Novel and Emerging Technologies (NET) Grant (PhD studentship)
Prof David Firmin and Dr Andrew Scott, Royal Brompton Hospital and Imperial College London
Summary: This project will develop an advanced MRI technique that can provide information relating to the cell structure in thin heart muscle tissue, which is a feature of many heart diseases. This technique may provide earlier diagnosis, new information on how diseases affect the heart and novel insights into treatments.
Diffusion tensor MRI is a unique, well-established and safe technique which is used to examine connections in the brain. In the heart, this technique can be used to provide information on the arrangement of muscle cells, which could provide earlier diagnosis and new insights into the many diseases affecting the heart. This team has recently used such MRI techniques to look at changes in the heart muscle as the heart is beating, and has studied how this is abnormal in patients who have a disease which causes thickening of the heart muscle. However, due to the movement of the heart when it beats and as people breathe, diffusion tensor MRI in the heart is difficult. Images must be collected during a short period of the heart beat where there is minimal movement while the patient holds their breath. This limits the detail that can be provided with these techniques and means that they cannot be used in patients with thinned heart muscle, for example after a heart attack.
Professor Firmin’s team also has considerable experience of using a technique known as spiral MRI which is a very efficient way to collect image information and is very resilient to the problems usually caused by movement. In this PhD project, diffusion tensor and spiral MRI techniques will be combined to produce a technique which will give greater detail, and provide reliable and accurate information on the microscopic structure of the heart muscle, for example in cases of thinned heart muscle after a heart attack. Initial work by the team has shown that this combination of techniques has potential, and the project will build on this, aiming to improve the detail shown in the images and the reliability of the method. The combined MRI techniques will be tested in a group of healthy volunteers and compared to existing techniques before applying them to the hearts of patients who have had a heart attack.
This technique also has the potential to be used to study other conditions where the heart muscle is thinner than normal, for example dilated cardiomyopathy where the heart muscle is stretched and thinned. As well as new insights into the way these diseases affect the heart, it is hoped that it will also provide earlier diagnosis of some conditions and be used to monitor the response of the heart muscle to treatment.