Diagnosing Fatty Liver Disease

A Better Way to Diagnose Nonalcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease is now common in America, where 29 million have the disease, as well as in other nations where obesity is a problem. Most often it is found in middle-aged people who are overweight or obese, but it is increasingly being found in children: more than 6 million American children have fatty liver disease, which can boost their odds for heart disease.

A fraction of people with nonalcoholic fatty liver will go on to develop hepatitis, liver cancer or liver failure. Since symptoms of nonalcoholic fatty liver are often vague (fatigue, malaise, a dull ache in the upper right abdomen), a quick and cost-efficient method of diagnosis is critical. The traditional way to test for evidence of the disease has been a liver biopsy, which is painful, costly, and carries its own risks.

Diego Martin, PhD

Emory Professor of Radiology Diego Martin, PhD, Department of Radiology, and colleagues set out to develop a better method for measuring fat levels in livers. "We wanted to develop a method that was faster, could be used on anyone, including children, and was more accurate than previous methods," says Diego, director of Emory's Body Imaging program.

His team developed High Speed T2-cOrrected magnetic resonance spectroscopy (HISTO), through a collaboration of scientists in the Clinically Applied Research Body MRI Program, and the Biomedical Engineering group for Georgia Tech, directed by Xiaoping Hu. Other project contributors include Dr. Xiaoping Hu, Nashiely Pineda Alonso, Puneet Sharma and Qin Xu.

"We initially tackled the problem of measuring lipid levels by constructing a laboratory model of a liver that could be imaged on an MRI. Such models are called 'phantoms' and are critical for these kinds of technical studies," Martin says. "Our liver phantom allowed us to test and design several different approaches. We honed in on one method that used spectroscopy."

The HISTO method uses an MRI to see the liver, but then relies on magnetic resonance spectroscopy (MRS) to measure the lipid content. The team tested the method on rats, then people. The HISTO technique worked and was much less invasive than previous methods while proving even more accurate. HISTO would also allow earlier diagnosis and treatment of nonalcoholic fatty liver disease.

"Martin and his colleagues have developed a powerful method that would reduce the need for patients to undergo invasive, risky and painful liver biopsies to assess liver lipid levels," says Raj Guddenppanavar, licensing associate with Emory's Office of Technology Transfer. "OTT is aggressively marketing this technology to companies who are leaders in the magnetic resonance imaging space."

Martin says his team is working to extend the ability of MRI techniques to also measure liver inflammation (hepatitis) and liver fibrosis, thereby providing a comprehensive liver examination that could reduce the need for liver biopsies. He adds: "Our overall objective is to provide safe, fast, non-invasive diagnostic methods that may promote earlier and more accurate diagnosis and monitoring of disease, improve therapy, and help in the development of better treatments."

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