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Quantitative Magnetic Resonance Imaging Techniques for the Measurement of Organ Fat and Body Composition - Validation and Initial Clinical Utility

Sakai, Naomi; (2021) Quantitative Magnetic Resonance Imaging Techniques for the Measurement of Organ Fat and Body Composition - Validation and Initial Clinical Utility. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

Ectopic fat is defined by excess deposition of triglycerides in non-adipose tissues that normally contain only small amounts of fat. Measuring the distribution of ectopic fat is important for understanding the pathogenesis of diseases such as obesity and type 2 diabetes mellitus (T2DM) and understanding variation in treatment response amongst patients. Body composition (the proportion of fat and lean mass in the body) is thought to influence both the development of T2DM and outcomes for treatments such as weight-loss surgery. It can also affect clinical outcomes in chronic diseases and malignancy. Quantitative magnetic resonance imaging (qMRI) enables objective measurements of tissue characteristics to be made directly from acquired data. In this thesis, a qMRI protocol based on chemical shift-encoded (CSE)-MRI, specifically the derived proton density fat fraction (PDFF) measurements, was validated against phantoms, and in volunteers and patients with obesity. A new, semi-automated tool for measurement of body composition from CSE-MRI images was developed and validated. CSE-MRI was used to quantify ectopic organ fat depots and body composition in diseases including obesity, T2DM and cancer. Specifically, differences in organ fat between patients with and without remission of T2DM after bariatric surgery was explored. Body composition was investigated in T2DM remission and it was also compared between patients with colorectal and lung cancer undergoing whole body MRI staging. Data from the pilot phase of a study investigating a new duodenal surfacing procedural treatment for T2DM (Revita-2) is presented, demonstrating the utility of hepatic fat content measured using PDFF as an endpoint in an international, multi-centre clinical trial. Finally, I describe the development of a novel technique for quantification of bone mineral density (BMD) using CSE-MRI techniques. The methodology and tools described in this thesis could be used to measure ectopic fat and body composition in future studies and have the potential for integration into clinical care pathways.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Quantitative Magnetic Resonance Imaging Techniques for the Measurement of Organ Fat and Body Composition - Validation and Initial Clinical Utility
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10126229
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