Diagnose liver pathology without the need to biopsy the patient, but through imaging biomarkers that are equivalent to a virtual biopsy of the liver. This is the objective of HepaTools, a tool developed by Ascires Grupo Biomédico.
The accumulation of fat, inflammation, fibrosis or iron overload in the liver are indicators linked to certain liver pathologies. Assessing its levels is key for early diagnosis or for the control of diseases such as non-alcoholic fatty liver and certain metabolic or autoimmune disorders, among others. Conventional biopsy is the reference test to study these parameters, but it is an invasive technique, requires hospital admission and can cause complications.
Cetir Ascires has been one of the pioneers in the introduction of this technique in Catalonia, equipment that imprints low-intensity vibrations on the abdomen. “With elastography we generate a visual map of the liver that allows us to know the degree of rigidity of this organ. Based on this information, we can establish whether the patient's liver is at a normal level, inflammation, fibrosis or cirrhosis”, explains Pilar Castellote, a biomedical engineer from Ascires who has participated in the project.
The assessment of these parameters is essential for early detection of liver disease. For example, the abnormal accumulation of fat in the liver, which occurs when more than 5-6% of fat is concentrated in this organ. It is a disease that can progress silently because it does not present symptoms. If it is not diagnosed and treated correctly, it can cause inflammation and cell damage (hepatic steatosis). A percentage of patients with this pathology will end up suffering from fibrosis and, in the most serious cases, cirrhosis, an already irreversible process.
According to the Spanish Association for the Study of the Liver (AEEH), 25% of the Spanish population over 15 years of age have hepatic steatosis, a variant of non-alcoholic fatty liver disease. Among specialists, there is concern about the effect that the intake of fast food and processed products is having on the development of liver disease. In fact, according to the AEEH, non-alcoholic fatty liver caused by the abuse of fast food and a sedentary lifestyle are already the main cause of cirrhosis in our country, above alcohol.
The liver is the largest organ in our body and is relatively mobile, which complicates the location of injuries. “The conventional biopsy is performed through the insertion of a needle to extract a sample of liver tissue and is not without risks. Therefore, a tool like HepaTools is a clear advantage for the patient, but also for the medical specialist. In fact, the assessment of the parameters is obtained in a quantitative and objective manner for the entire liver –and not just for a small sample of tissue, as occurs in conventional biopsy–, which makes it possible to more accurately locate possible liver damage” , points out José Manuel Santabárbara, coordinating engineer at AsciresLab.
Those responsible for the project have already published the determination of imaging biomarkers, the basis of HepaTools, in the international journal Diagnostics. Thus, based on four advanced multiparametric magnetic resonance sequences, fibrosis, fat accumulation, and iron overload in the liver are assessed.
The definition of these biomarkers supposes the preclinical validation of the HepaTools tool. The project is now in the clinical validation phase with patients diagnosed with non-alcoholic fatty liver, which Ascires is developing in collaboration with the Health Research Institute (INCLIVA). "Our objective is to generate a computer algorithm that, with the biomarkers that we have defined and a series of patient data, contributes to establishing an accurate diagnosis of liver disease," explains José Manuel Santabárbara.