Reduction of treatment costs and improved risk-stratification for diabetes patients in primary care: multi-organ MRI technology powered by artificial intelligence.

“代谢综合征的发病率激增，这是一系列疾病，包括肥胖、血压升高和2型糖尿病（T2 D），增加了脂肪肝、脂肪性肝炎、心脏病和中风的风险。涉及多个相互作用的器官，主要是胰腺、肝脏、脾脏、肾脏和心脏。虽然T2 D发生时胰腺不能正常工作，集中在一个单一的器官仅使用血液循环（例如胰腺）来诊断T2 D或评估其发展的风险是不够的，因为所有器官作为复杂系统相互作用，因此不仅每个器官有助于诊断，而且它们的组合也有助于诊断。（血液、尿液）生物标志物（例如肌酐、天冬氨酸转氨酶、HbA 1c）。然而，这些都不是足够的器官特异性，并将受益于补充成像，特别是MRI与其优秀的软组织对比度。一旦检测和诊断，T2 D通常是治疗药物Metalloid。这改变了糖尿病护理;但它有局限性。新的药物克服了许多这些限制，包括胰高血糖素样肽（GLP-1）受体激动剂和免疫疗法。不幸的是，这些药物的价格至少是二甲双胍的十倍，因此给每个糖尿病患者开处方对NHS来说是一个重大问题。该提案旨在开发一种方法，对那些预计Metabolic不足以治疗的患者进行分层，这些患者应该接受更先进，更昂贵的治疗。该技术将基于Perspectum的肝脏_Multiscan_。Perspectum已经开发了一种定量MRI方法来检测和分期早期肝脏疾病。此外，该公司还拥有试点数据，证明其在其他器官中的实用性，例如：其技术可用于从脾脏估计门静脉高压;它可以检测和测量胰腺炎和脂肪胰腺;并可以检查肾脏组织。此外，Perspectum的创始人最初致力于心脏MRI成像。该提案将肝脏_Multiscan_扩展到其他器官和血管-胰腺，肾脏，脾脏，主动脉-参与代谢综合征。Perspectum的技术发展将得到三个不同内分泌中心（利物浦、牛津、伦敦）的临床数据（包括循环生物标志物、基因分型和成像）的积累和分析的补充。患者和临床医生将积极参与。增强的多器官产品将由Perspectum商业化。该项目产生的数据将提供给英国各地的研究人员，他们正在努力促进我们对T2 D和代谢综合征的理解。"

"There has been a surge in incidence of the metabolic syndrome, a cluster of conditions including obesity, increased blood pressure and Type 2 diabetes (T2D), which increase the risk of fatty liver disease, steatohepatitis, heart disease and stroke. Multiple interacting organs are involved, primarily the pancreas, liver, spleen, kidneys and heart. Though T2D occurs when the pancreas doesn't work properly, concentrating on a single organ (e.g. pancreas) to diagnose T2D, or to assess the risk of it developing, is insufficient because all of the organs interact as a complex system, and so not only do each contribute to the diagnosis, but so does their combination.Most diabetes cases are detected using circulating (blood, urine) biomarkers (e.g. creatinine, aspartate transaminase, HbA1c). However, these are not sufficiently organ-specific and would benefit from complementary imaging, in particular MRI with its excellent soft-tissue contrast.Once detected and diagnosed, T2D is typically treated with the drug Metformin. This has transformed diabetes care; but it has limitations. New drugs overcome many of these limitations, including the glucagon-like peptide (GLP-1) receptor agonist and immunotherapies. Unfortunately, these cost at least ten times more than Metformin, so prescribing to everyone with diabetes poses a major problem for the NHS. This proposal aims to develop a method to stratify those patients for whom Metformin is expected to be inadequate and who should be prescribed more advanced, more expensive therapies. The technique will be based on Perspectum's Liver_Multiscan_.Perspectum has developed a quantitative MRI method to detect and stage early liver disease. As well, it has pilot data demonstrating its utility in other organs, for example: its technology can be used to estimate portal hypertension from the spleen; that it can detect and measure pancreatitis and fatty pancreas; and can characterise the tissue of the kidneys. Furthermore, Perspectum's founders worked originally in heart MRI imaging.This proposal will extend Liver_Multiscan_ to the other organs and vessels -- pancreas, kidney, spleen, aorta -- involved in the metabolic syndrome. The technical developments by Perspectum will be complemented by the accumulation and analysis of clinical data, both circulating biomarkers, genotyping and imaging, at three diverse endocrinology centres (Liverpool, Oxford, London). There will be strong patient and clinician involvement. The enhanced multi-organ product will be commercialised by Perspectum. The data produced by the project will be made available to researchers throughout the UK who are working to advance our understanding of T2D and the metabolic syndrome."