Non Invasive Characterization Of Liver Disease
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Non Invasive Characterization Of Liver Disease
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Author : Markus Karlsson
language : en
Publisher: Linköping University Electronic Press
Release Date : 2019-12-13
Non Invasive Characterization Of Liver Disease written by Markus Karlsson and has been published by Linköping University Electronic Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-12-13 with categories.
There is a large and unmet need for diagnostic tool that can be used to characterize chronic liver diseases (CLD). In the earlier stages of CLD, much of the diagnostics involves performing biopsies, which are evaluated by a histopathologist for the presence of e.g. fat, iron, inflammation, and fibrosis. Performing biopsies, however, have two downsides: i) biopsies are invasive and carries a small but non-negligible risk for serious complications, ii) biopsies only represents a tiny portion of the liver and are thus prone to sampling error. Moreover, in the later stages of CLD, when the disease has progressed far enough, the ability of the liver to perform its basic function will be compromised. In this stage, there is a need for better methods for accurately measuring liver function. Additionally, measures of liver function can also be used when developing new drugs, as biomarkers for drug-induced liver injury (DILI), which is a serious drug-safety issue. Magnetic resonance imaging (MRI) is a non-invasive medical imaging modality, which have shown much promise with regards to characterizing liver disease in all of the abovementioned aspects. The aim of this PhD project was to develop and validate MR-based methods that can be used to non-invasively characterize liver disease. Paper I investigated if R2* mapping, a MR-method for measuring liver iron content, can be confounded by liver fat. The results show fat does affect R2*. The conclusion was therefore that fat must be taken into account when measuring small amounts of liver iron, as a small increase in R2* could be due to either small amounts of iron or large amounts of fat. Paper II examined whether T1 mapping, which is another MR-method, can be used for staging liver fibrosis. The results of previous research have been mixed; some studies have been very promising, whereas other studies have been less promising. Unfortunately, the results in Paper II belongs to the less promising studies. Paper III focused on measuring liver function by dynamic contrast-enhanced MRI (DCEMRI) using a liver specific contrast agent, which is taken up the hepatocytes and excreted to the bile. The purpose of the paper was to extend and validate a method for estimating uptake and efflux rates of the contrast agent. The method had previously only been applied in health volunteers. Paper II showed that the method can be applied to CLD patients and that the uptake of the contrast agent is lower in patients with advanced fibrosis. Paper IV also used studied liver function with DCE-MRI in patients with primary sclerosing cholangitis (PSC). PSC is a CLD where the bile ducts are attacked by the immune system. When diagnosing PSC patients, it is common to use magnetic resonance cholangiopancreatography (MRCP), which is a method for imaging the bile ducts. Paper IV examined if there was any correlation between number and severity of the morphological changes, seen on MRCP, and measures of liver function derived using DCE-MRI. However, the results showed no such correlation. The conclusion was that the results indicates that MRCP should not be used to predict parenchymal function. Paper V developed a method for translating DCE-MRI liver function parameters from rats to humans. This translation could be of value when developing new drugs, as a tool for predicting which drugs might cause drug-induced liver injury. In summary, this thesis has shown that multimodal quantitative MR has a bright future for characterizing liver disease from a range of different aspects.
The Non Invasive Liver Biopsy
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Author : Mikael Forsgren
language : en
Publisher: Linköping University Electronic Press
Release Date : 2017-04-19
The Non Invasive Liver Biopsy written by Mikael Forsgren and has been published by Linköping University Electronic Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-04-19 with categories.
The liver is one of the largest organs within the human body and it handles many vital tasks such as nutrient processing, toxin removal, and synthesis of important proteins. The number of people suffering from chronic liver disease is on the rise, likely due to the present ‘western’ lifestyle. As disease develops in the liver there are pathophysiological manifestations within the liver parenchyma that are both common and important to monitor. These manifestations include inflammation, fatty infiltration (steatosis), excessive scar tissue formation (fibrosis and cirrhosis), and iron loading. Importantly, as the disease progresses there is concurrent loss of liver function. Furthermore, postoperative liver function insufficiency is an important concern when planning surgical treatment of the liver, because it is associated with both morbidity and mortality. Liver function can also be hampered due to drug-induced injuries, an important aspect to consider in drug-development. Currently, an invasive liver needle biopsy is required to determine the aetiology and to stage or grade the pathophysiological manifestations. There are important limitations with the biopsy, which include, risk of serious complications, mortality, morbidity, inter- and intra-observer variability, sampling error, and sampling variability. Cleary, it would be beneficial to be able investigate the pathophysiological manifestations accurately, non-invasively, and on regional level. Current available laboratory liver function blood panels are typically insufficient and often only indicate damage at a late stage. Thus, it would be beneficial to have access to biomarkers that are both sensitive and responds to early changes in liver function in both clinical settings and for the pharmaceutical industry and regulatory agencies. The main aim of this thesis was to develop and evaluate methods that can be used for a ‘non-invasive liver biopsy’ using magnetic resonance (MR). We also aimed to develop sensitive methods for measure liver function based on gadoxetate-enhanced MR imaging (MRI). The presented work is primarily based on a prospective study on c. 100 patients suffering from chronic liver disease of varying aetiologies recruited due to elevated liver enzyme levels, without clear signs of decompensated cirrhosis. Our results show that the commonly used liver fat cut-off for diagnosing steatosis should be lowered from 5% to 3% when using MR proton-density fat fraction (PDFF). We also show that MR elastography (MRE) is superior in staging fibrosis. Finally we presented a framework for quantifying liver function based on gadoxetate-enhanced MRI. The method is based on clinical images and a clinical approved contrast agent (gadoxetate). The framework consists of; state-of the-art image reconstruction and correction methods, a mathematical model, and a precise model parametrization method. The model was developed and validated on healthy subjects. Thereafter the model was found applicable on the chronic liver disease cohort as well as validated using gadoxetate levels in biopsy samples and blood samples. The liver function parameters correlated with clinical markers for liver function and liver fibrosis (used as a surrogate marker for liver function). In summary, it should be possible to perform a non-invasive liver biopsy using: MRI-PDFF for liver fat and iron loading, MRE for liver fibrosis and possibly also inflammation, and measure liver function using the presented framework for analysing gadoxetate-enhanced MRI. With the exception of an MREtransducer no additional hardware is required on the MR scanner. The liver function method is likely to be useful both in a clinical setting and in pharmaceutical trials.
Focal Liver Lesions
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Author : Riccardo Lencioni
language : en
Publisher: Springer Science & Business Media
Release Date : 2005-08-05
Focal Liver Lesions written by Riccardo Lencioni and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2005-08-05 with Medical categories.
Few fields of medicine have witnessed such impressive progress as the diagnosis and treatment of liver tumors. Advances in imaging technology, the development of novel contrast agents, and the introduction of optimized scanning protocols have greatly facilitated the non-invasive detection and characterization of focal liver lesions. Furthermore, image-guided techniques for percutaneous tumor ablation have become an accepted alternative treatment for patients with inoperable liver cancer. This book provides a comprehensive and up-to-date overview of the role of diagnostic and interventional radiology in respect of liver tumors. The volume moves from background sections on methodology and segmental liver anatomy to the main sections on the diagnosis of benign and malignant liver lesions. An integrated approach, focused on the correlation of ultrasound, CT, and MR imaging findings, is presented. Finally, a full section describes the principles, methods, and results of percutaneous tumor ablation techniques.
Need To Know Nafld
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Author : Naim Alkhouri
language : en
Publisher: CRC Press
Release Date : 2023-09-08
Need To Know Nafld written by Naim Alkhouri and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2023-09-08 with Medical categories.
Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the obesity and metabolic syndrome epidemics, which this up-to-date book deals with comprehensively. The contents outline disease mechanisms, diagnostic tests, management, varying manifestations, and special populations. It covers the mechanistic pathways that contribute to NAFLD development, including the role of genetic variants and the gut microbiome. It elaborates on noninvasive diagnostic tests to screen for NAFLD, determine its severity, and monitor response to lifestyle intervention and pharmacologic treatment. This book helps clinicians diagnose and treat this common and potentially deadly disease. Key Features: Reviews current drugs in development and provides practical advice to clinicians on the diagnosis and management of fatty liver. Proves attractive to primary care providers who are on the front line of managing patients with NAFLD, to gastroenterologists and hepatologists who would benefit from updated data on how to risk-stratify patients and identify those who will be eligible for pharmacologic treatment, and other specialists such as cardiologists, endocrinologists, and nephrologists who will find this book to be a useful reference on the extrahepatic manifestations of NAFLD. Focuses on extrahepatic manifestations and new insights on the mechanistic drivers of the disease.
Nonalcoholic Fatty Liver Disease An Issue Of Clinics In Liver Disease E Book
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Author : Arun J. Sanyal
language : en
Publisher: Elsevier Health Sciences
Release Date : 2012-08-12
Nonalcoholic Fatty Liver Disease An Issue Of Clinics In Liver Disease E Book written by Arun J. Sanyal and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-08-12 with Medical categories.
Dr. Sanyal's expertise as Chairman of the Division of Hepatology at Virginia Commonwealth University and the breadth of his published articles in hepatology make him the perfect person to compile state-of-the-art reviews on the topic of NASH/fatty liver. The articles in this issue address the following topics: The Genetic Epidemiology of Nonalcoholic Fatty Liver Disease; Relevance of Liver Histology to Predict Clinically Meaningful Outcomes in NASH; Mechanisms of Simple Hepatic Steatosis; Cellular and Molecular Basis for Phenotype of Steatohepatitis; Mechanisms of Disease Progression in NASH: New Paradigms; Can NASH Be Diagnosed, Graded and Staged Non-Invasively?; Is NAFLD in Children the Same Disease as in Adults?; The Cardiovascular Link to NAFLD: A Critical Analysis; Impact of Behavioral Disturbances and Their Treatment on Obesity and NAFLD; and Management of NASH.
Non Alcoholic Fatty Liver Disease
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Author : Geoffrey C. Farrell
language : en
Publisher: John Wiley & Sons
Release Date : 2013-02-06
Non Alcoholic Fatty Liver Disease written by Geoffrey C. Farrell and has been published by John Wiley & Sons this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-02-06 with Medical categories.
The sharp rise in cases of Non-alcoholic fatty liver disease is fast becoming one of the major concerns for hepatologists worldwide. This comprehensive clinical guide explains how to diagnose NAFLD and manage patients according to the best standards of care. Contributors from the world's leading institutions concentrate on patient care, drawing on their extensive experience.
Ultrasound Elastography
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Author : Monica Lupsor-Platon
language : en
Publisher: BoD – Books on Demand
Release Date : 2020-03-04
Ultrasound Elastography written by Monica Lupsor-Platon and has been published by BoD – Books on Demand this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-03-04 with Medical categories.
Elastography, the science of creating noninvasive images of mechanical characteristics of tissues, has been rapidly evolving in recent years. The advantage of this technique resides in the ability to rapidly detect and quantify the changes in the stiffness of soft tissues resulting from specific pathological or physiological processes. Ultrasound elastography is nowadays applied especially on the liver and breast, but the technique has been increasingly used for other tissues including the thyroid, lymph nodes, spleen, pancreas, gastrointestinal tract, kidney, prostate, and the musculoskeletal and vascular systems. This book presents some of the applications of strain and shear-wave ultrasound elastography in hepatic, pancreatic, breast, and musculoskeletal conditions.
Liver Research And Clinical Management
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Author : Luis Rodrigo
language : en
Publisher: BoD – Books on Demand
Release Date : 2018-05-02
Liver Research And Clinical Management written by Luis Rodrigo and has been published by BoD – Books on Demand this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-05-02 with Medical categories.
Hepatology is the medical specialty that studies the normal functioning of the liver and its diseases. It has experienced a steady progress in recent decades, as well as occurred in other medical specialties. It deals with the acute and chronic inflammatory processes of the liver, among which is the viral hepatitis. Recently, very effective drugs have been introduced in this field that achieves the elimination of the hepatitis C virus in the great majority of patients. Nonalcoholic steatohepatitis has increased markedly worldwide especially in Western countries in relation to overweight, diabetes, and other metabolic conditions. Cirrhosis and its complications are better managed, and patients live longer, thanks also to the earlier detection of hepatocarcinoma and the generalization of the use of liver transplants. This book deals with all of these interesting topics, thanks to the excellent collaboration of a great group of specialists that have collaborated with their knowledge and expertise in this edition.
Guidelines For The Prevention Care And Treatment Of Persons With Chronic Hepatitis B Virus Infection
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Author : WHO.
language : en
Publisher:
Release Date : 2015
Guidelines For The Prevention Care And Treatment Of Persons With Chronic Hepatitis B Virus Infection written by WHO. and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2015 with Chronic diseases categories.
These are the first World Health Organization (WHO) guidelines for theprevention care and treatment of persons living with CHB infection andcomplement similar recent published guidance by WHO on the prevention care and treatment of infection due to the hepatitis C virus (HCV). In contrastto several recent international guidelines on the management of CHB infectionfrom the United States Europe Asia-Pacific and the United Kingdom (UK) theprimary audience for these WHO guidelines is country programme managers inall settings but particularly in LMICs to help plan the development and scale up.
Diseases Of The Abdomen And Pelvis 2018 2021
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Author : Juerg Hodler
language : en
Publisher: Springer
Release Date : 2018-03-20
Diseases Of The Abdomen And Pelvis 2018 2021 written by Juerg Hodler and has been published by Springer this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-03-20 with Medical categories.
This open access book deals with imaging of the abdomen and pelvis, an area that has seen considerable advances over the past several years, driven by clinical as well as technological developments. The respective chapters, written by internationally respected experts in their fields, focus on imaging diagnosis and interventional therapies in abdominal and pelvic disease; they cover all relevant imaging modalities, including magnetic resonance imaging, computed tomography, and positron emission tomography. As such, the book offers a comprehensive review of the state of the art in imaging of the abdomen and pelvis. It will be of interest to general radiologists, radiology residents, interventional radiologists, and clinicians from other specialties who want to update their knowledge in this area.