Quantifying Body Composition and Liver Disease in Children using Free-Breathing MRI and MRE

使用自由呼吸 MRI 和 MRE 量化儿童的身体成分和肝脏疾病

• 批准号: 10160903
• 负责人: Kara Lynne Calkins
• 金额: $ 58.42万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-08 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10160903
• 关键词: 3-Dimensional; Abdomen; Adipose tissue; Age; Anesthesia procedures; Area; Biological Markers; Biopsy; Body Composition; Breathing; Child; Childhood; Chronic; Cirrhosis; Detection; Diagnosis; Disease; Early Diagnosis; Engineering; Fatty Liver; Fatty acid glycerol esters; Fibrosis; Gestational Diabetes; Goals; Gold; Hepatic; Image; Imaging Techniques; Individual; Infant; Ionizing radiation; Knowledge; Lead; Liver; Liver Failure; Liver Fibrosis; Liver diseases; Magnetic Resonance Imaging; Measures; Monitor; Morphologic artifacts; Mothers; Motion; Obesity; Overweight; Pathologist; Patients; Pharmaceutical Preparations; Population; Prevention strategy; Procedures; Protons; Radial; Radiation; Receiver Operating Characteristics; Reference Standards; Research; Research Personnel; Research Project Grants; Risk; Sample Size; Sampling Biases; Scanning; Scientist; Sedation procedure; Slice; Techniques; Technology; Testing; Therapeutic; Time; Tissues; Variant; Visceral; cohort; density; diagnosis evaluation; diagnosis standard; elastography; global health; high risk; image reconstruction; improved; innovation; liver biopsy; liver injury; liver transplantation; non-alcoholic fatty liver disease; nonalcoholic steatohepatitis; novel; obesity development; obesity in children; pediatric non-alcoholic fatty liver disease; prevent; radiologist; side effect; success; treatment response; young adult

PROJECT SUMMARY More than 13.7 million children in the U.S. are obese, and all are at high risk for non-alcoholic fatty liver disease (NAFLD), which can lead to fibrosis and progress to liver failure. NAFLD is the most common chronic pediatric liver disease and number one indication for liver transplant in young adults. Accurate assessments of visceral adipose tissue and hepatic fat and fibrosis are critical to the understanding, early diagnosis, and evaluation of new treatments for pediatric obesity and NAFLD. However, there is a lack of child-appropriate technologies to quantify visceral adipose tissue and hepatic fat and fibrosis. Conventional imaging techniques for body composition involve radiation and do not measure individual adipose tissue compartments. Although liver biopsy is the gold standard for diagnosis, this procedure is invasive, requires anesthesia and has complications. Moreover, biopsy findings can be non-specific and suffer from sampling bias and interpretation variability. Magnetic resonance imaging and elastography (MRI and MRE) are promising non-invasive technologies. MRI quantifies visceral adipose tissue and hepatic fat. MRE quantifies hepatic fibrosis. MRI and MRE do not require ionizing radiation or biopsy. However, current MRI/MRE technology is not appropriate for most children and infants because it requires breath-holding to limit abdominal motion. In young children and infants, breath-holding is not possible. Even in children who can breath-hold, inconsistency and reduced capacity in breath-holding leads to long scan times, corrupted images, failed scans, and unreliable results. Although sedation can facilitate breath-holding, it is associated with negative side effects. As a result, current MRI/MRE technologies typically exclude many children. To overcome these limitations, the research team created new free-breathing (FB) 3D stack-of-radial MRI technology to quantify visceral adipose tissue and hepatic fat in children and infants. The research team has also developed new 2D radial FB-MRE technology to quantify hepatic fibrosis in children. The objectives of this project are to further develop and evaluate FB-MRI/MRE. The research team will reduce FB-MRI/MRE scan times while maintaining high image quality, demonstrate a high level of accuracy and precision, validate FB-MRI/MRE results against biopsy, and test FB-MRI in a population that cannot breath-hold. The research team will leverage innovations in simultaneous multi-slice imaging, sparsity-constrained tensor image reconstruction, and self- navigation to: 1) Develop new radial FB-MRI/MRE technologies that quantify visceral adipose tissue and hepatic fat and fibrosis with rapid scan times (1-2 min) and minimal motion artifacts, 2) Measure the accuracy and precision of the new FB-MRI/MRE for quantifying these biomarkers, 3) Compare the FB-MRI/MRE biomarkers to liver biopsy in children with liver disease, and 4) Test new FB-MRI technology in infants. The innovative radial FB- MRI/MRE technology will reliably quantify body composition and liver disease in children and infants. In turn, FB-MRI/MRE will improve the early diagnosis, treatment monitoring, and understanding and management of pediatric obesity, NAFLD, and other liver diseases.

项目摘要 美国有超过1,370万儿童肥胖，所有这些儿童都有非酒精性脂肪肝病的高风险 （NAFLD），这可能导致纤维化并发展为肝衰竭。 NAFLD是最常见的慢性小儿 肝病和年轻人肝移植的第一指示。内脏的准确评估 脂肪组织和肝脂肪和纤维化对于理解，早期诊断和评估至关重要 小儿肥胖和NAFLD的新疗法。但是，缺乏适合儿童的技术 定量内脏脂肪组织和肝脂肪和纤维化。身体的常规成像技术 组成涉及辐射，不测量单个脂肪组织室。虽然肝脏 活检是诊断的黄金标准，此过程是侵入性的，需要麻醉并有并发症。 此外，活检结果可能是非特异性的，并且会遭受采样偏差和解释变异性的折磨。 磁共振成像和弹性图（MRI和MRE）是有希望的非侵入性技术。 MRI 量化内脏脂肪组织和肝脂肪。 MRE量化了肝纤维化。 MRI和MRE不需要 电离辐射或活检。但是，当前的MRI/MRE技术不适合大多数儿童和婴儿 因为它需要呼吸以限制腹部运动。在幼儿和婴儿中，呼吸不是 可能的。即使在能够呼吸呼吸的孩子中，不一致和呼吸呼吸的能力降低也会导致长时间 扫描时间，损坏的图像，失败扫描和不可靠的结果。虽然镇静可以促进呼吸的刺激 与负副作用有关。结果，当前的MRI/MRE技术通常排除许多儿童。 为了克服这些限制，研究团队创建了新的自由呼吸（FB）3D堆栈MRI 量化儿童和婴儿内脏脂肪组织和肝脂肪的技术。研究小组也有 开发了新的2D径向FB-MRE技术来量化儿童的肝纤维化。这个项目的目标 将进一步开发和评估FB-MRI/MRE。研究团队将减少FB-MRI/MRE扫描时间 保持高图像质量，表现出高度的准确性和精确度，验证FB-MRI/MRE结果 反对活检，并在无法呼吸的人群中测试FB-MRI。研究小组将利用 同时进行多切片成像，稀疏张量图像重建和自我的创新 导航到：1）开发新的径向FB-MRI/MRE技术，以量化内脏脂肪组织和肝脂肪 和快速扫描时间（1-2分钟）和最小运动伪像的纤维化，2）测量的准确性和精度 用于量化这些生物标志物的新型FB-MRI/MRE，3）将FB-MRI/MRE生物标志物与肝活检进行比较 在患有肝病的儿童中，4）在婴儿中测试新的FB-MRI技术。创新的径向FB- MRI/MRE技术将可靠地量化儿童和婴儿的身体组成和肝病。反过来， FB-MRI/MRE将改善早期诊断，治疗监测以及理解和管理 小儿肥胖，NAFLD和其他肝病。