Repeatability and Reproducibility of Multiparametric MRI

NCT ID: NCT03743272

Last Updated: 2025-12-01

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 61 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2017-06-03
• Study Completion Date: 2024-06-30

Brief Summary

This study aims to prospectively assess the repeatability and reproducibility of iron-corrected T1 (cT1), T2*, and hepatic proton density fat fraction (PDFF) quantification with multiparametric MRI using the LiverMultiScan™ (LMS, Perspectum Diagnostics, Oxford, UK) protocol across different field strengths, scanner manufacturers and models.

Detailed Description

As the burden of liver disease reaches epidemic levels, there is a high unmet medical need to develop robust, accurate and reproducible non-invasive methods to quantify liver tissue characteristics for use in clinical development and ultimately in clinical practice. Repeatability and reproducibility validation studies are important in evaluating metrics, such that any changes can be confidently attributed to disease progression or regression, rather than inter-examination variability in the instrument.

Magnetic resonance (MR) techniques offer an attractive non-invasive option for liver assessment. Multiparametric MRI is a safe and non-invasive method for quantification of liver tissue characteristics. Images for quantification of hepatic fat from proton density fat fraction (PDFF) maps, T2*, and iron-corrected T1 (cT1) can be rapidly obtained during abdominal breath-hold acquisitions without the need for contrast agents or additional external hardware. Iron correction of T1 is necessary to address the confounding effects of excess iron, which is common in chronic liver disease. LiverMultiScan™ (LMS, Perspectum Diagnostics, Oxford, UK) is a software application that can be used with supported MR-systems to correct T1 for the effects of excess iron, and thus, to calculate cT1 from T1 and T2* maps, and standardise to a 3T field strength.

This method has been shown to have high diagnostic accuracy for the assessment of liver fibrosis compared to histology, predict clinical outcomes in patients with mixed liver disease aetiology, stratify patients with non-alcoholic steatohepatitis (NASH) and cirrhosis, reliably exclude clinically significant liver disease and is cost-effective in diagnosing NAFLD.

In addition to demonstrating accuracy, imaging biomarker validation requires precision and repeatability (US Department of Health and Human Services, 2015). From a clinical perspective, it is essential to ensure that there is good inter-examination repeatability, so that any changes seen can be correctly attributed to disease progression or regression, rather than inter-examination variability. This is tested by examining the closeness of repeated measurements made in different MR examinations (with both subject and coil repositioning) over a time frame in which physiologic conditions are assumed constant.

This study aims to systematically test the repeatability and reproducibility of each multiparametric MRI measurement, cT1, T2* and PDFF, corresponding to hepatic fibro-inflammation, iron and fat respectively, across scanner field strength, manufacturer and model in human participants and phantoms.

Conditions

Liver Diseases; Primary Biliary Cirrhosis; Non-Alcoholic Fatty Liver Disease; Non-Alcoholic Steatohepatitis; Cirrhosis; Hemochromatosis; Viral Hepatitis; Autoimmune Hepatitis; Primary Sclerosing Cholangitis

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: CROSS_SECTIONAL

Study Groups

Liver condition

Participants who have a history of of liver disease

LiverMultiScan

Intervention Type: DEVICE

Up to 6 separate 5-10 minute abdominal MRI scans. Each scan requires a short breath hold.

Healthy volunteers

Participants who have do not have a diagnosed liver condition and are in general good health

LiverMultiScan

Intervention Type: DEVICE

Up to 6 separate 5-10 minute abdominal MRI scans. Each scan requires a short breath hold.

Interventions

LiverMultiScan

Up to 6 separate 5-10 minute abdominal MRI scans. Each scan requires a short breath hold.

Intervention Type: DEVICE

Other Intervention Names

Multiparametric Magnetic Resonance Imaging (mpMRI)

Eligibility Criteria

Inclusion Criteria

• Any person over 18 years of age.
• Participant is willing and able to give informed consent.

Exclusion Criteria

• The participant may not enter the study if they have any contraindication to magnetic resonance imaging (inc pregnancy, extensive tattoos, pacemaker, shrapnel injury, severe claustrophobia).
• Any other cause, including a significant disease or disorder which, in the opinion of the investigator, may either put the participant at risk because of participation in the study or affect the participant's ability to participate in the study.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Perspectum

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Rajarshi Banerjee, BM BCh MS DPhil

Role: PRINCIPAL_INVESTIGATOR

Perspectum Diagnostics

Locations

Leiden University Medical Centre

Leiden, , Netherlands

Addenbrookes Hospital

Cambridge, Cambridgeshire, United Kingdom

University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR)

Oxford, Oxfordshire, United Kingdom

Southampton General Hospital

Southampton, , United Kingdom

Countries

Netherlands; United Kingdom

References

Pickles E, Kumar S, Brady M, Telford A, Pavlides M, Bulte D. Comparison of liver iron concentration calculated from R2* at 1.5 T and 3 T. Abdom Radiol (NY). 2023 Mar;48(3):865-873. doi: 10.1007/s00261-022-03762-4. Epub 2022 Dec 15.

Reference Type: DERIVED

PMID: 36520162 (View on PubMed)

Other Identifiers

LMSRR

Identifier Type: -

Identifier Source: org_study_id