Neubauer Group: Oxford Centre for Clinical Magnetic Resonance Research

OCMR uses sophisticated cardiac MR imaging and spectroscopy methods to phenotype cardiovascular disease – in small-scale proof-of-principle studies, large-scale multicentre clinical trials and ultra-large scale population imaging programmes. As well as running their own research programmes, OCMR serves as a collaboration partner to any group wanting to strengthen their clinical research with state of the art non-invasive phenotyping tools.

MRI scanner with patient, consultant and radiographer.

Background

My group is developing and applying cutting-edge non-invasive phenotyping tools based on Magnetic Resonance Imaging (MRI). I lead the Oxford Centre for Clinical Magnetic Resonance Research (OCMR), one of the leading imaging research centres in the world. MRI, and its cardiac application (CMR), is the most versatile non-invasive imaging technique, allowing assessment of cardiac volumes, function and mass, tissue contractility, perfusion, oxygenation, metabolism, fibre structure, and blood flow.

Mechanistic proof-of-principle studies

My centre’s interests are broad, with ~50 ongoing studies covering topics such as hypertrophic cardiomyopathy, heart failure, diabetes, obesity and cardiac metabolism (with Oliver Rider and Masliza Mahmod). We run programmes in the characterisation of cardiac tissue pathology in ischemic and nonischemic heart disease with mapping techniques (with Vanessa Ferreira and Stefan Piechnik), fibre structure imaging (with Matthew Robson and Liz Tunnicliffe) and non-invasive assessment of chronic liver disease (with Michael Pavlides, Rajarshi Banerjee, Ellie Barnes and Stephen Harrison). We also lead development of high field (7 Tesla) imaging (with Matthew Robson and Aaron Hess) and 31P-spectroscopy (with Chris Rodgers), hyperpolarised 13C MR spectroscopy (with Damian Tyler), 4D flow (with Aaron Hess and Saul Myerson) and fast real-time imaging (with Jane Francis). We also collaborate with Charis Antoniades and Keith Channon on their novel methods to characterise coronary inflammation with CT. These studies are investigating mechanisms of disease, elucidating the effects of new drug treatments, and developing novel diagnostic methods.

Large scale multicentre studies

Together with Chris Kramer (Virginia), we have set up the largest study into hypertrophic cardiomyopathy (HCM), the most frequent monogenic heart disease (about 1:500). Most individuals are symptom free with normal life expectance, but a subset will develop severe complications including sudden death. Current risk predictors have severe limitations. Our HCM registry is recruiting nearly 3000 patients in a multicentre study including 44 centres in Europe and North America, characterising them with detailed CMR scans, state of the art genetic testing (led by Hugh Watkins) and serum biomarker analysis (led by Carolyn Ho, Boston). Our goal is to re-define risk stratification in this important disease, so that fewer patients will die from it and more get appropriate treatments (such as automated defibrillators). Link to HCMR website.

Ultra-large scale population imaging

The UK Biobank population study (Chief Investigator Prof Rory Collins) has recruited 500,000 volunteers aged 40-69 living in the community. As part of the imaging enhancements our consortium recently received £43m to obtain multi-organ MR scans (heart, brain, abdomen, carotid, bone) in 100,000 of those individuals. In dedicated imaging centres, 18 patients per day are examined over a 5 year period. Together with Prof Steffen Petersen, London, I lead the cardiac imaging enhancement. Over 13,000 subjects have already been scanned, and initial phenotypes and their relation to genetic and environmental factors are being elucidated. This study will allow unique insights into imaging predictors of common diseases.