3D vector MR elastography (MRE) assessed tissue heterogeneity increases with chronic liver disease progression

Motivation: Hepatic fibrosis, despite traditionally viewed as a diffuse occurrence, has been shown to vary spatially with disease progression. Goal(s): MR elastography (MRE) measures mechanical properties and their spatial variations can potentially provide holistic insights into tissue inhomogeneity. Approach: Twenty-five rats based a metabolic dysfunction associated steatotic liver disease (MASLD) model monthly underwent MRE to investigate tissue inhomogeneity during cirrhosis development. Results: Results demonstrated increases in both microscopic and macroscopic inhomogeneities with disease progression. In cirrhotic livers, while mean MRE measurements correlated subtly with histological fibrosis and portal pressure, tissue heterogeneity presented stronger associations. Liver tissue heterogeneity is a complementary predictor of disease progression. Impact: Assessing liver tissue heterogeneity via 3D vector MR elastography could enhance disease progression monitoring in chronic liver diseases and potentially predict clinically significant outcomes, offering a more comprehensive diagnostic approach than traditional mean liver stiffness and loss modulus measurements alone.