Non-Invasive Characterization of Liver Disease

Non-Invasive Characterization of Liver Disease
Author: Markus Karlsson
Publisher: Linköping University Electronic Press
Total Pages: 77
Release: 2019-12-13
Genre:
ISBN: 9179299423

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.

Chronic Liver Failure

Chronic Liver Failure
Author: Pere Ginès
Publisher: Springer Science & Business Media
Total Pages: 583
Release: 2010-11-03
Genre: Medical
ISBN: 1607618664

Chronic liver failure is a frequent condition in clinical practice that encompasses all manifestations of patients with end-stage liver diseases. Chronic liver failure is a multiorgan syndrome that affects the liver, kidneys, brain, heart, lungs, adrenal glands, and vascular, coagulation, and immune systems. Chronic Liver Failure: Mechanisms and Management covers for the first time all aspects of chronic liver failure in a single book, from pathogenesis to current management. Each chapter is written by a worldwide known expert in their area and all provide the latest state-of-the-art knowledge. This volume is specifically designed to provide answers to clinical questions to all doctors dealing with patients with liver diseases, not only clinical gastroenterologists and hepatologists, but also to internists, nephrologists, intensive care physicians, and transplant surgeons.

Diseases of the Abdomen and Pelvis 2018-2021

Diseases of the Abdomen and Pelvis 2018-2021
Author: Juerg Hodler
Publisher: Springer
Total Pages: 262
Release: 2018-03-20
Genre: Medical
ISBN: 3319750194

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.

Magnetic Resonance Elastography

Magnetic Resonance Elastography
Author: Sudhakar K. Venkatesh
Publisher: Springer
Total Pages: 143
Release: 2014-10-01
Genre: Medical
ISBN: 1493915754

The first book to cover the groundbreaking development and clinical applications of Magnetic Resonance Elastography, this book is essential for all practitioners interested in this revolutionary diagnostic modality. The book is divided into three sections. The first covers the history of MRE. The second covers technique and clinical applications of MRE in the liver with respect to fibrosis, liver masses, and other diseases. Case descriptions are presented to give the reader a hands-on approach. The final section presents the techniques, sequence and preliminary results of applications in other areas of the body including muscle, brain, lung, heart, and breast.

Biomarkers in Liver Disease

Biomarkers in Liver Disease
Author: Victor R. Preedy
Publisher: Springer
Total Pages: 0
Release: 2017-07-14
Genre: Medical
ISBN: 9789400776746

In the past decade there has been a major sea change in the way disease is diagnosed and investigated due to the advent of high throughput technologies, such as microarrays, lab on a chip, proteomics, genomics, lipomics, metabolomics etc. These advances have enabled the discovery of new and novel markers of disease relating to autoimmune disorders, cancers, endocrine diseases, genetic disorders, sensory damage, intestinal diseases etc. In many instances these developments have gone hand in hand with the discovery of biomarkers elucidated via traditional or conventional methods, such as histopathology or clinical biochemistry. Together with microprocessor-based data analysis, advanced statistics and bioinformatics these markers have been used to identify individuals with active disease or pathology as well as those who are refractory or have distinguishing pathologies. New analytical methods that have been used to identify markers of disease and is suggested that there may be as many as 40 different platforms. Unfortunately techniques and methods have not been readily transferable to other disease states and sometimes diagnosis still relies on single analytes rather than a cohort of markers. There is thus a demand for a comprehensive and focused evidenced-based text and scientific literature that addresses these issues. Hence the formulation of Biomarkers in Disease The series covers a wide number of areas including for example, nutrition, cancer, endocrinology, cardiology, addictions, immunology, birth defects, genetics, and so on. The chapters are written by national or international experts and specialists.

Ultrasound Elastography

Ultrasound Elastography
Author: Monica Lupsor-Platon
Publisher: BoD – Books on Demand
Total Pages: 148
Release: 2020-03-04
Genre: Medical
ISBN: 1789857090

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 Cirrhosis

Liver Cirrhosis
Author: Georgios Tsoulfas
Publisher: BoD – Books on Demand
Total Pages: 304
Release: 2017-07-05
Genre: Medical
ISBN: 9535133098

Liver cirrhosis represents one of the major challenges for most physicians and surgeons on a global scale. This book provides practicing hepatologists, gastroenterologists and liver surgeons with a valuable tool in their efforts to understand the (molecular) mechanisms involved, be updated regarding the newest and less invasive diagnostic methods, and educate themselves about the challenges involved in the management of liver cirrhosis and its complications. The authors of this book represent a team of true global experts on the topic. In addition to the knowledge shared, the authors provide their personal clinical experience on a variety of different aspects of liver cirrhosis, giving us a well-rounded overview.

Non-Alcoholic Fatty Liver Disease

Non-Alcoholic Fatty Liver Disease
Author: Elisabetta Bugianesi
Publisher: Springer Nature
Total Pages: 358
Release: 2020-09-28
Genre: Medical
ISBN: 3319958283

The goal of this book is to promote awareness of non-alcoholic fatty liver disease (NAFLD) – which is rapidly replacing viral hepatitis as the leading cause of chronic liver disease in Europe, North and South America and Asia – and to share the latest information on evolving approaches to diagnosis and treatment. The book offers a comprehensive overview of the current topics of interest in the field, and provides clinical guidance on NAFLD through a multidisciplinary approach based on the latest scientific understanding of this multisystemic disease, involving the expertise of specialists including hepatologists, diabetologists, and cardiologists. The respective contributions address various aspects, including the newly released international guidelines, novel diagnostic modalities, and new experimental drugs. The work will appeal to a broad readership, from residents in internal medicine to specialists.​

Liver Research and Clinical Management

Liver Research and Clinical Management
Author: Luis Rodrigo
Publisher: BoD – Books on Demand
Total Pages: 250
Release: 2018-05-02
Genre: Medical
ISBN: 178923090X

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.

Translational Research Methods in Diabetes, Obesity, and Nonalcoholic Fatty Liver Disease

Translational Research Methods in Diabetes, Obesity, and Nonalcoholic Fatty Liver Disease
Author: Andrew J. Krentz
Publisher: Springer
Total Pages: 557
Release: 2019-04-02
Genre: Medical
ISBN: 3030117480

This book aims to aid the selection of the most appropriate methods for use in early phase (1 and 2) clinical studies of new drugs for diabetes, obesity, non-alcoholic fatty liver disease (NAFLD) and related cardiometabolic disorders. Clinical research methods to assess the pharmacokinetics and pharmacodynamics of new diabetes drugs, e.g. the euglycemic clamp technique, have become well-established in proof-of-mechanism studies. However, selection of the most appropriate techniques is by no means straightforward. Moreover, the application of such methods must conform to the regulatory requirements for new drugs. This book discusses the need for new pharmacotherapies for diabetes, obesity and NAFLD and the molecular targets of drugs currently in development. Emerging technologies including functional imaging, circulating biomarkers and omics are considered together with practical and ethical issues pertaining to early phase clinical trials in subjects with cardiometabolic disorders. Translational Research Methods in Diabetes, Obesity, and Non-Alcoholic Fatty Liver Disease is of interest to biomedical scientists, pharmacologists, academics involved in metabolic research and clinicians practicing in these specialties.