Transforming Non-Invasive Liver Disease Detection by MRE: The Hepatogram

NCT ID: NCT02565446

Last Updated: 2023-10-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

243 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-09-30

Study Completion Date

2022-11-17

Brief Summary

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A variety of liver insults lead to pathological changes in liver architecture that culminate in cirrhosis. While invasive liver biopsy was required to detect cirrhosis, the development of magnetic resonance elastography (MRE) has revolutionized our ability to detect liver fibrosis through non-invasive means that involve measurement of liver stiffness. However, a number of pathological findings occur in liver in response to various insults that precede cirrhosis and are clinically important to identify such as steatosis associated with NASH, inflammation associated with viral hepatitis, and congestion associated with cardiac hepatopathy. Detection of such entities provides essential diagnostic, prognostic, and treatment information but yet is not available non-invasively. Recent murine studies from this group of investigators has identified that MRE technology can be adapted to non-invasively detect these conditions. Implementing this into the practice will transform it by obviating the need for invasive liver biopsies in patients suspected of having such forms of suspected liver disease. This will differentiate Mayo from other institutions where such technology is not available.

An additional aim of this study is to examine the impact of obstructive sleep apnea (OSA) on the pathogenesis of nonalcoholic fatty liver disease (NAFLD), both common comorbidities of obesity. Recent evidence indicates a potential link between OSA and severity of NASH and fibrosis, but the mechanisms of OSA- associated hypoxia on liver disease progression in NAFLD is unclear. This study offers the unique opportunity to analyze this association, as the study population will undergo routine evaluation for OSA, as part as the preoperative work-up prior to bariatric surgery.

Detailed Description

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Conditions

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Obesity Fatty Liver

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Bariatric

Obese adult subjects who are scheduled to undergo bariatric surgery

Group Type EXPERIMENTAL

Magnetic Resolution Elastography (MRE)

Intervention Type PROCEDURE

Magnetic Resolution Elastography (MRE): Three-dimensional magnetic resonance elastography (3DMRE), Waves at frequencies of 30 Hz, 40 Hz, and 60 Hz.

Clinical

Subjects who received abdominal surgery for non-liver related indications (cholecystectomy, pancreatic cyst resection)

Group Type EXPERIMENTAL

Magnetic Resolution Elastography (MRE)

Intervention Type PROCEDURE

Magnetic Resolution Elastography (MRE): Three-dimensional magnetic resonance elastography (3DMRE), Waves at frequencies of 30 Hz, 40 Hz, and 60 Hz.

Interventions

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Magnetic Resolution Elastography (MRE)

Magnetic Resolution Elastography (MRE): Three-dimensional magnetic resonance elastography (3DMRE), Waves at frequencies of 30 Hz, 40 Hz, and 60 Hz.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Age ≥ 18 years
2. Verbal and written fluency of the English Language
3. Able to consent

Exclusion Criteria

1. Absolute contraindications to MRI including pacemaker, automatic implantable cardioverter/defibrillator (AICD) device, cochlear implant, ventriculoperitoneal (VP) shunt, aneurysm clip, deep brain stimulator, and severe claustrophobia
2. Absolute contraindications to liver biopsy including coagulopathy
3. History of decompensated cirrhosis complicated by one or more of the following: esophageal variceal hemorrhage, ascites, hepatic encephalopathy, or spontaneous bacterial peritonitis.
4. Women who are pregnant or breastfeeding
5. History of liver transplantation or hepatic resection
6. History of primary or secondary hepatic malignancy
7. Current or previous excessive alcohol consumption within 6 months of study enrollment defined as \> 30 grams/day for men and \> 20 grams/day for women
8. Current or prior history of therapy for underlying liver disease including interferon-based medications, other antiviral agents, immunomodulatory therapy, biologic response modifier therapy, and complementary/alternative medications including (but not encompassing) milk thistle
9. Any severe medical condition that, in the opinion of the Principal Investigator, would serve as an exclusion criterion for study enrollment
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

Mayo Clinic

OTHER

Sponsor Role lead

Responsible Party

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Alina M. Allen

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Alina Allen, MD

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic

Locations

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Mayo Clinic in Rochester

Rochester, Minnesota, United States

Site Status

Countries

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United States

References

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Wu H, Zhu Z, Li J, Qiu C, Xu P, Glaser KJ, Murphy MC, Venkatesh SK, Yaqoob U, Graham R, Mounajjed T, Manduca A, Winkelmann CT, Yashiro H, Manohar R, Allen AM, Shah VH, Ehman RL, Yin M. Three-Dimensional Vector MR Elastography for Evaluating Tissue Mechanical Heterogeneity to Assess Liver Disease Progression. Radiology. 2025 Apr;315(1):e242349. doi: 10.1148/radiol.242349.

Reference Type DERIVED
PMID: 40167439 (View on PubMed)

Li J, Lu X, Zhu Z, Kalutkiewicz KJ, Mounajjed T, Therneau TM, Venkatesh SK, Sui Y, Glaser KJ, Hoodeshenas S, Manduca A, Shah VH, Ehman RL, Allen AM, Yin M. Head-to-head comparison of magnetic resonance elastography-based liver stiffness, fat fraction, and T1 relaxation time in identifying at-risk NASH. Hepatology. 2023 Oct 1;78(4):1200-1208. doi: 10.1097/HEP.0000000000000417. Epub 2023 May 1.

Reference Type DERIVED
PMID: 37080558 (View on PubMed)

Allen AM, Shah VH, Therneau TM, Venkatesh SK, Mounajjed T, Larson JJ, Mara KC, Schulte PJ, Kellogg TA, Kendrick ML, McKenzie TJ, Greiner SM, Li J, Glaser KJ, Wells ML, Chen J, Ehman RL, Yin M. The Role of Three-Dimensional Magnetic Resonance Elastography in the Diagnosis of Nonalcoholic Steatohepatitis in Obese Patients Undergoing Bariatric Surgery. Hepatology. 2020 Feb;71(2):510-521. doi: 10.1002/hep.30483. Epub 2019 Mar 15.

Reference Type DERIVED
PMID: 30582669 (View on PubMed)

Related Links

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Other Identifiers

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K23DK115594

Identifier Type: NIH

Identifier Source: secondary_id

View Link

15-003148

Identifier Type: -

Identifier Source: org_study_id

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