MRI and Stable Isotope Tracer Studies for Detecting the Progression of Non-Alcoholic Steatohepatitis (NASH)

2020-01-21 11:32:40 | BioPortfolio


One-third of the world's population suffers from Non-Alcoholic Fatty Liver Disease (NAFLD), that is a disease with an accumulation of fat in the liver. Some patients with NAFLD will progress in their disease to develop inflammation, scarring of the liver tissue, and cirrhosis that can lead to liver failure. The mechanisms of the disease and its progression are still not fully understood. It is therefore critical to find early markers that can identify the patients that will progress so that they can be treated early.

A compound called L-carnitine, synthesised in the body from two amino acids; lysine and methionine, is critical for fat metabolism. Some studies have shown that it is decreased in liver disease patients and that L-carnitine supplementation can protect the liver function.

This study aims to increase the understanding of the mechanisms behind NAFLD disease progression through its different stages. This may help diagnostic methods to be developed to predict the patients at risk for developing severe liver disease. Furthermore, fat metabolism and L-carnitine levels will be established in the different disease stages to evaluate whether fat metabolism could be compromised.

Magnetic Resonance Imaging (MRI) will be used for imaging of the whole liver and the heart to investigate metabolism and function non-invasively. Whole-body metabolism and how carbohydrates are taken up from diets are converted to fats in the body will be explored using stable isotope labelling. This study will recruit 30 participants with NAFLD; 10 each for low-risk NALFD, biopsy-proven NASH and compensated NASH cirrhosis. Participants will undergo MRI, followed by a stable isotope labelled study, where through blood- and breathe samples, metabolism will be investigated.

An additional 10 healthy participants will be assessed using MR techniques to assess whether an injection of L-carnitine can lead to increase of L-carnitine in the liver such that it can be detected by MR. This is to validate a methodology prior to using it in NAFLD participants.


STUDY 1: Functional and Metabolic Parameters in participants with NAFLD Participants will undertake two study visits, within a 14-day period. One of the visits will involve MR assessments that will take up to three hours in total. The second visit will involve a postprandial study day using stable isotopes. Baseline samples will be taken from participants, and after they have been fed a standardised test meal to assess whole-body and liver specific postprandial metabolism - this visit will last up to eight hours.

Magnetic Resonance Imaging (MRI) and Spectroscopy (MRS) and stable isotope labelling are two methodologies to investigate in vivo metabolism and function non-invasively. MRI gives information about liver structure and tissue composition, and heart function. MRS can also evaluate tissue energetics and composition using spectroscopy. Stable isotope-labelling studies allow for the measurement of whole-body fatty acid oxidation and de-novo lipogenesis in the pre- and post-prandial state. These two methodologies will be used in our study to evaluate participants with different severity of NAFLD and could help elucidate how the disease progresses.

STUDY 2: MRI evaluation of L-carnitine In parallel to study 1, the physiological response to L-carnitine (50 mg/kg i.v.) will be investigated only in healthy participants with 1H MRS.

These participants will only take part in one visit, during which they will undergo a baseline MRI scan, followed by the injection of L-carnitine. The MRI/MRS will be repeated two hours after the injection. AC has previously been measured in skeletal muscle using 1H MRS. In this study it will be measured in the septum of the heart and in the liver pre and 2 hours post-injection of 50 mg/kg i.v. of L-carnitine.

Study Design


Non-Alcoholic Fatty Liver Disease


Magnetic Resonance Imaging, Stable Isotope Study


Not yet recruiting


University of Oxford

Results (where available)

View Results


Published on BioPortfolio: 2020-01-21T11:32:40-0500

Clinical Trials [4843 Associated Clinical Trials listed on BioPortfolio]

T1-mapping by Cardiovascular Magnetic Resonance Imaging to Assess Non-Alcoholic Fatty Liver Disease

On clinically indicated Cardiovascular Magnetic Resonance studies, native T1-times and extracellular volume of the liver will be assessed and findings correlated with established risk calc...

Genetic Studies of Non-Alcoholic Fatty Liver Disease

Background: - Non-alcoholic fatty liver disease is the most common form of liver disease in the United States. It includes many conditions. Researchers want to study fatty liver disease b...

Study of the Safety and Tolerability of AXA1957 in Adolescent Subjects With Non-Alcoholic Fatty Liver Disease (NAFLD)

This is a randomized, single blind study to determine whether AXA1957, a novel composition of amino acids, is safe and well tolerated. Subjects will be adolescents with non-alcoholic fatty...

Magnetic Resonance Imaging in Evaluating Response to RadiationTherapy in Patients With High Grade Glioma

RATIONALE: Diagnostic procedures, such as magnetic resonance imaging, may help doctors predict a patient's response to treatment and help plan the best treatment. PURPOSE: This clinical tr...

Effect of Liraglutide on Fatty Liver Content and Lipoprotein Metabolism

Non-alcoholic fatty liver disease (NAFLD) is commonly associated with obesity, metabolic syndrome and type 2 diabetes. NAFLD, in patients with type 2 diabetes, has been shown to be associa...

PubMed Articles [24593 Associated PubMed Articles listed on BioPortfolio]

Diagnostic Use of Magnetic Resonance Imaging and Magnetic Resonance Arthrography for Intra-Articular Pathologies of the Hip Joint.

In no other country magnetic resonance imaging (MRI) is as frequently used as in Germany. The study's aim is to analyse a daily referral procedure for hip MRI in German healthcare and to estimate inef...

Accuracy of proton magnetic resonance for diagnosing non-alcoholic steatohepatitis: a meta-analysis.

Liver biopsy is the reference standard test to differentiate between non-alcoholic steatohepatitis (NASH) and simple steatosis (SS) in non-alcoholic fatty liver disease (NAFLD), but noninvasive diagno...

Imaging protocols for renal multiparametric MRI and MR urography: results of a consensus conference from the French Society of Genitourinary Imaging.

To develop technical guidelines for magnetic resonance imaging aimed at characterising renal masses (multiparametric magnetic resonance imaging, mpMRI) and at imaging the bladder and upper urinary tra...

Liver Fat and Cardio-metabolic Risk Factors among School Age Children.

Non-alcoholic fatty liver disease is a major risk factor for cardio-metabolic disease in adults. The burden of liver fat and associated cardio-metabolic risk factors in healthy children is unknown. In...

Effect of different healing stages on stable isotope ratios in skeletal lesions.

Physiological stress is one of the various factors that can have an impact on stable isotope ratios. However, its effect on bone collagen stable isotope ratios is still not fully understood. This stud...

Medical and Biotech [MESH] Definitions

The use of molecularly targeted imaging probes to localize and/or monitor biochemical and cellular processes via various imaging modalities that include RADIONUCLIDE IMAGING; ULTRASONOGRAPHY; MAGNETIC RESONANCE IMAGING; fluorescence imaging; and MICROSCOPY.

A technique applicable to the wide variety of substances which exhibit paramagnetism because of the magnetic moments of unpaired electrons. The spectra are useful for detection and identification, for determination of electron structure, for study of interactions between molecules, and for measurement of nuclear spins and moments. (From McGraw-Hill Encyclopedia of Science and Technology, 7th edition) Electron nuclear double resonance (ENDOR) spectroscopy is a variant of the technique which can give enhanced resolution. Electron spin resonance analysis can now be used in vivo, including imaging applications such as MAGNETIC RESONANCE IMAGING.

Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (MAGNETIC RESONANCE IMAGING).

A type of MAGNETIC RESONANCE IMAGING that uses only one nuclear spin excitation per image and therefore can obtain images in a fraction of a second rather than the minutes required in traditional MRI techniques. It is used in a variety of medical and scientific applications.

The creation of a visual display of the inside of the entire body of a human or animal for the purposes of diagnostic evaluation. This is most commonly achieved by using MAGNETIC RESONANCE IMAGING; or POSITRON EMISSION TOMOGRAPHY.

More From BioPortfolio on "MRI and Stable Isotope Tracer Studies for Detecting the Progression of Non-Alcoholic Steatohepatitis (NASH)"

Quick Search

Relevant Topic

Hepatology is the study of liver, gallbladder, biliary tree, and pancreas, and diseases associated with them. This includes viral hepatitis, alcohol damage, cirrhosis and cancer. As modern lifestyles change, with alcoholism and cancer becoming more promi...

Searches Linking to this Trial