This article is based on material provided by Resonance Health, an Australian company specialising in the development and delivery of non-invasive medical imaging software and services.
Resonance Health have developed, and are now providing, an alternative to liver biopsy as a way of determining Liver Iron Concentration (LIC), a key metric for people affected or potentially affected by iron overload as a result of genetic haemochromatosis (GH).
Ferriscan is a process by which data from MRI scans is processed using specially developed software and the company’s expertise to report a patients LIC. Acquired magnetic resonance images are securely transmitted to the Resonance Health Service Centre in Australia where the FerriScan analysis procedure produces a mean LIC measurement and a colour coded map reflecting the iron distribution across the liver. The company say that the system provides “proven accuracy in the determination of liver iron concentration and has the highest sensitivity and specificity over the range of liver iron concentrations of any MRI-based method of LIC measurement.”
The Ferriscan technique appear to be robust and is in use across a number of UK hospitals, notably St Mary’s in London where the 1000th scan was recently celebrated.
For the patient, the benefits are obvious compared to the taking of a biopsy, often painful and time demanding, with slow reporting times. The MRI scan is non-invasive, painless and takes only about ten minutes, and provides the clinician with a report within two or three working days.
Interestingly, Ferriscan is also much cheaper for the health service budget-holders, and provides clinicians with more accurate and replicable information, meaning better treatment and monitoring. Unlike liver biopsy, which provides an analysis of LIC in only one small area, scanning analyses a cross-section of the liver typically thousands of times larger than biopsy, hence reducing the potential for a significant sampling error.
The process is performed at a central ISO 13485 certified Service Centre and has regulatory clearance and approvals in the USA, Europe and Australia. This certification and approval of the technique is of course an important re-assurance for patients, but it also clears the way for all of our NHS Trusts up and down the country to be able to commission the Ferriscan service.
So with all of these positive points going for it, the question arises as to why it is not being routinely used for measuring LIC in GH patients. The answer, according to the company, lies in the need to educate consultants about the availability of the service as an alternative and about its advantages.
The Haemochromatosis Society would like to see the service made available to all patients that needs to be monitored and every hepatologist using it where appropriate. Taking the opportunity to secure accurate, quick results, at reduced cost and (most importantly perhaps) with far less pain and disruption to patients would seem to be the obvious thing to do.
David Head, Chief Executive at The Haemochromatosis Society, said “For those at risk of loading iron, the prospect of being monitored by biopsy is a daunting one. This new technique has the potential to address many of the issue around the accurate monitoring of storage iron and we are pleased to see some of our hospitals and consultants using it – though more should be doing so.”
The company’s factsheet about Ferriscan can be downloaded from this link, though do bear in mind that this is material produced by an organisation with a commercial interest. However patients are encouraged to discuss the MRI option with their consultants when a measurement of LIC is needed.
Author: David Head
Date: October 2015