AI-Aided MRI Provides Cost-Effective Alternative to Painful, Invasive Liver Biopsies

Patients with autoimmune hepatitis (AIH), a chronic condition, require lifelong treatment with corticosteroids and immunosuppressants. Their clinical management is challenging, with most patients experiencing recurring periods of subdued, followed by flared disease activity - requiring close and continual monitoring using a liver biopsy to adjust drug dose. The expensive, invasive, and imperfect nature of liver biopsy, together with its poor patient acceptance and associated safety risks, especially in children, are driving the urgent need to replace it with cost-effective noninvasive techniques that can accurately monitor disease activity and treatment response in patients with AIH. Now, a new study has shown that an artificial intelligence-enhanced, noninvasive liver health diagnostic tool can be a cost-effective alternative to painful, invasive liver biopsies for monitoring disease activity and treatment response in patients with AIH.

The health economic study performed by Oxford Academic Health Science Network (AHSN, Oxford, UK) showed that Perspectum’s (Oxford, UK) LiverMultiScan could deliver estimated significant cost savings of up to GBP 336,926 for 100 patients over five years if the AI diagnostic tool replaced surveillance liver biopsies in NHS England’s AIH patient care pathways. Over and above reducing healthcare costs, previously published evidence suggests that including LiverMultiScan in the clinical care of patients with AIH could improve clinical decision-making, patient safety, and experience.

LiverMultiScan is a noninvasive MRI scan to aid in the detection of chronic liver disease, delivering a precision image and a detailed, visual report, with quantitative metrics to assess liver tissue characteristics and provide a comprehensive picture of liver health. In a single 15-minute noninvasive MRI procedure, LiverMultiScan provides three clinically significant metrics measuring fibro-inflammation by iron-corrected T1 (cT1), liver fat, measured by proton density fat fraction (PDFF), and correlates of liver iron levels (T2) to help assess the extent of liver disease. LiverMultiScan is the only technology measuring cT1, a proprietary biomarker that measures the level of fibro-inflammation, offering the potential for earlier diagnosis even at the stage when disease progression can still be stopped and reversed, as well as monitoring of disease progression or regression.

“Noninvasive imaging with LiverMultiScan can detect the presence and extent of liver fibro-inflammation in a risk-free manner, resulting in reduced liver biopsy frequency for AIH patients,” noted Mamta Bajre, MBBS, M.Sc. Health Economics, lead author of the study and member of the NHS England’s Oxford AHSN. “Our study demonstrates that integrating LiverMultiScan in AIH patient pathways leads to significant cost savings for the NHS, while reducing hospitalisation and management costs associated with liver biopsy. By eliminating risks and complications associated with liver biopsy, LiverMultiScan helps improve patient outcomes and experience.”

“Although necessary for diagnosis, liver biopsy is not sustainable for long-term monitoring of patients with AIH. Factoring in LiverMultiScan’s economic benefits shown in this independent study with its ability to positively impact clinical management by detecting sub-clinical disease and predicting clinical outcomes, along with feedback from all stakeholders involved in patient care, I can say LiverMultiScan is probably one of the best monitoring tools to support the management of patients with AIH,” said Elizabeth Shumbayawonda, Ph.D., a clinical scientist spearheading the research in AIH and other autoimmune liver diseases at Perspectum.

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