A new study shows that an imaging technology developed by Mayo Clinic researchers can identify liver fibrosis with high accuracy and help eliminate the need for liver biopsies. Liver fibrosis is a common condition that can lead to incurable cirrhosis if not treated in time. The study, which included 113 patients, was presented Nov. 3 at The Liver Meeting, an annual gathering of the American Association for the Study of Liver Disease, in San Francisco.
The technology, called magnetic resonance elastography (MRE), produces color-coded images known as elastograms that indicate how internal organs, muscles and tissues would feel to the touch. Red is the stiffest; purple, the softest. Other imaging techniques do not provide this information.
“Knowing the liver’s elasticity or stiffness is invaluable in diagnosing liver disease,” says Jayant Talwalkar, M.D., M.P.H., a Mayo Clinic hepatologist and co-investigator on the study. “A healthy liver is very soft, while a liver with early disease begins to stiffen. A liver with cirrhosis, advanced liver disease, can be rock hard.”
For more information, please watch our Medical Edge Story on MRE.
I received a letter signed by Dr. Talwalkar M.D., M.P.H asking me if I would be interested in taking part in his study of using MR elastography to evaluate liver conditions. I am not opposed to taking part in this research endeavor but I am wondering if this will be at a cost to me and my insurance. I don’t beleive my insurance will cover this type of procedure if other means have been used and a conclusion has been made. My recent liver biopsy (ouch) determined that I had little to minimal scarring from carrying Hep. C around for the past 35 years. Please advise.
Hi Debra,
Thank you for your question. I will look into this more and share a response with you soon.
Debra,
I talked to the research study coordinator working with Dr. Talwalkar. The MRE test for this study is covered, but other expenses (such as your transportation to the test) are not covered. The research coordinator, Stephanie, will be in touch with you to offer more information.
Thank you.
Is this research open to candidates? I recently had a liver biopsy and have been diagnosed with Stage 2 Fibrosis. It took me 5 weeks to recover completely from the biopsy. I am very interested in participating. Thank you
Anthony M.
Hi Anthony,
I will send you an email with more information. Thank you.
Hello,
I am very interested and would like to make an appointment to have a MRE performed.
I recently had my appendix removed 2 weeks ago and the doctor informed me that my liver was yellow and that i should watch my alcohol intake as well as food intake.
I would like to know if my insurance will cover this test.
I have all my blood tests from last week and 2 others showing good on Bil and Alb.
Please advice when I can drive up to have this performed and if it will be covered by insurance.
John McHugh
Hello Mr. McHugh,
I’ve sent a note to Dr. Talwalkar’s office. A member of his staff, Stephanie, will be calling you.
Thank you very much for your time.
Hello,
I had surgery at the Mayo (Rochester) in 2004 for crohn’s disease. I also have Hep C and am very interested in learning about your new MRE technology. Are you looking for candidates for this study. Also, if you are not interested in subjects for your study could you please tell me how much this test would cost. Thank you in advance.
Brian Madore
3/25/09
Is the MRE available at this time? Is it still part of a study? Is it only available at Mayo Clinic?
How would I go about making an appt?
I have an appt with gastro to discuss Hepatitis C evaluation. I completed chemo for NHL DLBC Stage IV Aug 2008. Gastro has been monitoring my Hepatitis C, waiting for me to be completely recovered from chemo. Liver Biopsy would be invasive and risky. My platelets and WBC Count are below normal. I am alcohol free for 14 months and intend to stay that way.
Thanks very much.
Hello,
I posted in March asking about the MRE but I never did receive a reply?
thanks
Brian
Thank you for your interest. I’ve forwarded your notes to Dr. Talwalkar’s office and one of his staff will be in touch.
I was recently diagnosed with fatty liver disease and also diabetes. My ALT is 103 & the AST is 76,triglicerides are 158 & HDL is 31. Also my creatinine is .53 & amylase is 21. I had a CT scan with contrast & it shows my liver is at the upper limits of normal in size and the lower limits of normal in density. Would like this test instead of a biopsy. Could this be scheduled?
Hi Ellen,
I’ve sent a note to Dr. Talwalkar’s office. A member of his staff, Stephanie, will be calling you.
Thank you.
My liver biopsy indicates that I have mild to moderate focal inflammation of portal tracts with mild spotty chronic lobulitis. My antimitochondrial antibody was negative. Biopsy was performed March 2008. Many other liver tests have been performed. All liver tests were negative. Would I be a candidate for the MRE test to obtain a more accurate diagnosis of my liver condition?
Stephanie A
I have been diagnosed with AIH- bridging fibrosis(stage 3)early stage cirrohsis, patchy lobulitis, acidopilic bodis, & rare plasma cells (from my liver biopsy) done in June 09. I have stared Imuran and Prednisone and my AST/ALT numbers have just about normalized. With little side effects- thankfully- I am now concerned about the bridging fibrosis, and possible cirrhosis.
I would be very interested in the MRE test, to see how if there has been any improvement and any other details since the biopsy was done. I am a 36 year old female- very casual alcohol consumer (1 glass of wine a month?)- healthy in all other aspects. I had a doppler ultrasound done in March- which the doctor reading it called “normal liver”…and then in July- same doc did anther, calling it “cirrhotic”…concerning.
thanks for your time.
Your note has been forwarded for a response.
Almost the same situation with me. I recently had my gallbladder removed and the surgeon told me while they were in there with the laproscope they could see my liver was cirrhotic (caused by viral hepatitis). But when I went to see the Liver Coordinator, she told me according to my ultrasound and ct scan and past labs, my liver is smooth and healthy!!!! I am to start of treatments, but, if it truly is cirrhotic, then, the treatments will destroy my liver completely. I have requested an MRE to be done due to the fact that a biopsy is too dangerous! I finally found a place in San Diego where they do MRE and have scheduled an appt to have it done. It is the latest in technology and not invasive like the biopsy! No pain! So, good luck with your case and hope all goes well for you!
Thank you for your interest. I’ve forwarded your notes to Dr. Talwalkar’s office and one of his staff will be in touch.
my mom is having this done and it is a serious procedure i dont see how you put patients thruugh stree and worry abot having a procedure like this done you are killing families from this i hope you sleep good at night.
I’ve sent a note to Dr. Talwalkar’s office. A member of his staff, Stephanie, will be contacting you today.
i HAVE BEEN TOLD THAT MY PAST DRINKING HAS CAUSED ME TO HAVE A LIVER PROBLEM. HOWEVER THE DR. HAVE SAID I’M FINE. CAN YOU TELL ME WHAT TO DO?
I was diagnosed with Hep C and after a gallbladder removal was told my liver was cirrhotic. The Hepatologist looked at my labs and recent MRI, ultrasound and said my liver was smooth and pretty normal. What is going on? I need to know where an MRE can be done in the San Diego/LA area. This is VERY important because I do not want a biopsy done..too invasive and too risky besides being too painful. Please help!
Thank you for your comment. I have sent your question to Dr. Talwalkar.
I was diagnosed with Hep C and after a gallbladder removal was told my liver was cirrhotic. The Hepatologist looked at my labs and recent MRI, ultrasound and said my liver was smooth and pretty normal. What is going on? I need to know where an MRE can be done in the San Diego/LA area. This is VERY important because I do not want a biopsy done..too invasive and too risky besides being too painful. Please help!
Hi Ms. Figueroa,
I’ve sent a note to Dr. Talwalkar’s office. A member of his staff, Stephanie, will be contacting you today.
Thank you.
I was diagnosed with chronic hep. B when I was pregnant with my daughter about 10 years ago. At the time, I was told that the medications out there wouldn’t help my situation since I never had any acute hep B symptoms. My liver panel are all normal.
Now my doctor wants a liver biopsy and start treating me. I am very worried about the accuracy of liver biopsy since it is not guaranteed to hit the “right” spot. And worried about the invasiveness of the biopsy. I will be very interested in MRE. Could you let me know if you are still accepting new testers.
I live in Michigan. Anything available local to me?
Thanks so much for your response!
Joan
Hi Joan,
A representative from Dr. Talwalkar’s office will be contacting you today.
Thank you.
Amy
Does the MRE involve using a contrast? I get very sick after Cat Scans and HIDA scans. I have been very ill and can’t go out of my house because any toxin causes pain in my Liver (RUQ) I had elevated Liver function and GGT test !/08 I stopped drinking alcohol and haven’t touched it since. I found out that I had SOD (sphincter of oddi dysfunction) finally this last 3/09 after numerous tests. I believe I have 2 things going on in my body. The SOD and Liver fibrosis. My doctors say I don’t have cirrhosis but I believe by how I’m feeling I believe I have fibrosis of the liver. My gall bladder was removed last 12/08. It had alot of scarring on the outside of it according to the surgeons op report. The surgeon said the liver looked ok at that time. When my liver function tests where done in 1/08 no liver biopsy was done. My doctor told me to stop drinking alcohol. At the time of the lab tests an Abdominal ultrasound was done and showed that the upper portion of my liver was in the upper range of normal. I have had numerous ultrasounds done over the course of a year and the liver is normal in size. I have not felt well since the SOD surgery done 6/09. I have been given so many drugs (dilotid,celexa,vicodin,valium, contrast iodine) over the course of a year (from 9/09 to 9/09) they have made me so sick. The last drug I took for 3 1/2 weeks,(7/09-8/09) for anxiety, Celexa, gave me so much abdomen pain, burning pain across my upper right and left abdomen, and my liver was aching and tender, so I stopped taking it. It’s interesting how my ALP which used to be up around 120-140 over the last 2 years has come down and is around 110. The AST/ALT are back in normal ranges also. What concerns me is that I now have liver cirrhosis. Stage 2-3. Just by the way I’m feeling. I had to quit my xray job because I would get liver pain every time I went into the xray room. There are darkroom chemicals in the room. I have been confined to my home. I have had to remove items in my home that make me sick. I’m intolerant to any toxic chemical that enters my body. It’s a nightmare. I’m hoping the MRE will be able to find the problem. Thank you for your help.
The MRE is very interestin. I liked how u told alot about itl……….
I’m very interested in your MRE for the liver.
I had a liver Biopsy 13 months ago and was diagnosed with Hepatitis Geno type 1B stage 3 fibrosis. Due to the debilitating side effects and low success rate, particularity those with Geno type 1B, I have chosen not to undergo any interferon therapy. I am currently taking many teas and supplements including Natcell Thymus and must say I feel incredible. I am tested monthly by my Doctor and all of my tests are normal(ALT, AST Liver enzymes Iron etc.) with the exception of a slightly low white blood cell count (3.5 out of a range of 3.8-10.8) and Absolute Lymphocytes (581 out of a range 850-3900). I would like more information on the Liver MRE procedure and would like to know if it is available in California and if not, more information on how to proceed with the Mayo Clinic for this poocedure.
Thank You,
Marcia
Marcia – I’ve sent a note to Dr. Talwalkar’s office. A member of his staff, Stephanie, will be contacting you today.
I’m interested in having this test. I’ve never had liver biopsied, but had hepc and recently stopped drinking. Can I participate? Can you fwd this to Dr. Talwalkar’s office?
Yes, certainly we will forward your question to Dr. Talwalkar’s office for his review. Thank you.
Where can I get an MRE in the San Diego Area?
Please check with your local care provider.
How is an MRE done
I had my gallbladder out in August 2011.Bloodwork done 3 days later showed a slightly elevated liver enzyme. I saw a gastroenterologist for post cholyectomy syndrome and he prescribed Cholestipol.He then retested my enzymes and the one which had been elevated returned to normal but another one was slightly elevated. I had a ultrasound before my surgery and a Hyda scan both of which were normal.I also had more in depth bloodwork to look for hepatitis and other markers of disease all normal results.He is now suggesting a biopsy…I would like to explore other avenues before taking this extreme measure.Would MRE be a beneficial imaging technique for my situation.I live about and hour from the Mayo in Jacksonville .Thank you.
If a diagnosis is still required, then a liver biopsy is probably the best test. MRE is excellent at detecting liver fibrosis but cannot identify the condition that might be causing liver enzymes to be elevated. Dr. Talwalkar
Dear Dr. Talwalkar and or associate,
My Test results from Nov 16, 2012, ALT 336, AST 122, LDL 158, HDL 49, Non HDL Chol 187, Triglycerides 145, Glucose 103, FSH 33, LH 26, Tot Testosterone 78, Hemo A1c 5.4, Urea Bun 22, Albumin 4.9 Albumin/Globlulin ratio 2, Bili 0.8, ALK Phos 74, Homocysteine 11.6, Platelet count 157, Iron 141, C-Reactive Protein .11, Vit D 52, PSA .6
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Dec 1, 2012, AST 104, ALT 357, Alk Phosp Serum 81 (normal), Bili .6 normal
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Dec 12, 2012, Alpha FetoProtein 1.5 in range < 6.1,
with the ultrasound upper right quadrant showing normal liver, including gall bladder .…
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I constantly feel light slow to rapid, bubbling,fizzing [keeping me awake when i need to sleep], better in morning before fully wake-up, worse after a Bowel movement seeming occurring in lower abdomen , not sure what causes, please advise if possible what to check
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Also 20+ years sour taste. extreme around each august 2 years so far. no issue medically found. I then eat loads of dark green vegs.
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Also had Hep B as year old, with yellow skin and eyes.
No yellow currently.
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Urine started having light to medium amount clear bubbles , some appearing connected as sequential links, to naked eye appears lots clear items floating, color urea light yellow.
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BM is often either smelly floating soft brown chunks cardboard with few random yellowish, looks like lemon pits or smooth darker clay.
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I would like to expedite MRE exploration or other avenues before taking any liver biopsy extreme measure…I live near palm beach (south florida) Florida airport easy flight to Mayo in Jacksonville, else I'm also driving distance to Miami.
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Would MRE, or please advise if other testing modalities can be a beneficial imaging technique for my situation?
Thank you for your message.
Unfortunately, we cannot diagnose conditions, provide second opinions or make specific treatment recommendations through this correspondence. However, I have attached a couple of links to pages on our website that you may find helpful: http://www.mayoclinic.org/liver-disease/?mc_id=comlinkpilot&placement=bottom, http://www.mayoclinic.com/health/liver-problems/DS01133/DSECTION=treatments-and-drugs. If you would like to seek help from Mayo Clinic, please call one of our appointment offices in Arizona at 480-301-1735; Florida, 904-953-0323; or Minnesota, 507-284-2511.
I am 42 years old and have just found out that I am Hep C + and my test results dont look good. ALT:154, AST:163, GGT:199, Albumin 3.4, Globulin:4.7 with evidence of spleen enlargement. Glucos (fasting 105) and Platelet count of 96.6.
I wanted to find out if MRE is available somewhere in India, Dubai, Asia or Middle East? Also, what does the test cost in the US?
Does UCSF approve of this method? I have had two of the three types of biopsies they do there. The needle one and the jugular one. Dr. Ascher has given me two transplants. How exactly does this method work? I am willing to go to PHOENIX for you to try the method but I need more info. I prefer to communicate through email.
Thank you,
Susan
Almost the same situation with me. I recently had my gallbladder removed and the surgeon told me while they were in there with the laproscope they could see my liver was cirrhotic (caused by viral hepatitis). But when I went to see the Liver Coordinator, she told me according to my ultrasound and ct scan and past labs, my liver is smooth and healthy!!!! I am to start of treatments, but, if it truly is cirrhotic, then, the treatments will destroy my liver completely. I have requested an MRE to be done due to the fact that a biopsy is too dangerous! I finally found a place in San Diego where they do MRE and have scheduled an appt to have it done. It is the latest in technology and not invasive like the biopsy! No pain! So, good luck with your case and hope all goes well for you!