3D Free-Breathing Fat and Iron Corrected T1 Mapping

3D 自由呼吸脂肪和铁校正 T1 映射

基本信息

批准号：
10432272
负责人：
Li Feng
金额：
$ 25.35万
依托单位：
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-01 至 2023-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10432272
关键词：
3-Dimensional Address Biological Markers Biopsy Breathing Characteristics Chemicals Chronic Cirrhosis Clinic Clinical Clinical Research Data Deposition Development Disease Early Diagnosis Etiology Evaluation Fatty Liver Fatty acid glycerol esters Fibrosis Funding Mechanisms Goals Image Imaging Techniques Inflammation Iron Lead Liver Liver Dysfunction Liver Fibrosis Liver diseases Liver parenchyma Magnetic Resonance Imaging Maps Measurement Measures Methods Modality Modeling Motion Oils Pathology Patient Monitoring Patients Performance Pilot Projects Play Portal Hypertension Prevalence Primary carcinoma of the liver cells Protons Publishing Radial Radiation exposure Recovery Reproducibility Resolution Role Source Speed Techniques Testing Time United States National Institutes of Health Water base cell injury chronic liver disease clinically significant cohort data acquisition density design disease heterogeneity elastography fatty liver disease high reward high risk image reconstruction imaging biomarker in vivo interest liver biopsy liver inflammation neglect non-alcoholic fatty liver disease nonalcoholic steatohepatitis novel performance tests reconstruction respiratory simple steatosis soft tissue

项目摘要

Project Summary Non-alcoholic fatty liver disease (NAFLD) has a global prevalence of ~25% and is a leading etiology of chronic liver disease worldwide. Nonalcoholic steatohepatitis (NASH), as an advanced form of NAFLD, involves steatosis, inflammation and concomitant iron deposition in the liver. Due to chronic cellular injury, NASH can also cause liver fibrosis, which is a common trigger of more severe liver complications such as cirrhosis, portal hypertension, or hepatocellular carcinoma (HCC). As a result, simultaneous measures of these clinical indicators are crucial to provide more accurate and comprehensive assessment of NASH. Magnetic resonance imaging (MRI) is a well- accepted modality for evaluating NASH due to its excellent soft-tissue contrast resolution and abundant contrast mechanisms without radiation exposure, allowing for multiparametric assessment of the liver. Several MRI- related biomarkers, such as proton density fat fraction (PDFF), T2*/R2*, and elastography-derived stiffness, have been developed and established for quantitative assessment of liver fat, iron, and fibrosis, respectively, but none has been demonstrated for evaluating inflammation, the most important clinical hallmark throughout the disease course of NASH. T1 is an MRI parameter that can potentially be a useful marker for NASH, and there has long been an interest in using T1 changes to characterize liver inflammation and/or fibrosis. However, existing standard T1 mapping methods suffer from several limitations when applied to NASH patients. First, and most important, standard T1 mapping only measures composite T1 (water-fat-iron-mixed T1) of the liver, which can result in substantial bias due to the increased fat and iron content in the liver of NASH patients. This is because both fat and iron have short T1, while conversely, inflammation/fibrosis tends to prolong T1. Second, T1 mapping of the liver, particularly with 3D whole-liver coverage, remains challenging due to respiratory motion and the slow imaging speed of MRI, which can reduce measurement accuracy and reproducibility. These problems represent major barriers for evaluating fatty liver diseases and associated disease heterogeneity using T1 mapping. The overarching goal of this application is to propose and test a novel 3D liver T1 mapping method that could address these challenges. The new method, called Magnetization-Prepared Dixon Golden-angle RAdial Sparse Parallel (MP-Dixon-GRASP) MRI, features adaptive inversion recovery-prepared multi-echo stack-of-stars acquisition in combination with advanced model-based image reconstruction, which will enable free-breathing fat/iron- corrected T1 mapping to estimate the “true T1” of underlying liver parenchyma. Our main hypothesis to be tested in this R21 proposal is that by removing the influence of fat and iron, more accurate T1 can be estimated as a better marker of liver inflammation/fibrosis. If successful, this technique can be further combined with concomitant T2* and PDFF quantification to ultimately provide a new free-breathing 3D multiparametric MRI technique for assessment of NASH and potentially other chronic liver diseases of high clinical impact.

项目概要非酒精性脂肪肝病 (NAFLD) 的全球患病率约为 25%，是慢性肝病的主要病因非酒精性脂肪性肝炎 (NASH) 是 NAFLD 的一种晚期形式，涉及脂肪变性、由于慢性细胞损伤，NASH 也会导致肝脏炎症和铁沉积。肝纤维化，这是更严重的肝脏并发症的常见触发因素，例如肝硬化、门静脉高压、或肝细胞癌 (HCC) 作为癌症的结果，同时测量这些临床指标对于诊断至关重要。磁共振成像 (MRI) 可以提供更准确、更全面的 NASH 评估。因其出色的软组织对比度分辨率和丰富的对比度而成为公认的 NASH 评估方式无需辐射暴露的机制，允许对肝脏进行多参数评估相关生物标志物，例如质子密度脂肪分数 (PDFF)、T2*/R2* 和弹性成像衍生的硬度，已分别开发和建立用于定量评估肝脏脂肪、铁和纤维化，但没有已被证明可用于评估炎症，这是整个疾病最重要的临床标志 NASH 的病程是一个 MRI 参数，可能成为 NASH 的有用标记，并且长期以来一直存在。人们一直对使用 T1 变化来表征肝脏炎症和/或纤维化感兴趣。首先，标准 T1 映射方法在应用于 NASH 患者时存在一些局限性。重要的是，标准 T1 映射仅测量肝脏的复合 T1（水-脂肪-铁混合 T1），这可以由于 NASH 患者肝脏中的脂肪和铁含量增加，导致了很大的偏差。脂肪和铁的 T1 都较短，而相反，炎症/纤维化往往会延长 T1。其次，T1 映射。由于呼吸运动和缓慢的速度，肝脏的成像，尤其是 3D 全肝脏覆盖，仍然具有挑战性。 MRI 的成像速度会降低测量精度和再现性。主要用于使用 T1 映射评估脂肪肝疾病和相关疾病的异质性。该应用的总体目标是提出并测试一种新颖的 3D 肝脏 T1 映射方法，该方法可以解决这种新方法称为磁化准备迪克森黄金角径向稀疏并行。 (MP-Dixon-GRASP) MRI，具有自适应反转恢复准备的多回波星堆栈采集功能与先进的基于模型的图像重建相结合，这将使自由呼吸的脂肪/铁校正 T1 映射以估计潜在肝实质的“真实 T1” 我们要测试的主要假设。在这个 R21 提案中，通过消除脂肪和铁的影响，可以将更准确的 T1 估计为如果成功，该技术可以进一步与肝脏炎症/纤维化相结合。伴随 T2* 和 PDFF 量化，最终提供新的自由呼吸 3D 多参数 MRI 评估 NASH 和潜在的其他具有高度临床影响的慢性肝病的技术。