Imaging liver inflammation
Research type
Research Study
Full title
Imaging hepatic inflammation using dynamic positron emission tomography
IRAS ID
106248
Contact name
Michael Peters
Contact email
Sponsor organisation
BSUH Sponsorship committee
Research summary
Positronemission tomography (PET) is a technique for imaging glucose metabolism. It scans the bodily distribution of
fluorodeoxyglucose (FDG), a radioactive substance chemically similar to glucose that is administered intravenously
and taken up in increased amounts by metabolically active tissue, especially cancer.
PET is an emerging technique for imaging inflammation because inflammatory cells are also metabolically active.
Our aim is to test the feasibility of PET for imaging liver inflammation of which there are several causes, including a
spectrum of alcohol related diseases ranging from severe alcoholic hepatitis (SAH) to stable cirrhosis. Excess fat in
the liver (hepatic steatosis) also causes liver inflammation known as Non Alcoholic SteatoHepatitis. NASH develops
in ~30% of patients with hepatic steatosis and eventually leads to liver cirrhosis. The clinical implications of diagnosing
liver inflammation vary according to the cause. Thus SAH may be difficult to separate clinically from other forms of liver damage and requires liver biopsy for diagnosis. Likewise, NASH can only be diagnosed by biopsy. If we can image liver inflammation using PET, the need for biopsy would be significantly reduced.
Liver is the only tissue able to transfer its glucose and FDG back into blood. Liver and blood FDG concentrations therefore ‘parallel’ each other. When the liver is inflamed, however, we predict that FDG will be trapped in inflammatory cells, and liver and blood concentrations will ’diverge’. ‘Patlak’ analysis is a method for quantifying this ‘divergence’. We aim to apply it to images of the liver and heart (for blood FDG concentration) acquired continuously for 30 minutes after FDG injection. We will also image the liver at 60 minutes using CT, from which we will measure liver fat content.
We aim to recruit 20 patients divided into 4 groups: SAH, decompensated alcoholic cirrhosis, simple steatosis and
NASH. All participants will have had liver biopsy.REC name
London - London Bridge Research Ethics Committee
REC reference
13/LO/1545
Date of REC Opinion
18 Dec 2013
REC opinion
Further Information Favourable Opinion