Multiparametric MRI’s Cost-Effectiveness for MASH, with Rajarshi Banerjee, MD, PhD

New research suggests multiparametric magnetic resonance imaging (mpMRI) with LiverMultiScan is a viable tool for identifying and managing patients with metabolic dysfunction-associated steatotic liver disease (MASLD), offering a cost-effective alternative to liver biopsy and other noninvasive tests.1

“Multiparametric MRI is a very great technology for tissue characterization, and since the diagnosis of MASH, metabolic associated steatohepatitis, is a tissue characterization diagnosis… the technology and the disease meet like hand and glove,” Rajarshi Banerjee, MD, PhD, CEO of Perspectum, told HCPLive.

The RADIcAL-1 trial enrolled more than 800 patients from Germany, the Netherlands, Portugal, and the UK to test the cost-effectiveness and resource use associated with Perspectum’s LiverMultiScan, a commercially available, 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.1,2

In RADIcAL-1, investigators assessed whether mpMRI with LiverMultiScan plus standard of care (SoC) was more cost-effective than SoC alone for MASLD risk stratification. Results showed mpMRI improved diagnosis rates, reduced the need for specialist consultations, and avoided unnecessary liver biopsies.1

Although patients in the SoC arm of the trial had significantly more specialist appointments with healthcare professionals and for patient assessments than those in the imaging arm (P = .015), the imaging arm had a significantly higher percentage of patients with a final diagnosis at the end of the trial compared with SoC (57% vs 48%; P = .0012).1

Additionally, using a QALY loss of 0.03 per patient per missed diagnosis, the use of mpMRI in the imaging arm was deemed to be cost-effective with an incremental cost-effectiveness ratio of €5067.77 ($5,530.28 USD) per 1.02 QALYs gained (€4968.40[$5,421.09 USD]/QALY gained).1

“The fact that not only was this the most effective test, but it was cost-effective versus all the cheaper tests, was the real eye opener here. Many found it surprising, including some of the study authors,” Banerjee said. “That should help develop the key pillars to get this into guidelines in different countries.”

Banerjee concluded by saying that he believes patients with liver disease deserve better than what is currently being provided to them.

“We have ways to monitor and manage disease such that you can prevent heart attacks and prevent liver-related outcomes. Whilst you're always in a position where you could do more research, don't let the welfare of the patient be sacrificed for that extra paper or that extra outcome measure,” he said. “I think that's really important to highlight because there is a strong body of evidence that LiverMultiScan should be used clinically, and that's been demonstrated in several settings.”

Editors’ note: Banerjee has relevant disclosures with Perspectum.

References

1. Brooks A.Multiparametric MRI Cost-Effective for Noninvasively Identifying, Managing MASLD. HCPLive. March 18, 2025. Accessed March 19, 2025. https://www.hcplive.com/view/multiparametric-mri-cost-effective-noninvasively-identifying-managing-masld

2. Perspectum. LiverMultiScan Clinical Primer. Accessed March 19, 2025. https://www.perspectum.com/clinical-solutions/livermultiscan-healthcare-professionals