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

Project objectives 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

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 Current recruitment

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

WAVE SENSE image showing inflamed and normal tissue

Enhancement curves Patient 3Patient 4 time-point

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

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

Volume renderings patient 4 Ktrans Ve Vp Kfp First Pass Vp

Volume renderings patient 3 KtransVe Vp Kfp First Pass Vp

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

Cumulative frequency histograms, patient 4, enhanced Toft’s

Cumulative frequency histograms, patient 4, first pass

Multi-parameter segmentation

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 Further work Future possibilites could include: Bowel motility measurements using ultra-fast SENSE imaging with contrast enhancement CT perfusion and permeability