Advanced Imaging for the assessment of Colorectal Liver Metastases
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Embargo End Date
2025-06-12
ICR Authors
Authors
Castagnoli, F
Document Type
Thesis or Dissertation
Date
2024-12-12
Date Accepted
Abstract
This thesis explores the deployment of advanced imaging techniques in the management of patients with colorectal liver metastases, emphasizing the role of artificial intelligence (AI), abbreviated MRI protocols, quantitative CT and MRI assessment for the assessment of colorectal liver metastasis at disease diagnosis and follow-up. The research aims to improve diagnostic accuracy, treatment planning, and outcome assessment through innovative imaging approaches.
First, the application of AI in MRI reconstructions is evaluated. AI algorithms are being employed to swiftly reconstruct higher-resolution images from MRI scans, thereby reducing scan times and improving imaging efficiency. This advancement has the potential to improve patient discomfort through reducing acquisition time in clinical practice, while maintaining or enhancing diagnostic accuracy.
Second, acknowledging the growing demands for using MRI, the performance of a 10-15 minute long abbreviated liver MRI protocol following the initial diagnosis of liver metastases on CT is assessed. Although abbreviated MRI protocols have been shown effective for assessing response and segmental liver involvement for the follow-up of colorectal liver metastasis, their use for the initial baseline assessments to evaluate the presence and site of liver metastases is unclear. This research seeks to address this gap and assess the benefits for disease and surgical staging.
Third, the application of quantitative MRI to evaluate treatment response of SBRT is examined. SBRT represents a significant advancement in radiation therapy, enabling the precise delivery of high doses of radiation to tumours while sparing surrounding healthy tissue. Despite its promise in treating colorectal liver metastases, challenges remain in disease response assessment. This research aims to identify imaging parameters for identifying response and treatment benefits.
Last, the potential surgical impact of hepatic steatosis assessed using CT imaging on pre-operative imaging is also investigated. Hepatic steatosis, which can be prevalent in the general population but specifically in patients with colorectal cancer due to neoadjuvant systemic treatments, is associated with an increased risk of postoperative complications. Anecdotally, surgeons report that steatotic livers bleed more than non-steatotic livers during surgery which may further increase morbidity. The study will explore hepatic steatosis as a potential risk factor for peri-operative morbidity and blood loss, which can contribute to more informed surgical decision-making.
In summary, in this project, I will evaluate non-invasive and novel approaches by applying different state-of- the-art imaging techniques to improve the detection of metastatic liver lesions, in the preoperative mapping of colorectal liver metastases (both before and after neoadjuvant chemotherapy), for the assessment of treatment response and for informing perioperative complications.
Citation
2024
DOI
Source Title
Publisher
Institute of Cancer Research (University Of London)