MR assessment of hepatic hydatid disease
Research type
Research Study
Full title
Multi-metric quantitative MRI for the assessment of hepatic hydatid disease - a pilot study
IRAS ID
220530
Contact name
Stuart Taylor
Contact email
Sponsor organisation
University College London
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Cystic echincoccosis (CE), caused by infection with the dog tapeworm, is a major worldwide healthcare problem with increasing prevalence in the developed world. Approximately 75% of CE involves the liver, with treatments incurring significant cost and patient morbidity.
The key to CE treatment is correct identification of active infection but differentiation from inactive disease is highly problematic. Current treatment guidelines base activity assessment on ultrasound (US), blood tests and microscopic analysis of fluid obtained at surgery when available. Blood tests however can take many years to become negative even following successful treatment and US evaluation is subjective. Assessment of disease ‘activity’ is therefore a major challenge, particularly once patients are undergoing treatment. The lack of accurate tools to assess treatment response has undermined the development of management guidelines, particularly concerning the length of treatment and indications for surgery/invasive treatments.
Magnetic Resonance Imaging (MRI) scans provide an opportunity to not only assess the appearances of disease but the opportunity to apply quantitative scanning technique to address this challenge. Magnetic Resonance Spectroscopy (MRS) has shown promising results in identifying active infection in cyst fluid, but has yet to be applied clinically. Alternative quantitative MR approaches include T1 mapping, susceptibility mapping and Diffusion Weighted Imaging/Intra-voxel Incoherent Motion but have little supportive data to date.
Measurements of CE activity that do not require sampling of the cysts are therefore essential to defining treatment endpoints. Multiple quantitative MR methods could also be used to develop composite measurements of disease activity. A new quantitative radiological ‘fingerprint’ for each stage of the natural life-cycle of hepatic CE will improve diagnosis and therapeutic planning.
To date, liver quantitative MRI has not yet been applied to these patients. With this pilot study, we aim to demonstrate the potential of quantitative MRI methods in the assessment of active/inactive hepatic CE.
REC name
London - Brent Research Ethics Committee
REC reference
17/LO/0623
Date of REC Opinion
30 May 2017
REC opinion
Further Information Favourable Opinion