“Our results show a consistent, across-the-board precision advantage of 3D MRE over 2D MRE in severe obesity – an advantage that may reduce stiffness measurement variability near clinically relevant liver stiffness thresholds and help avoid misclassification of patients with an incorrect stage of fibrosis,” Dr. Reeder said in a recent RSNA News article. 

The study was performed at both the University of Wisconsin–Madison and the University of California, San Diego (UCSD) together with UCSD radiologist and co-principal investigator Claude B. Sirlin, MD. The findings were published in Radiology and impact patients with metabolic dysfunction-associated steatotic liver disease (MASLD), which is the most common cause of chronic liver disease. 

When MASLD is not treated correctly, it can advance to metabolic dysfunction-associated steatohepatitis (MASH) and possibly lead to fibrosis, cirrhosis, or end-stage liver disease.  

There are two approved therapies for an intermediate stage of this disease, but it needs to be accurately identified. While liver biopsy is the gold standard for diagnosing MASH, there is interest in a noninvasive alternative like MRE. But in patients with severe obesity, which is associated with these liver diseases, the performance of 2D MRE might degrade. 

Dr. Reeder said radiologists shouldn’t reject 2D MRE just yet despite 3D MRE’s precision. 

“3D MRE may be better suited for settings where maximal precision is critical, such as the longitudinal monitoring of therapeutic response,” Dr. Reeder said. “2D MRE may be an adequate and practical alternative when 3D MRE is either unavailable or there is concern for potential technical failure.” 

Read more in the RSNA News article “3D MRE: More Precise for Measuring Liver Stiffness in Adults with Severe Obesity” and Radiology publication “Comparative Precision of 3D MRE and 2D MRE for Measurement of Liver Stiffness in Adults with Severe Obesity.”