A groundbreaking study published today in Nature Medicine has validated Perspectum's iron corrected T1 (cT1) as a powerful predictive biomarker for both liver-related and cardiac outcomes. The research demonstrates that liver disease, which can be accurately quantified using MRI cT1 technology, serves as a modifiable cardiac risk factor.
The prospective cohort study, titled "Cardiac and liver impairment on multi-organ MRI and associations with major adverse cardiovascular and liver events," analyzed MRI data from 28,841 community-based individuals in the UK Biobank over a four-year period. Researchers explored the associations between cardiac and liver impairment with cardiovascular and liver events, hospitalization, and mortality using quantitative MRI measurements of left ventricular ejection fraction and cT1.
"The results confirm previous observations of the liver being an early warning sign for cardiac risk as well as confirming the value of cT1 as a measure of liver-related health," said study co-author Andrea Dennis, Ph.D. "The American Heart Association recently highlighted the importance of metabolic dysfunction-associated steatotic liver disease (MASLD) awareness, which is often undiagnosed, as a major risk factor for atherosclerotic cardiovascular disease."
Key Findings Reveal Significant Risk Correlations
The study revealed several critical insights with important clinical implications:
- Elevated cT1 (>800ms) in the liver was associated with a 30% increased risk of experiencing a heart-related hospitalization
- Higher levels of cT1 (over 875ms) led to a nine-fold increase in risk of experiencing a serious liver-related health outcome within four years
- Combined cardiac and liver impairment accelerated the time to a cardiovascular event by 20 months
These findings demonstrate the interconnected nature of liver and cardiac health, highlighting the importance of comprehensive assessment approaches.
Advancing Beyond Traditional Diagnostic Methods
"These findings show how multiparametric MRI with AI allows us to see more than with traditional, single organ, analogue tests," explained Perspectum CEO Rajarshi Banerjee, M.D., Ph.D. "Specifically, the study shows how Perspectum's LiverMultiScan results can predict cardiac and liver outcomes. These are the data the regulators need to move away from liver biopsy as a reference standard."
The research comes at a pivotal time when imaging biomarkers are transforming medical diagnostics. While cardiac imaging has pioneered this transformation, liver imaging biomarkers have rapidly evolved from experimental to essential in clinical practice. Advanced imaging methods have proven safer, more effective, and more cost-efficient than traditional blood tests and biopsies.
Expert Perspectives on Clinical Impact
Arun Sanyal, M.D., professor in the gastroenterology division at the VCU School of Medicine, emphasized the significance of these findings: "The Hepatology community has long sought alternatives to liver biopsy in clinical trials, mirroring our shift away from biopsy-based clinical practice. cT1 from multiparametric MRI has now emerged as a leading solution to this challenge."
Dr. Sanyal further noted that "the outcomes data from this study firmly establishes cT1 as a reproducible biomarker with significant prognostic utility, demonstrating its ability to predict clinical outcomes in patients with MASLD."
Clinical Applications and Future Directions
The study provides strong evidence supporting the use of multi-organ MRI to stratify at-risk patients and enable early intervention. This approach could be particularly valuable for managing MASLD, a growing global public health problem fueled by the prevalence of obesity and related metabolic disorders.
"Clinically, if someone has suspected liver disease, rather than biopsying them, now we can offer them a scan, and if that scan is normal, their chance of having clinical events that are worrying, liver decompensation, heart attacks, is low," Dr. Banerjee explained in a separate interview. "On the less reassuring but more precision medicine side, if someone has a positive scan, i.e., they have an elevated corrected T1 score, then we know that these are the patients to prioritize for care and counseling."
The research also suggests potential applications for evaluating new metabolic treatments, such as incretins, across multiple organs in a single scan, potentially streamlining clinical trials and treatment monitoring.
About LiverMultiScan Technology
LiverMultiScan is an FDA-cleared software medical device intended for diagnosis, monitoring, and clinical management of patients with liver diseases. The non-invasive, non-contrast technology assesses liver disease activity, fat, and iron using existing MRI infrastructure and provides visually enhanced patient-friendly results.
The technology has demonstrated clinical utility in diagnosing and monitoring various liver diseases, including MASLD/MASH, autoimmune hepatitis, and viral hepatitis, offering a promising alternative to more invasive diagnostic procedures.
As Dr. Banerjee concluded, "Liver cT1 is now scientifically established as a non-invasive alternative for measuring liver health and, as a result, pushing old clinical guidelines to be re-evaluated and rewritten."
