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Title: Minimal preparation magnetic resonance colonography
Author: Jardine, V. L.
Awarding Body: University of Cambridge
Current Institution: University of Cambridge
Date of Award: 2005
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Magnetic resonance colonography has the potential to combine accurate colorectal tumour detection with a minimally invasive approach that avoids potentially harmful ionising radiation. This thesis details the development and initial feasibility demonstration of a strategy for minimal preparation MR colonography. An initial review of the ‘normal’ unprepared colon was undertaken to establish the typical MR appearances. This indicated firstly that colonic intra-luminal material frequently contains foci of similar signal intensity to tumour, and secondly that combined analysis of several image contrast techniques might improve discrimination. Subsequently, several potential oral preparation strategies and imaging techniques were investigated in a trial involving healthy volunteers. Oral contrast agents and dietary manipulation significantly influenced the intra-luminal signal of the colon, potentially allowing discrimination between faeces, lesions and the bowel wall. Preparation with oral ferric ammonium citrate and a restricted high fat, low fibre diet proved optimal for faecal signal manipulation and palatability. A second healthy volunteer study evaluated potential modifications to both the preparation strategy and sequence parameters. Sequence optimisation was refined using phantom models constructed to simulate the bowel, polypoid lesions and surrounding abdominal fat. The feasibility of a minimal preparation MR technique was demonstrated in patients at high risk of colorectal cancer by comparing it to both conventional preparation CT colonography and colonoscopy. This work demonstrates the feasibility of minimal preparation MR colonography for colonic evaluation without cathartic cleansing. This technique, with further development and evaluation, could form the basis of a clinical investigation for colorectal tumour detection.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available