The instance of fatty liver, a condition where fat in the body accumulates in the liver, is on the rise.

Hepatologist Dr. Kevork Peltekian is on the front lines in the fight against fatty liver disease, a condition many consider a silent epidemic.

“If I took my ultrasound machine today and went down on university avenue, and I started doing ultrasounds on everybody going by, out of 100 people that I do ultrasound, anywhere between 30 and 40 will have fat in their liver,” says Peltekian.

Dr. Peltekian says out of that 30 to 40 per cent, about five per cent will end up with serious complications.

“It can lead to scarring of the liver, cirrhosis of the liver, sometimes, so much damage occurs that the liver fails and might require transplantation,” says Peltekian.

Currently, the only way to diagnose those patients at the highest risk is through a liver biopsy.

Radiologist Dr. Sharon Clarke is working on an alternative.

“What we're working on with MRI is a non-invasive way to detect inflammation and fibrosis known as steatohepatitis, these are the patients who are at the most risk,” says Clarke.

Dr. Clarke and her team are focusing on several approaches to diagnosing and assessing fatty liver.

“This includes MR liver elastography, where you apply pressure to the liver over the patient's skin and measure how stiff the liver is non-invasively,” says Clarke.

They are also working on a way to look at the different types of fat in the liver.

“Livers with more saturated fatty acids, versus polyunsaturated fatty acids, are considered to be more at risk for fibrosis and inflammation,” says Clarke.

Dr. Clarke also hopes to develop ways to look at metabolism in the liver, something unique to MRI.

“You can't access on a pathology specimen or a biopsy anything about metabolism, so this would be a great opportunity to assess the function of the liver in vevo and non-invasively,” says Clarke.

Dr. Clarke says MRI offers many advantages over biopsy - it is non-invasive and unlike a biopsy, it represents the whole organ.

“With MRI, this gives us the advantage to image the whole liver and see where there's areas that we can do a targeted biopsy or assess the heterogeneity of the disease.”

Dr. Peltekian says research like Dr. Clarke's is crucial to early diagnosis.

“If I can now have a simple test that can be done without radiation, which is what MRI scan is, then it can give me full information on the amount of inflammation and scarring in the liver, then we're ahead of the game,” says Peltekian.