M19 — May 2012 — Magnetic Resonance Elastography

Intro: Every year, thousands of people are diagnosed with liver diseases such as Hepatitis C. The virus causes the liver to become damaged and stiff through a process called fibrosis. The only way to test the liver for this issue is with a needle biopsy, which can be uncomfortable because it's invasive. But now, Doctors at Mayo Clinic have developed new technology that allows doctors to determine the stiffness of the liver without needle sticks. It's called magnetic resonance elastography, and it's making treating liver disease easier and more effective for many patients.

Working in the yard is one way Vicki Cummings stays fit. She's always taken good care of her health.

So when Vicki was diagnosed with Hepatitis C, she was stunned.

"I was in shock."

It turns out she's likely had the virus since the day she was born. She says her mom got it from a blood transfusion during a medical procedure back in the 1960's and unknowingly passed it onto her daughter during delivery.

"I'm asymptomatic."

But to make sure her liver is not becoming stiff from fibrosis, which can lead to irreversible cirrhosis, Vicky's had a liver biopsy.

"They go in with a needle in between your ribs."

Uncomfortable and inconvenient.

"No pulling sod on those days."

But Vicky has also had, and much prefers, a new test called Magnetic Resonance Elastography, or MRE.

"MR Elastography is a technique for imaging the mechanical properties of tissue."

Dr. Richard Ehman invented the technology. It uses MRI and low frequency mechanical vibrations, and it allows doctors to see the liver in a new way. It not only shows the structure of the liver, but it also shows the stiffness of the liver tissue. Other imaging techniques can't do that.

"The vibrations that we apply are not uncomfortable, and the risks associated with the exam would be those that would be associated with an MRI exam, which, in general, is a very safe procedure."

Here's how it works: a piece of equipment that looks like a little drum is placed on the patient's abdomen. The vibrations move through stiff tissue and supple tissue at different rates. A computer analyzes the differences and shows what's healthy soft tissue and what is not. What the doctor sees is a color coded image called an elastogram.

"The red would correspond to cirrhosis."

MRE is noninvasive, and it gives a picture of the entire liver, not just a sampling of one area, as is the case with biopsies.

"With a needle biopsy we're taking a tiny, little thread of liver tissue and using that to represent the status of the whole liver, and you can see how if we sampled one area that was basically normal it might not detect disease in other parts of the liver."

Being able to determine the status of the liver more comfortably and accurately will likely translate to more effective treatments for patients like Vicky. Her liver is still healthy. And she's grateful that MRE technology will help give doctors a more effective way to monitor her health.

For Mayo Clinic News Network I'm Vivien Williams.

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Dr. Ehman says MRE may replace the need for many biopsies, but will not replace them altogether.

Dr. Ehman's team is exploring many other applications of MRE technology. They've already found that MRE provides information that's helpful in planning surgery for patients with certain types of brain tumors.

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