Photo Credit: Eranicle

A recent study found that MRE-based liver stiffness measurements predicted cirrhosis and decompensation in patients with early-stage ALD.

The use of magnetic resonance elastography (MRE) for assessing liver stiffness effectively predicts the development of cirrhosis or decompensation in patients with early-stage alcohol-related liver disease (ALD), according to findings published in Abdominal Radiology.

Meng Yin, PhD, and colleagues enrolled patients with ALD who had at least one MRE assessment between 2007 and 2020. They obtained information on demographics, liver chemistries, MELD score within 30 days of the first MRE, and alcohol abstinence history using EMRs. The researchers assessed liver stiffness, fat fraction, and disease progression.

Liver Stiffness Predictive in Multiple Models

The study included 182 patients (men, n=132; median age, 57). Most patients (n=110) had early-stage ALD, and 23 of these patients (20.9%) developed cirrhosis after a median follow-up of 6.2 years. Among the 72 patients with compensated cirrhosis, 33 (45.8%) developed decompensation (median follow-up, 4.2 years).

Dr. Yin and colleagues found that MRE-based liver stiffness, considered both independently and with adjustments for age, alcohol abstinence, fat fraction, and sex, was a significant, independent predictor for both future cirrhosis (HR=2.0–2.2; P=0.002–0.003) and hepatic decompensation (HR=1.2–1.3; P=0.0001–0.006).

Every 1 kPa increment in baseline liver stiffness doubled the risk for developing cirrhosis in all Cox models.

“If using a categorical variable, liver stiffness [equal to or greater than three] kPa can distinguish [patients with ALD] with a significantly increased risk for developing cirrhosis (P=0.02),” Dr. Yin and colleagues wrote,

Identifying Risk and Guiding Clinical Management

The researchers noted several limitations of their study, including the difficulty of selecting patients with ALD for inclusion due to the potential coexistence of metabolic diseases and the retrospective design. Some of the strengths identified included the long-term nature of the follow-up period and the alignment of their results with prior research. Dr. Yin and colleagues also pointed to future research to validate the current findings due to the absence of a validation cohort.

“Our study highlights the value of a single baseline MRE-based liver stiffness measurement in predicting cirrhosis and decompensation in patients with ALD, providing a tool for identifying high-risk individuals and guiding personalized clinical management,” the authors wrote.