Disease Status in Primary Sclerosing Cholangitis by Elastography
Disease Status in Primary Sclerosing Cholangitis by Elastography
Primary sclerosing cholangitis (PSC) is a chronic liver disease that can lead to liver
 cirrhosis, liver failure and liver cancer. Assessment of disease status is important to
 determine optimal treatment but the diagnosis of PSC is challenging. There is a dire need of
 an accurate non-invasive tool for longitudinal assessment of PSC. MR Elastography (MRE) has
 been recently proven to estimate liver fibrosis noninvasively and accurately. Estimation of
 liver fibrosis by MRE along with imaging derived morphological information (MRCP) will be
 utilized in this study comprehensively to provide a surrogate non-invasive imaging biomarker
 for monitoring disease status in PSC. Successful outcomes will provide an opportunity for
 optimal treatment triage including liver transplantation via accurate and non-invasive
 estimation of true disease status in PSC.
Primary sclerosing cholangitis (PSC) is a chronic liver disease that causes inflammation and
 obstruction of bile ducts. It can eventually lead to liver cirrhosis due to fibrosis, liver
 failure and liver cancer. The diagnosis of PSC is challenging as there is no single
 diagnostic test and usually involves a multidisciplinary approach with MRI playing a major
 role. Assessment of disease status is important to triage patients for optimal treatment
 including liver transplantation and prevention of liver failure. There are however no
 established blood tests that can reliably track the disease progression and repeated liver
 biopsies have multiple drawbacks including complications, costs and feasibility. There is a
 dire need of an accurate non-invasive tool for longitudinal assessment of PSC. MR
 Elastography (MRE) has been recently proven to estimate liver fibrosis noninvasively and
 accurately. Estimation of liver fibrosis by MRE along with imaging derived morphological
 information (MRCP) will be utilized in this study comprehensively to provide a surrogate
 non-invasive imaging biomarker for monitoring disease status in PSC. The patients would have
 or will agree to undergo a liver FibroScan examination to grade fibrosis within 3 months of
 the MRI examination. In addition to the standard protocol liver and biliary MR examination
 including MRCP and contrast enhanced imaging, MRE will be added to the study exam following
 informed consent. A control group of non-PSC subjects with known chronic liver disease such
 as chronic viral hepatitis who have had liver biopsy and FibroScan within similar time frame
 of 3 months, to assess fibrosis grade will also undergo MR Elastography in order to validate
 the results of fibrosis by MRE. The study has significant implications for care of patients
 with PSC. Successful outcomes will provide an opportunity for optimal treatment triage
 including liver transplantation via accurate and non-invasive estimation of true disease
 status in PSC.
Inclusion Criteria:

 -  Patients with known PSC

 -  Control group of patients with Non-PSC chronic liver disease with recent (<3month)
 liver biopsy and under imaging surveillance.

 Exclusion Criteria:

 -  General Contraindications to MRI such as pacemaker, brain aneurysm clips etc.

 -  Pregnancy