EARTHWORM: pEristAlsis in Real-Time Human mri to study the interWOven fRequency & Microstructural properties

Introduction

EARTHWORM will develop a new paradigm of adaptive and focused comprehensive Magnetic Resonance Imaging (MRI) techniques to study peristaltic motion and the underlying microstructure throughout the human body.

Importance of Peristaltic Motion

Peristaltic motion is responsible for multiple key functions in the human body, such as:

• Food transport through the gastro-intestinal system
• Rapid and directed sperm transport
• Embryo implantation
• Retrograde menstruation for the preservation of body iron

Alterations in peristaltic motion are linked to the pathophysiology of diseases such as adenomyosis, Crohn’s disease, endometriosis, and Parkinson’s disease, among many others, which together affect over 10% of EU citizens.

Complexity of the Underlying Process

The underlying process of peristaltic motion requires a complex cascade of events, which can be disrupted by a range of factors, including:

1. Interrupted neuronal activity
2. Altered biochemistry
3. Changes in the interwoven layers of muscle fibers and connective tissue

These disruptions can result in hyper- and hypomotility of the involved organs. Similarly, changes in motility are associated with resulting microstructural damage.

Limitations of Current Imaging Techniques

Despite the undisputed importance of studying peristaltic motion, current imaging techniques often focus on suppressing or altering peristalsis through unphysiological preparations. This approach forces ongoing human life to comply with the needs of the assessment techniques.

Innovative Approach

The confluence of novel lower field MRI scanners, real-time end-to-end AI methods, external MR-compatible sensors, and efficient multi-contrast techniques allows for the development of a new paradigm to study the link between microstructure and motility patterns in the abdomen and pelvis.

By replacing rigid, pre-defined examinations with a continuous running MR acquisition that adapts to ongoing life, this approach provides novel and eloquent information. It paves the way for enhanced diagnosis and bespoke, data-driven nonlinear continuum dynamic modeling approaches to reveal signatures of disease and interconnect previously disjoint observations.

Clinical Pilot Studies

Two embedded clinical pilot studies will facilitate immediate translation of these innovative techniques into practical applications.