New thesis on magnetic resonance imaging (MRI) in diagnosis and prognosis of primary sclerosing cholangitis
Aristeidis Grigoriadis, from the Gastroenterology and Rheumatology Unit at the Department of Medicine, Huddinge (MedH) will defend his thesis "Magnetic resonance imaging as a tool for diagnosis, evaluation and prognosis in patients with primary sclerosing cholangitis" on February 17, 2023. Main Supervisor is Annika Bergquist (MedH).
What's the main focus of your thesis?
In my thesis, we have evaluated magnetic resonance imaging (MRI) as a tool for diagnosis, and prognosis in individuals with primary sclerosing cholangitis (PSC). PSC is a chronic inflammatory liver disease, characterized by the progressive destruction of the bile ducts. Sometimes it also leads to liver failure and need for liver transplantation for those affected. Moreover, individuals with PSC have an increase risk of developing bile duct cancer (cholangiocarcinoma).
MRI is an imaging method where we, instead of ionizing radiation, use a powerful magnet to image the inner parts of the human body. We have studied the liver, bile ducts, and gallbladder of patients with the main variant of the disease called "large duct" PSC. Moreover, we have evaluated individuals with a rarer PSC-variant called “small duct" PSC. "Small duct PSC" has a better prognosis compared to "large duct" PSC.
Which are the most important results?
The evaluation and interpretation of MRI of individuals with PSC is challenging even for experienced radiologists. However, imaging findings from MRI examinations, seem to have the potential to be used to predict which patients will develop bile duct cancer or the need for liver transplantation. Moreover, some patients with “small duct" PSC will develop “large duct" PSC. However in this study we weren't able to identify laboratory or imaging findings that could predict this progression in patients.
How can this new knowledge contribute to the improvement of people's health?
We have deepened our understanding of how MRI can contribute to the healthcare of individuals with PSC. Moreover, we have developed a new prognostic score, called the DiStrict score. It's a score system we can use to calculate the prognosis for individuals with the disease. The score has potential to be used in clinical practice to classify patients into different risk categories of developing need for liver transplantation and in counseling individuals with PSC.
What are your future ambitions?
I want to continue my research in PSC and other areas of liver and pancreas radiology.