Quantitative Real-Time MRI for the Assessment of Gastric Motility

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Embargo End Date

ICR Authors

Blackledge, Matthew

Authors

Neubauer, L
Forstreuter, L
Winter, F
Mankertz, F
Wielputz, MO
Grajecki, DS
Steveling, A
Aghdassi, AA
Zeissig, S
Blackledge, MD
Voit, D
Frahm, J
Schnell, S
Weitschies, W
Grossmann, L

Document Type

Journal Article

Date

2026-05-01

Date Accepted

Abstract

<jats:title>ABSTRACT</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Current reference standards for measuring gastric emptying and motility are not considered optimal due to the time required, ionizing radiation, invasiveness, and spatial resolution.</jats:p> </jats:sec> <jats:sec> <jats:title>Purpose</jats:title> <jats:p>To assess gastric motility using novel real‐time dynamic magnetic resonance imaging in combination with static measurements for gastric emptying and training of an automated deep‐learning‐based segmentation pipeline.</jats:p> </jats:sec> <jats:sec> <jats:title>Study Type</jats:title> <jats:p>Prospective.</jats:p> </jats:sec> <jats:sec> <jats:title>Participants</jats:title> <jats:p>The study included 36 healthy volunteers (20 female, mean 24 ± 3 years) and three patients with diagnosed Crohn's disease.</jats:p> </jats:sec> <jats:sec> <jats:title>Field Strength/Sequences</jats:title> <jats:p>Participants ingested water to assess fasting motility and pineapple juice for the postprandial state. 3 T, 3D spoiled gradient echo (GRE) sequence and real‐time spoiled GRE.</jats:p> </jats:sec> <jats:sec> <jats:title>Assessment</jats:title> <jats:p>Gastric emptying was measured by using the gastric volume, while motility was analyzed by tracking changes in the antrum's cross‐sectional area and applying Fast Fourier Transformation. Segmentations were performed using a trained semantic segmentation model.</jats:p> </jats:sec> <jats:sec> <jats:title>Statistical Tests</jats:title> <jats:p> Linear Mixed Model with continuous dependent variables and fixed effects. Models included a random intercept for participants. Statistical significance was defined as <jats:italic>p</jats:italic>  = 0.05. </jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p> The method enabled volumetric analysis of gastric content from 3D breath‐hold static acquisition and time‐resolved quantification of peristaltic parameters from real‐time FLASH2 imaging at high temporal resolution (here 6.24 fps). Water emptied rapidly and exponentially ( <jats:italic>t</jats:italic> <jats:sub>1/2</jats:sub>  = 14.77 ± 10.55 min), while juice showed slower emptying ( <jats:italic>t</jats:italic> <jats:sub>1/2</jats:sub>  = 64.24 ± 11.87 min). Contraction frequencies (fasted: 2.76 ± 0.43 cpm, fed: 2.89 ± 0.43 cpm) and velocities (fasted: 1.67 ± 0.38 mm/s, fed: 1.72 ± 0.37 mm/s) were within physiological ranges, with fasting conditions characterized by stronger occlusion compared to the fed. Measurements taken from three patients proved that the workflow could be used in a clinical context. </jats:p> </jats:sec> <jats:sec> <jats:title>Data Conclusion</jats:title> <jats:p>Real‐time MRI with AI‐based analysis enabled quantitative assessment of gastric emptying and motility, revealing physiological peristaltic parameters and state‐dependent differences in occlusion.</jats:p> </jats:sec> <jats:sec> <jats:title>Evidence Level</jats:title> <jats:p>2.</jats:p> </jats:sec> <jats:sec> <jats:title>Technical Efficacy</jats:title> <jats:p>Stage 1.</jats:p> </jats:sec>

Citation

Journal of Magnetic Resonance Imaging, 2026, 63 (5), pp. 1482 - 1495

DOI

10.1002/jmri.70243

URI

https://repository.icr.ac.uk/handle/internal/7767

Rights

http://creativecommons.org/licenses/by/4.0/

Source Title

Journal of Magnetic Resonance Imaging

Publisher

WILEY

ISSN

1053-1807

eISSN

1522-2586

Collections

Radiotherapy and Imaging

Research Team

Computational Imaging

Notes