Publications

@article{Thiagarajan2021-rh,

title = {Metabolic imaging in non-alcoholic fatty liver disease: 

 Applications of magnetic resonance spectroscopy},

author = {Prarthana Thiagarajan and Stephen J Bawden and Guruprasad P Aithal},

year  = {2021},

date = {2021-02-01},

journal = {J. Clin. Med.},

volume = {10},

number = {4},

pages = {632},

publisher = {MDPI AG},

abstract = {Non-alcoholic fatty liver disease (NAFLD) is poised to dominate 

 the landscape of clinical hepatology in the 21st century. Its 

 complex, interdependent aetiologies, non-linear disease 

 progression and uncertain natural history have presented great 

 challenges to the development of effective therapies. Progress 

 will require an integrated approach to uncover molecular 

 mediators, key pathogenic milestones and response to 

 intervention at the metabolic level. The advent of precision 

 imaging has yielded unprecedented insights into these processes. 

 Quantitative imaging biomarkers such as magnetic resonance 

 imaging (MRI), spectroscopy (MRS) and elastography (MRE) present 

 robust, powerful tools with which to probe NAFLD metabolism and 

 fibrogenesis non-invasively, in real time. Specific advantages 

 of MRS include the ability to quantify static metabolite 

 concentrations as well as dynamic substrate flux in vivo. Thus, 

 a vast range of key metabolic events in the natural history of 

 NAFLD can be explored using MRS. Here, we provide an overview of 

 MRS for the clinician, as well as key pathways exploitable by 

 MRS in vivo. Development, optimisation and validation of 

 multinuclear MRS, in combination with other quantitative imaging 

 techniques, may ultimately provide a robust, non-invasive 

 alternative to liver biopsy for observational and longitudinal 

 studies. Through enabling deeper insight into inflammatory and 

 fibrogenic cascades, MRS may facilitate identification of novel 

 therapeutic targets and clinically meaningful endpoints in 

 NAFLD. Its widespread use in future could conceivably accelerate 

 study design, data acquisition and availability of 

 disease-modifying therapies at a population level.},

keywords = {magnetic resonance, metabolic liver disease, NAFLD, spectroscopy},

pubstate = {published},

tppubtype = {article}

}