Ricerca Progetti nazionali, regionali, internazionaliNAZIONALIPRIN 2022A multifaceted quantitative approach by Magnetic Resonance

A multifaceted quantitative approach by Magnetic Resonance Imaging to stratify liver derangement and dysfunction in chronic liver disease: a prospective multicenter study by texture analysis, IVIM evaluation and T1 relaxometry

This research project deals with quantitative functional liver MRI imaging in chronic liver disease (CLD). During the progression CLD, three main events occur:

1. conversion of the lobule into nodule;

2. fibrosis development and architectural derangements;

3. vascular changes from sinusoids to capillaries (capillarization of sinusoids).

The event (1) leads to the hepato-carcinogenesis while the events (2-3) to a reduced liver function. As the organ disease progresses, loss of intercellular spaces, capillary fenestrations, depositions of dense fibrillar matrix in the space of Disse and hepatocyte functions reductions occur.

During the progressions of the disease, we can observe three major events related to the event (3):

- a decrease of the portal venous flow that consequently bypasses the parenchyma via portosystemic venous shunts;

- an increase of the mean transit time due to the restriction caused by the deposition of collagen;

- the increase of the hepatic arterial flow to counteract the portal venous blood flow reduction.

Therefore, the contrast agent (CA) kinetic is modified: the enhancement in the liver specific phase decreases and CAs are eliminated by the biliary system later and to a lesser extent, along with the progression of fibrosis. Our research hypothesis is that Magnetic Resonance Imaging (MRI) quantitative parameters obtained by a multifaceted quantitative approach may best depict the progression of the above mentioned events.

The purposes of our project are stratification, scoring and outcome prediction:

1) to stratify various grades of CLD, previously clinically classified, using quantitative parameters obtained from MRI exams including:

- Native T1 value of the liver parenchyma, from T1 mapping (T1m) pre-CA administration.

- T1 Reduction Rate (T1RR) value after GD‐EOB‐DTPA (EOB) administration

- Intravoxel Incoherent Motions (IVIM) parameters (D*, D, f and (1-f)) from MR diffusion-weighted imaging (DWI), widely discussed in the following paragraphs of this project.

2) to obtain a radiological score starting from the parameters reported above by recurring to a “quantitative functional liver imaging score (qFLIS)” that allows to predict the outcome of the CLD patients in term of presence/absence of hepatic decompensation events, onset of hepatocellular carcinoma and liver related death.

3) to predict the patient’s outcome. This project also aims, if it is possible, to evaluate the grade of CLD, using texture analysis (investigate the architectural-structural changes of the liver). This task fits in the field of the radiomics and its target is to analyze quantitatively the changes of the voxels in T1w images. Once obtained a prediction score also from this analysis, we will compare these results with the qFLIS already calculated, in order to obtain accurate prevision values of patient outcome.

 

Data di avvio 16 Ottobre 2023

Data di completamento 16 Ottobre 2025

Total cost  € 75948,00

 

Progetto 2022EC5YTY finanziato all’interno del Bando PRIN 2022 di cui al Decreto Direttoriale n. 104 del 02/02/2022 nell’ambito del Piano Nazionale di Ripresa e Resilienza, Missione 4 – Componente 2. Dalla Ricerca all’Impresa - Investimento 1.1 Fondo per il Programma Nazionale della Ricerca (PNR) e Progetti di Ricerca di Rilevante Interesse Nazionale (PRIN), finanziato dall’Unione europea – NextGenerationEU – CUP B53D23020220006