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ISBE-AstraZeneca Strategic Alliance Project 26

ISBE-AstraZeneca Strategic Alliance Project 26. Evaluation of Crohn’s disease using T1-weighted dynamic contrast-enhanced MRI (DCE-MRI). Karl Embleton. develop an M. R. based imaging technique to provide dynamic contrast enhanced images for investigation of inflammatory bowel disease

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ISBE-AstraZeneca Strategic Alliance Project 26

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  1. ISBE-AstraZeneca Strategic Alliance Project 26 Evaluation of Crohn’s disease using T1-weighted dynamic contrast-enhanced MRI (DCE-MRI) Karl Embleton

  2. develop an M. R. based imaging technique to provide dynamic contrast enhanced images for investigation of inflammatory bowel disease derive disease volume measurements from contrast enhanced images of inflammatory bowel disease assess the application of endothelial permeability measurements to inflammatory bowel disease assess reproducibility of these measurements and the ability to identify treatment effects Project objectives

  3. Current recruitment • Five patients scanned at present • 3 with small regions of inflammation • 1 with large region, fistula present • 1 with previous ileostomy • Each patient scanned once only

  4. MRI protocol 512x512x50 axial sense breathold 512x512x25 coronal sense 256x256x25 morphological post-contrast 512x512x128 2mm axial post-contrast WAVE 256x256x25 morphological fat-sat post-contrast

  5. WAVE SENSE image showing inflamed and normal tissue

  6. Enhancement curves Patient 3 Patient 4 time-point

  7. Permeability analysis Standard Toft’s Enhanced Toft’s with automated AIF First-pass leakage profile A model based on that of St Laurence and Lee allowing direct estimation of local tissue blood flow will also be applied

  8. Parameter map overlays, patient 4 Kfp WAVE SENSE First pass VP Vp Ve Ktrans

  9. Volume renderings patient 4 Ktrans Vp Ve First Pass Vp Kfp

  10. Volume renderings patient 3 Vp Ktrans Ve First Pass Vp Kfp

  11. Mean parameter measurement for whole ROI Enhanced Toft’s with Ve abd auto AIF First Pass

  12. Cumulative frequency histograms, patient 4, enhanced Toft’s

  13. Cumulative frequency histograms, patient 4, first pass

  14. Multi-parameter segmentation

  15. Further work Recruitment increased to a second hospital Reproducibility and measurement of treatment effects is required for next patients: 2 scans within 1 week prior to anti-inflammatory 1 scan after 2 weeks treatment Future possibilites could include: Bowel motility measurements using ultra-fast SENSE imaging with contrast enhancement CT perfusion and permeability

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