# Project 3: A Novel Simultaneous Multiparametric MRI Approach for the Quantitative Assessment of Non-alcoholic Fatty Liver Disease

> **NIH NIH P20** · UNIVERSITY OF HAWAII AT MANOA · 2024 · $330,138

## Abstract

Project Summary – Project 3 (Rettenmeier)
Nonalcoholic fatty liver disease (NAFLD) has emerged as a major health concern in the world and is fueled by
the growing pandemic of obesity and insulin resistance as a consequence of overnutrition and a more sedentary
lifestyle. Thus, improving dietary habits is crucial to reduce the risk of disease onset and progression. However,
the drivers for disease progression are not fully understood, and reliable noninvasive tools to monitor and
characterize hepatic changes are urgently needed to improve risk assessment and interventions. NAFLD is
characterized by fat accumulation in the liver and encompasses simple nonalcoholic fatty liver and the more
progressive nonalcoholic steatohepatitis (NASH). NASH is strongly associated with the development of fibrosis,
cirrhosis and hepatocellular carcinoma. The differentiation between benign NAFLD and NASH using current
noninvasive diagnostic tools remains challenging and biopsy is often needed for a definitive diagnosis. The key
histological features of NASH include the degree of steatosis, necroinflammation and fibrosis and is often
associated with iron overload. Among them, the stage of fibrosis has been shown to be the most reliable predictor
of liver-related mortality and presents a prominent target for the development of new imaging techniques.
Magnetic resonance elastography (MRE) is considered the imaging gold standard which targets the increase in
extracellular matrix in fibrotic liver tissue based on stiffness measurements. Recently, multiparametric MRI (mp-
MRI) approaches have evolved that use MR relaxometry to assess the increase of extracellular fluid (ECF)
volume as a measure of fibrosis. These methods use T2* mapping to account for iron deposition which presents
a major confounding factor in the assessment of ECF volumes. Both, MRE and MRI techniques have shown
promising results, however, improvements in specificity and accuracy are still needed. Our long-term goal is to
develop a novel QSM based multiparametric MRI approach (QSMmp-MRI) that addresses shortcomings of
previous mp-MRI techniques by incorporating quantitative susceptibility mapping (QSM) into the method. QSM
has high specificity towards magnetically active iron compounds such as ferritin and hemosiderin and could
improve the quantification of iron load in NASH patients and thereby indirectly enhance the accuracy of the
corresponding ECF volume measurements in liver tissue. Overall, this new technique will enable the assessment
of hepatic tissue parameters such as fibrosis, inflammation, steatosis, and iron load. The objective of this
proposal is to implement the QSMmp-MRI sequences and to perform initial testing in a pilot study that uses
noninvasive MRE as reference. In Aim 1, we will develop a set of MR sequences to quantify T1, T2*, magnetic
susceptibility, and proton density fat fraction maps based on motion-robust radial sampling. Different acquisition
modes will be tested, and perfor...

## Key facts

- **NIH application ID:** 10782541
- **Project number:** 5P20GM139753-03
- **Recipient organization:** UNIVERSITY OF HAWAII AT MANOA
- **Principal Investigator:** Christoph Alexander Rettenmeier
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $330,138
- **Award type:** 5
- **Project period:** 2022-03-20 → 2027-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10782541

## Citation

> US National Institutes of Health, RePORTER application 10782541, Project 3: A Novel Simultaneous Multiparametric MRI Approach for the Quantitative Assessment of Non-alcoholic Fatty Liver Disease (5P20GM139753-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10782541. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*