Vers un nouveau paradigme pour le diagnostic et suivi non invasif des hépatopathies chroniques par imagerie

 

An Tang

Centre hospitalier de l'Université de Montréal

 

Domaine : Nutriton et métabolisme

Programme chercheurs-boursiers - Junior 1

Concours 2013-2014

Partenaire

Fondation de l'Association des radiologistes du Québec

Chronic liver disease can be difficult to diagnose because symptoms can be vague or even absent. Chronic liver disease from any cause can lead to liver fibrosis, a process of tissue scarring in response to injury. Over time, fibrosis can evolve toward cirrhosis, an advanced stage where liver function is disrupted. Once cirrhosis is established, patients have an increased risk of developing gastrointestinal bleeding, liver cancer, and liver failure that may require transplantation. To confirm a diagnosis of chronic liver disease, a biopsy is currently needed.

A biopsy involves inserting a needle inside the liver to remove a small piece of tissue which is then examined under a microscope to determine the amount of fibrosis. Liver biopsy is an invasive and potentially painful procedure associated with a risk of bleeding in 0.5% of cases, a concern for patients and their physicians. Because of the dynamic nature of chronic liver disease, it is impractical to repeat liver biopsies over several decades. Therefore, there is a clear need for noninvasive alternatives to liver biopsy.

The goal of this research program is to develop and validate imaging-based methods for assessment of chronic liver disease. In the first project, a clinical trial will be performed to compare three noninvasive methods called magnetic resonance elastography, acoustic radiation force impulse, and transient elastography (Fibroscan) for measuring liver fibrosis. In the second project, a clinical trial will be performed to measure liver fat in patients with type 2 diabetes using two methods based on magnetic resonance. In the third project, we will develop a software for measuring liver volume with an industrial partner based in Montreal. Used in combination, these methods may reduce the need for liver biopsies and facilitate the monitoring of chronic liver disease.