“If you remove part of the liver it grows back in six to eight weeks, but how much of the liver can be removed, and where does the limit go? Neither researchers nor surgeons know this with any certainty,” explains Professor Lundberg.
Fantastic technologyToday the best method for diagnosing liver disease is to take a sample, a biopsy, using a needle. The volume is roughly 10 to 20 microlitres and because the sample is so small it is difficult to know whether the test is taken from a healthy or diseased part of the liver.
“MRI technology is fantastic and we get new tools for it every year. We can measure the amount of fat in the liver, or measure the uptake of a contrast agent to get an idea of how well it works, we can measure levels of many different elements, including iron and phosphorus compounds,” says Professor Lundberg.
One problem is that the liver can suffer from fibrosis, where connective tissue is formed in the liver. The liver becomes stiff and its function deteriorates. Using a technology called elastography, a unit sends vibrations into the body.
The MRI system reveals how the vibrations move through a healthy and diseased liver, which informs us about liver stiffness.
Painless examinationProfessor Lundberg and colleagues have developed a protocol where they use an MRI system to find a number of parameters which, in combination, provide answers on the function of the liver. For the patient the examination is completely painless and all measurements are done at a single occasion.
“We also do conventional biopsies, analyse them and compare them with the results of the MRI examination.”
Digital pathology, a new research field, will also be used in the project. In an intelligent database the pathologist gets help with visualising tissue samples and diagnose diseases by studying and comparing images of tissue, cells or organs – in this case the liver.
Foto: Monica Westman
The aim of the project, LIFE, Liver Intrinsic Function Evaluation, is to develop an intuitive, useful, simple tool that shows the condition of the liver. The group also hopes to simulate a surgical procedure to see its effect on the liver, before actually performing it in the operating theatre.
Broad financingLIFE is co-financed by the Swedish Research Council (SEK 2.8m) and Vinnova (SEK 3.6m). Additional funding comes from the Östergötland County Council, Linköping University and various companies which contribute for instance in the form of industrial PhD students.
“This is an excellent combination. Here the Swedish Research Council finances the scientific part and Vinnova the implementation in health care, ” says Professor Lundberg.
The companies participating are LiU spin-offs: Amra and Wolfram Mathcore, both located at the Mjärdevi Science Park. In total the project has a budget of more than SEK 10m.
“This is a good example of how researchers from different fields can solve a problem together. Here we have a collaboration between physicists, radiologists, systems biologists, surgeons, internists and visualisers from health technology companies that can quickly get the technology out to the health care sector. Without CMIV this would not have been possible,” says Professor Lundberg.
The other participants in the Swedish Research Council project are Per Sandström, Stergios Kechagaias, Sven Almer and Örjan Smedby.