Selvaraj EA, Culver EL, Bungay H, Bailey A, Chapman RW, Pavlides M. Evolving role of magnetic resonance techniques in primary sclerosing cholangitis. World J Gastroenterol 2019; 25(6): 644-658 [PMID: 30783369 DOI: 10.3748/wjg.v25.i6.644]
Corresponding Author of This Article
Michael Pavlides, BSc, DPhil, MBBS, MRCP, Doctor, Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Level 0, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, United Kingdom. michael.pavlides@cardiov.ox.ac.uk
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Feb 14, 2019; 25(6): 644-658 Published online Feb 14, 2019. doi: 10.3748/wjg.v25.i6.644
Evolving role of magnetic resonance techniques in primary sclerosing cholangitis
Emmanuel A Selvaraj, Emma L Culver, Helen Bungay, Adam Bailey, Roger W Chapman, Michael Pavlides
Emmanuel A Selvaraj, Michael Pavlides, Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
Emmanuel A Selvaraj, Emma L Culver, Adam Bailey, Roger W Chapman, Michael Pavlides, Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
Emmanuel A Selvaraj, Emma L Culver, Adam Bailey, Michael Pavlides, Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust and the University of Oxford, Oxford OX3 9DU, United Kingdom
Helen Bungay, Department of Radiology, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
Author contributions: All authors have contributed to write, revise and submit this review.
Supported bythe National Institute of Health Research (NIHR) Biomedical Research Centre, based at Oxford University Hospitals NHS Foundation Trust; and Oxfordshire Health Service Research Committee (OHSRC) as part of Oxford Hospitals Charity, Oxford.
Conflict-of-interest statement: Pavlides M is a shareholder for the company Perspectum Diagnostics and has applied for a patent for medical imaging. All other authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Michael Pavlides, BSc, DPhil, MBBS, MRCP, Doctor, Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Level 0, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, United Kingdom. michael.pavlides@cardiov.ox.ac.uk
Telephone: +44-1865-234577
Received: November 28, 2018 Peer-review started: November 28, 2018 First decision: January 18, 2019 Revised: January 25, 2019 Accepted: January 28, 2019 Article in press: January 28, 2019 Published online: February 14, 2019 Processing time: 78 Days and 16.5 Hours
Abstract
Development of non-invasive methods to risk-stratify patients and predict clinical endpoints have been identified as one of the key research priorities in primary sclerosing cholangitis (PSC). In addition to serum and histological biomarkers, there has been much recent interest in developing imaging biomarkers that can predict disease course and clinical outcomes in PSC. Magnetic resonance imaging/magnetic resonance cholangiopancreatography (MRI/MRCP) continue to play a central role in the diagnosis and follow-up of PSC patients. Magnetic resonance (MR) techniques have undergone significant advancement over the last three decades both in MR data acquisition and interpretation. The progression from a qualitative to quantitative approach in MR acquisition techniques and data interpretation, offers the opportunity for the development of objective and reproducible imaging biomarkers that can potentially be incorporated as an additional endpoint in clinical trials. This review article will discuss how the role of MR techniques have evolved over the last three decades from emerging as an alternative diagnostic tool to endoscopic retrograde cholangiopancreatography, to being instrumental in the ongoing search for imaging biomarker of disease stage, progression and prognosis in PSC.
Core tip: Magnetic resonance imaging/magnetic resonance cholangiopancreatography (MRI/MRCP) remains the cornerstone in the diagnosis and follow-up of primary sclerosing cholangitis (PSC) patients. However, heterogeneity in acquisition, image processing and interpretation varies significantly. There is ongoing interest in establishing non-invasive methods to predict clinical endpoints in PSC. A number of recent publications have focused on objectively quantifying output from various magnetic resonance (MR) techniques and have suggested MR parameters as potential prognostic risk-stratification tool in PSC. Our aim is to revisit the historical use of imaging in PSC and consolidate the evolving role of the different MR techniques to date in the quest for establishing a validated imaging biomarker for PSC.
