{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T20:00:58Z","timestamp":1783886458638,"version":"3.55.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T00:00:00Z","timestamp":1739145600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T00:00:00Z","timestamp":1739145600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Perspectum Diagnostics Ltd"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with suspected acute gallstone disease typically undergo abdominal ultrasound. MRCP is often used for patients with abnormal LFTs, potentially making ultrasound unnecessary for this group. Despite high inter-reader variability in MRCP interpretation, new AI technologies may automate and standardize detection and measurement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Patients with suspected acute gallstone disease and abnormal liver function tests were randomized into two diagnostic pathways, direct MRCP and standard care. Admission data, healthcare resource use, and clinical outcomes were recorded. National Health Service national 20\/21 tariffs were used to calculate and compare healthcare costs. MRCP scans were subsequently analysed using MRCP\u2009+\u2009software (Perspectum Ltd).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      27 participants were enrolled over 12 months, 15 to direct MRCP and 11 to standard care. One patient was excluded from analysis. Mean patient time to diagnostic report and mean per patient associated direct medical cost and mean cost to diagnosis for the direct MRCP and standard of care group was 2.53 days, \u00a3449.54, and \u00a3647 respectively for the direct MRCP group and 4.18 days costing \u00a3742.06 and \u00a3896 for standard care. MRCP\u2009+\u2009analysis of 11 scans showed significant differences between the groups in terms of gallbladder volume (80.2mm\n                      <jats:sup>3<\/jats:sup>\n                      gallstone present versus 30.1mm\n                      <jats:sup>3<\/jats:sup>\n                      without,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018 and cystic duct median width (4.6\u00a0mm gallstone present versus 2.7\u00a0mm without,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Direct MRCP may be a feasible and potentially cost-effective diagnostic strategy for patients with suspected acute gallstone disease and deranged LFTs. Automated measurement of MRCP parameters shows promise in detecting obstruction. Larger trials are warranted to assess this potential.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>This study is registered with ClinicalTrials.gov (NCT03709030). Registration date: October 17, 2018.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-025-03637-0","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T05:50:11Z","timestamp":1739166611000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Pilot feasibility study to determine the utility of direct access and quantitative magnetic resonance cholangiopancreatography (MRCP) in the assessment of suspected acute biliary or ductal gallstone presentations"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5091-6768","authenticated-orcid":false,"given":"Alex","family":"Novak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Acharya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Beer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Espinosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giles Bond","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrene","family":"Saga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Andrews","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Bailey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahir","family":"Soonawalla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1016-3121","authenticated-orcid":false,"given":"Helen","family":"Bungay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9882-8874","authenticated-orcid":false,"given":"Michael","family":"Pavlides","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,10]]},"reference":[{"key":"3637_CR1","doi-asserted-by":"publisher","first-page":"g2669","DOI":"10.1136\/bmj.g2669","volume":"348","author":"KS Gurusamy","year":"2014","unstructured":"Gurusamy KS, Davidson BR. 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The study protocol and design were approved by the National Health Service (NHS) Health Research Authority (IRAS ID 240894).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All participants provided written informed consent before enrolment in the study. The consent process included a detailed explanation of the study\u2019s purpose, procedures, potential risks and benefits, and the voluntary nature of participation. Patients were informed about the randomisation process and the two diagnostic pathways (direct MRCP and standard care). They were also made aware that their MRCP scans would be analysed using MRCP\u2009+\u2009software. Participants were assured of their right to withdraw from the study at any time without affecting their standard medical care. The study protocol, including the consent procedure, was approved by Health Research Authority (IRAS ID 240894).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not Applicable. This manuscript does not contain any individual person\u2019s data in any form, including identifying images or personal or clinical details that could compromise anonymity. As such, no specific consent for publication was required from any individuals. All data presented in this study are aggregated and anonymized, ensuring the privacy and confidentiality of all participants involved in the research. We have adhered strictly to ethical guidelines and data protection regulations throughout the study and in the preparation of this manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"MP is a shareholder in Perspectum. This study was funded and sponsored by Perspectum Ltd. The funder was involved in data analysis involving the MRCP+ platform. The corresponding author had access to all study data and had final responsibility for the decision to submit for publication.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The guarantor of the study is Prof Alex Novak; He accepts full responsibility for the finished work and\/or the conduct of the study, had access to the data, and controlled the decision to publish.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor"}},{"value":"The lead author, Prof Alex Novak, affirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned have been explained.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Transparency declaration"}}],"article-number":"72"}}