Recent Publications
Explore our library of peer-reviewed clinical evidence, including the recent publication in Open Heart, "Cardiac abnormalities in Long COVID 1-year post-SARS-CoV-2 infection".
Read Roca-Fernandez et al. See all publications
NAFLD: Early detection for timely treatment
Welcome back to the Physician Education Hub. This week I want to discuss the well-known but alarming reports that nonalcoholic fatty liver disease (NAFLD) has reached epidemic proportions around the world. In the U.S., one in three American adults is living with NAFLD, and up to 14% of middle-aged Americans have the more aggressive form of the disease, nonalcoholic steatohepatitis (NASH). Ironically, even with such high prevalence rates, it is often undiagnosed. As a result, its untreated progression accounts for a growing proportion of cirrhosis and hepatocellular cancer. Evidence suggests that diagnosing and intervening early is crucial to preventing disease progression, improving patient health outcomes, and reducing future healthcare costs. Furthermore, clinical guidelines (AGA, AACE and AASLD) recommend using noninvasive diagnostic technologies for the early assessment of disease activity and potential outcomes.
What’s your blood pressure? What’s your cholesterol? What’s your cT1?
To highlight the importance of early diagnosis, I’d like to share an article by Prof. Stephen Harrison, an expert Hepatologist with decades of clinical and research experience in chronic liver diseases. In his article, “What’s your blood pressure? What’s your cholesterol? What’s your cT1”, Prof. Harrison emphasizes that patients with early stages of NAFLD are likely to respond to lifestyle modifications, so early detection is the key to timely and effective treatment and potentially halting or even reversing the disease. According to Prof. Harrison, it is essential to look beyond the mere presence or absence of fat (provided by ultrasound) or localized patterns of injury (provided by biopsy) in the liver and opt for diagnostic modalities that provide a more comprehensive insight into NAFLD's impact on the entire liver for improved management.
The utility of cT1
Prof. Harrison introduces the noninvasive MRI-based liver biomarker, LiverMultiScan cT1, which may help with:
- Detection and monitoring of liver disease activity and severity in patients with chronic liver disease (CLD) like NAFLD, providing additional metrics on liver health.
- Identification of patients at risk of disease progression and adverse outcomes, with biopsy-paired studies showing that a cT1 above 875 ms is indicative of at-risk NASH.
Treatment adherence
The biggest obstacle in lifestyle intervention is treatment compliance — physicians are unable to accurately convey the gravity of the situation to their patients because patients don’t understand complex data provided by other diagnostics. Prof. Harrison points out that cT1 values, which correlate with histological liver disease activity and severity, are provided with a colored liver map in the LiverMultiScan report, including an embedded red-green color scale corresponding to the range of possible cT1 values. A study by McKay and colleagues showed that this intuitive and simple representation of complex information could contribute to physician-engagement with patients, with potential to encourage them to understand their condition better and adhere to their treatment plans.
What’s your cT1?
Prof. Harrison comments, “just as blood pressure and cholesterol levels act as key indicators of heart conditions, cT1 value has shown to provide a picture of liver health” – and suggests there is potential to help improve early diagnosis and treatment for the millions of adult Americans living with CLD, “by making cT1 as common as blood pressure or cholesterol levels.”
-Dr. Carlos Duncker
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Disclosures
- LiverMultiScan and cT1 are manufactured by Perspectum.
- Dr. Carlos Duncker is a Perspectum employee.
- Prof. Stephen Harrison is a paid consultant for Perspectum.