Multiparametric MR for Rapid Imaging Assessment of the Liver (RIAL)
The RIAL study aims to investigate whether non-invasive measurement of liver fat, iron content and fibrosis are as accurate as liver biopsy specimens in determining if patients have non-alcoholic fatty liver disease (NAFLD) or steatohepatitis (NASH), or other suspected liver disease.
Currently, the gold-standard for the diagnosis and staging of liver disease is a liver biopsy.
In this study, consecutive patients will be offered a multiparametric MR scan to assess their liver while they await a liver biopsy.
Study time-frame: The scan will be performed in the 6-week period before their biopsy, and results will be compared to biopsy findings. results will be presented at the end of the study when MR data outcomes are compared to gold-standard biopsy dat. Participants will only have to attend one study visit to participate - there will be no patient follow-up.
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Rapid Imaging Assessment of the Liver Using Multiparametric Magnetic Resonance|
- Liver fat content [ Time Frame: Day 1 ] [ Designated as safety issue: No ]Liver fat content in this study is measured with MR spectroscopy during cardiac-gated breatholds
- Liver fibrosis [ Time Frame: Day 1 ] [ Designated as safety issue: No ]Liver fibrosis is measured by the T1 relaxation time in milliseconds (continuous variable) using MR. Higher degrees of fibrosis are predicted to have a higher T1 value. These results will be compared to gold-standard histology.
Biospecimen Retention: Samples With DNA
Fresh frozen plasma, frozen serum, and whole blood for DNA analysis
|Study Start Date:||March 2011|
|Estimated Study Completion Date:||September 2012|
|Estimated Primary Completion Date:||September 2012 (Final data collection date for primary outcome measure)|
Liver Biopsy patients
All patients due to have a liver biopsy for the assessment of parenchymal liver disease.
Obesity per se as a cause of liver dysfunction and failure has been well studied. However, although it is a very common disease, at present the only reliable way to diagnose it is with percutaneous liver biopsy. This is painful and not without risk, as the liver is a highly vascular organ. Even with ultrasound guidance, it is still a diagnostic test that is underused as it carries a 1:1000 risk of serious adverse events (eg bleeding, infection, bowel perforation) because it is invasive. Moreover, the patients requiring the test often have impaired clotting of their blood due to liver dysfunction, and so are at higher risk of bleeding, and need to be observed in hospital for a few hours after the procedure. This adds to the cost of the procedure. As a result of these factors, liver biopsy is not used in all patients for whom NAFLD, NASH or other liver disease are suspected, unless the patients have clinically moderate to severe disease.
With the increasing prevalence of obesity in the community, NASH and NAFLD are becoming increasingly common, and there is a need for a reliable, feasible and cost-effective non-invasive diagnostic tool for these conditions. Moreover, they often coexist with other liver diseases (eg tumours, or autoimmune liver disease). There are approximately 1.5million UK adults with mild to moderate liver disease which, at present, cannot be ascertained non-invasively.
Developments in magnetic resonance medicine may allow us to accurately diagnose liver fibrosis, using the amount of extracellular fluid (ECF) as a biomarker for fibrosis. T1 mapping of the liver can reliably show differences in ECF content and thereby allow quantification of the degree of liver fibrosis. In conjunction with MR spectroscopy and T2* mapping for concurrent interpretation of lipid and iron content, this will allow rapid non-invasive diagnosis of the type and/or severity of many common liver diseases (NAFLD/NASH, hepatitis, iron overload).
|Contact: Rajarshi Banerjee, BMBCh MA||+44 1865 firstname.lastname@example.org|
|John Radcliffe Hospital, Oxford University Hospitals NHS Trust||Recruiting|
|Oxford, England, United Kingdom, OX3 9DU|
|Contact: Rajarshi Banerjee, BM BCh MA +44 1865 221875 email@example.com|
|Principal Investigator: Jane D Collier, MB ChB MD|
|Study Director:||Eleanor Barnes, BSc MBBS PhD||University of Oxford|
|Study Director:||Stefan Neubauer, MD||University of Oxford|