetic resonance elastography (MRE) is proving better at diagnosing cases of nonalcoholic fatty liver disease.

A Mayo Clinic radiology professor and medtech entrepreneur is among the authors of new research findings suggesting that an advanced form of magnetic resonance imaging he pioneered and commercialized could be used for more liver disease patients.

Dr. Richard Ehman, an innovator in the field of magnetic resonance elastography (MRE) and CEO of Rochester-based Resoundant Inc., participated in a University of California-San Diego study that determined a new kind of 3D MRE scanner is better at diagnosing cases of nonalcoholic fatty liver disease (NAFLD) than the now-standard 2D technology, is simpler to use and could help a wider range of patients.

The study results, published last month in the American Journal of Gastroenterology, are likely to shape the future of the emerging MRE market, in which Resoundant is an early player—especially so if 3D MRE scanners can be shown to better combat NAFLD, which affects one-quarter of all Americans and can lead to cirrhosis, liver cancer and liver failure.

MRE is a relatively new technique that uses magnetic resonance imaging (MRI) coupled with low-frequency mechanical waves to provide quantifiable measurements of liver stiffness, which is a predictor of liver disease such as NAFLD and fibrosis.

Initially approved by the FDA in 2009, backers say MRE is becoming the preferred method for evaluating patients with liver fibrosis due its non-invasive and highly sensitive capabilities. It is also approximately one-half the cost of biopsies at around $700 per scan.

Dr. Ehman was one of the authors of the new UC-San Diego study. In it, the researchers conducted a prospective study of 100 patients (56 percent women) with biopsy-proven NAFLD to assess the capabilities of 2-D versus and a novel 3D version of MRE. They found that while both were highly accurate for diagnosing advanced fibrosis, the 3D version provided additional capabilities in some patients.

“3D MRE is probably the most accurate non-invasive method to detect advanced fibrosis,” the study’s lead author, Dr. Rohit Loomba of the UC San Diego School of Medicine, said in a statement.

Further, he said, the results suggested that MRE usage could be extended to screening patients with advanced liver fibrosis for cirrhosis, as well as determining the best candidates for enrollment into clinical trials aimed at reversing advanced fibrosis.

Ehman founded Resoundant in 2013 with backing from the Mayo Clinic’s venture capital arm. It is an original tenant in the Mayo Business Accelerator business incubator in downtown Rochester.

Its patented 2D device is being marketed as an add-on to MRI systems from GE, Philips and Siemens. The device consists of a paddle-like apparatus that is used in conjunction with an MRI scan to non-invasively measure the stiffness of liver tissue caused by hepatic fibrosis – something that previously could only be done with frequently inaccurate ultrasounds or through biopsies.

Resoundant and others backers of the technology believe MRE technology can have a major impact in diagnosing NAFLD, mainly because detecting the disease through other non-invasive means can be tricky. One such current method is the use of molecular biomarkers in blood, but this has not proven accurate enough for routine clinical use. And while ultrasound-based methods are also commonly used, they have high failure rates, especially in obese patients.