Magnetic resonance elastography: Status of clinical applications

Abstract

Magnetic resonance elastography (MRE) is an imaging technology that has been available as an FDA-cleared upgrade to MRI systems since 2009. Worldwide, MRE technology has been installed on approximately 1000 MRI systems. In October 2017, the AMA approved the creation of a CPT code for MRE. In MRE, propagating shear waves in the range of 30–300 Hz are generated in tissue, and imaged with a phase contrast MRI technique. The wave images are processed with an inversion algorithm to generate cross-sectional images quantitatively depicting the complex shear modulus of tissue. The main application of MRE is currently in noninvasive diagnosis of chronic liver disease. Published studies have established the MRE is the most accurate and technically successful non-invasive modality for diagnosing liver fibrosis. Many other promising applications of MRE are being explored by investigators around the world, including assessment of diseases of the brain, heart, lung, and muscle and tumors of breast, liver, prostate, liver, and other organs. The new applications that closest adoption in clinical practice are (1) assessment of brain disease and (2) advanced diagnosis of liver disease. These new applications require acquisition sequences and processing algorithms that are more advanced than the current product MRE techniques.Magnetic resonance elastography (MRE) is an imaging technology that has been available as an FDA-cleared upgrade to MRI systems since 2009. Worldwide, MRE technology has been installed on approximately 1000 MRI systems. In October 2017, the AMA approved the creation of a CPT code for MRE. In MRE, propagating shear waves in the range of 30–300 Hz are generated in tissue, and imaged with a phase contrast MRI technique. The wave images are processed with an inversion algorithm to generate cross-sectional images quantitatively depicting the complex shear modulus of tissue. The main application of MRE is currently in noninvasive diagnosis of chronic liver disease. Published studies have established the MRE is the most accurate and technically successful non-invasive modality for diagnosing liver fibrosis. Many other promising applications of MRE are being explored by investigators around the world, including assessment of diseases of the brain, heart, lung, and muscle and tumors of breast, liver, prostate, liv...