Researchers at the University of Oxford have secured £2.2m to investigate alternative liver cancer surveillance methods for patients with cirrhosis.
The study, known as the AMULET clinical study, will evaluate the use of non-contrast-enhanced magnetic resonance imaging (MRI) scans in comparison to the current standard, ultrasound, focusing on improved early detection of hepatocellular liver cancer.
This initiative is taken on by the DeLIVER team at the University of Oxford, in partnership with colleagues from the Universities of Nottingham, Bournemouth, and Glasgow Caledonian.
Cirrhosis is scarring of the liver caused by long-term liver damage, with symptoms including feeling sick and tired, yellow skin and eyes, itchy skin, and a swollen tummy.
The funding has been awarded by the Efficacy and Mechanism Evaluation (EME) Programme, a joint venture between the National Institute for Health and Care Research (NIHR) and the Medical Research Council.
Dr Michael Pavlides, head of liver imaging at the Oxford Centre for Clinical Magnetic Resonance Research assumes the role of the AMULET study's chief investigator.
Mr Pavlides is a prominent figure in the NIHR Oxford Biomedical Research Centre's Imaging and Cancer Themes.
With predictions by Cancer Research UK suggesting the possibility of 9,700 new cases of liver cancer annually by 2038-2040, this study aims at refining the diagnostic process.
Most cases of liver cancer occur in people with liver cirrhosis, thus necessitating regular surveillance, with the current standard being ultrasound.
However, while early detection of liver cancer stands a better chance of treatment success, some patients have had early signs go undetected due to the ultrasound's sensitivity limits.
MRI isn't a conventional method for liver cancer surveillance.
A standard clinical liver MRI scan requires an injected dye, known as a contrast, which isn't ideal as it's invasive, adds to the duration and cost of the procedure, and the dye can accumulate in the brain over extensive use.
Therefore, a shorter non-contrast-enhanced MRI protocol is being established by the study team.
The aim is to leverage its potential for higher sensitivity surveillance in contrast to ultrasound and contrast-enhanced MRI.
The new EME funding for AMULET will deliver the team an opportunity to try this alternative MRI approach in a prospective group of 300 patients with liver cirrhosis.
These patients are part of the DeLIVER programme, funded by Cancer Research UK.
Besides comparative evaluation of the new technology against ultrasound, the study could offer valuable insights into the biology of cirrhosis progression to liver cancer.
This could help shape future early detection and preventive strategies, providing a veritable lifeline to thousands in need.
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