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Illustrations of a patient undergoing a liver examination by standard needle biopsy (top), and by a new imaging approach called magnetic resonance elastography (bottom).© 2009 Mayo Clinic

Nearly 200,000 Americans are hospitalized each year for chronic liver disease. Typically, a biopsy is used to diagnose and evaluate the liver for signs of stiffening, or fibrosis. For a biopsy, the doctor uses a needle to take a tiny sample of liver tissue and then examines it under the microscope for scarring or other signs of disease.

As an alternative to liver biopsies, NIH-funded investigators led by Richard Ehman at the Mayo Clinic have developed Magnetic Resonance (MR) elastography, a noninvasive MRI approach that can measure the amount of stiffness in a very small amount of tissue. The noninvasive detection of fibrosis by MR elastography offers patients multiple advantages over biopsy examination, including less discomfort, a much lower risk of complications, and a decrease in expense.

Elastograms of patient with normal liver (left) and patient with diseased liver (right). Red and yellow mark hardened tissue in the liver (area inside dotted lines).Mayo Clinic

According to Dr. Ehman, MR elastography has already made a substantial difference in patient care. One example is a patient with hemophilia who previously contracted hepatitis C from a blood transfusion. Liver biopsy was contraindicated because of the hemophilia, but MR elastography was used to determine if there was fibrosis associated with the hepatitis. In this case, the results showed fibrosis and the individual was started on antiviral therapy.

Early results show this same technique might also be used to improve the detection of breast cancer and help distinguish a benign mass, such as fibrocystic disease, from cancer.