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MADAM Leong Ah See, 45, has endured two liver biopsies to date.

As a former liver transplant patient, she has to undergo regular checks to confirm that her new liver is still working.

But she dreads the sessions: Preparing for them involves an eight-hour fast and a great deal of pain.

A thick needle is pushed through the abdomen into the liver and a sliver 1.5cm in length is cut off and removed for testing in the laboratory.

"I have to hold my breath and be still for 10 seconds, which is both difficult and uncomfortable," said Madam Leong.

She is happy to learn that by 2010, she may have a painless option which does not involve needles - for which she is willing to fork out more than the $1,000 she now pays for a regular biopsy.

The new diagnostic method, developed by the Mayo Clinic in the United States, involves taking pictures of the liver.

But Dr Sudharkar Venkatesh, who brought the technique - called magnetic resonance elastography (MRE) - back to the National University Hospital (NUH), needs two years to find out if imaging differs for Asian patients.

Dr Venkatesh, a consultant in diagnostic radiology at NUH, also needs to build up a data bank of scans of both healthy and diseased livers.

Several hundred people here have to undergo painful biopsies each year. Some are transplant patients like Madam Leong, while others make up the 400 or so people each year here who are diagnosed with liver cancer.

Others may be suffering from cirrhosis, a hardening or scarring of the liver which can be caused by heavy drinking or the hepatitis B and C diseases. A high rate of hepatitis B here means liver problems are fairly common.

Sometimes, if the sample is not good enough, patients have to repeat the ordeal.

And, as with any surgery, it carries some risk: If the patient breathes, or moves, as the needle shoots out to cut the liver, one of the blood vessels in the organ's dense network could get punctured.

The needle may also scratch the liver or nick nearby organs such as the gall bladder or a lung.

With MRE, the patient lies down and a vibrating disk 19cm wide is placed on his abdomen, enabling images to be taken. The whole procedure lasts 16 seconds.

The images highlight the damaged areas of the liver, with cancerous tissue showing up differently from scar tissue.

Dr Venkatesh has been given research funds for his study on the use of the machine for Asian patients.

He expects to scan liver images from 250 people for his data bank.

He said the Mayo Clinic has found the technique to be extremely accurate.

Even though the system is not yet in clinical use at NUH, it is still helping patients, he said.