Use of Radiological Clips for Improving Quantitative Ultrasound Imaging

使用放射夹改善定量超声成像

• 批准号: 10202531
• 负责人: Michael L. Oelze
• 金额: $ 34.46万
• 依托单位: UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10202531
• 关键词: Accounting; Adoption; Anatomy; Animal Cancer Model; Animal Model; Animals; Breast; Breast Cancer Model; Breast Cancer Patient; Breast Cancer therapy; Calibration; Cancer Detection; Cell Death; Classification; Clinic; Clinical; Clinical Research; Clip; Cosmetics; Data; Diagnosis; Diagnostic; Female; Gold; Human; Imaging Techniques; In Situ; In complete remission; Longitudinal Studies; Magnetic Resonance Imaging; Malignant Neoplasms; Mammography; Medical; Monitor; Neoadjuvant Therapy; North America; Operative Surgical Procedures; Outcome; Pathologic; Patients; Physical assessment; Procedures; Process; Property; Radiation therapy; Radiology Specialty; Recurrence; Research; Residual Cancers; Roentgen Rays; Shapes; Signal Transduction; Surgeon; Techniques; Technology; Testing; Time; Tissues; Titanium; Translating; Ultrasonics; Ultrasonography; Woman; advanced breast cancer; attenuation; base; chemotherapy; clinical imaging; electric impedance; hormone therapy; human study; improved; in vivo; malignant breast neoplasm; novel; predicting response; quantitative ultrasound; response; standard care; tool; transmission process; treatment responders; treatment response; tumor

Project Summary Radiological markers or clips are an essential diagnostic and surgical tool. Radiological clips made of titanium or gold are widely used, compatible with MRI and have proven safe for use in human patients. These clips come in many shapes and sizes and are visible with both X-ray and ultrasound. The clips provide large ultrasonic scattering signals because they are made of gold or titanium, which have large impedance mismatch with tissue. For example, patients with locally advanced breast cancer (LABC) undergoing neoadjuvant chemotherapy have clips placed in the tumors so that surgeons can locate and excise, with accuracy, residual cancer tissue. Over the last fifteen years, we have been developing quantitative ultrasound (QUS) imaging techniques for a number of applications including monitoring of therapy response. We have demonstrated that QUS techniques can detect the response of tumors to therapy because QUS is sensitive to the presence of cell death. Recently, we were able to implement this approach in a small clinical study, where we demonstrated the ability of QUS to definitively detect and predict the response of LABC patients to chemotherapy between one and four weeks from therapy onset. We verified that QUS could identify LABC therapy responders and nonresponders. However, we hypothesize that accuracies of QUS estimates in humans can be dramatically improved by incorporating a novel calibration procedure that utilizes appropriate radiological clips as an in situ calibration target. Clinically, these clips are already being placed in tumors for various diagnostic tasks. By inserting an appropriate type of clip, the clip can be used as an in situ calibration providing a reference signal for QUS estimates. The in situ reference will automatically correct for attenuation and transmission losses from overlying tissue layers. Current reference phantom techniques are incomplete in providing corrections for attenuation and transmission losses. Therefore, the use of appropriate radiological clips as calibration targets will provides superior bias and variance of QUS estimates resulting in improved accuracy for identifying LABC response. The scientific premise of the proposed research is that radiological markers used for X-ray and conventional ultrasound can also be used as an in situ calibration target for improving QUS estimates in vivo. Novel calibration procedures will be tested and refined in phantom studies, in animals models of cancer and finally validated in human breast cancer patients undergoing neoadjuvant chemotherapy using QUS to identify early responders to therapy. To verify this scientific premise we propose three specific aims. 1) Develop and refine an in situ calibration approach in phantom studies that accounts for layering effects on QUS estimates thereby improving QUS estimate accuracy. 2) Validate the in situ calibration approach in animal models of cancer and quantify calibration properties in a longitudinal study. 3) Collect longitudinal QUS patient data at early time points during the course of neoadjuvant chemotherapy using a novel in situ calibration procedure and quantify the improvements of QUS classifier accuracy with the in situ calibration approach.

项目摘要 放射学标记或夹子是必不可少的诊断和手术工具。钛制成的放射夹 或黄金被广泛使用，与MRI兼容，并被证明可安全用于人类患者。这些剪辑来了 在许多形状和尺寸中，X射线和超声都可以看到。夹子提供大型超声波 散射信号是因为它们是由黄金或钛制成的，它们与组织的阻抗不匹配。 例如，接受新辅助化疗的局部晚期乳腺癌（LABC）患者患有 放置在肿瘤中的夹子，使外科医生可以通过准确的残留癌组织来定位和消费。 在过去的15年中，我们一直在开发定量超声（QUS）成像技术 许多应用，包括监测治疗反应。我们已经证明了QUS技术 可以检测肿瘤对治疗的反应，因为Q对细胞死亡的存在敏感。最近， 我们能够在一项小型临床研究中实施这种方法，在这里我们证明了Q的能力 明确检测并预测LABC患者对化疗的反应 治疗发作。我们验证了QUS可以识别LABC治疗响应者和无反应者。 但是，我们假设人类中QUS估计值的准确性可以通过 结合一种新型的校准程序，该程序利用适当的放射夹作为原位校准 目标。临床上，这些剪辑已经被放置在肿瘤中，以进行各种诊断任务。通过插入 适当类型的剪辑，该夹子可以用作原位校准，从而为QUS提供参考信号 估计。原位参考将自动纠正上覆盖的衰减和传输损失 组织层。当前的参考幻影技术在提供衰减和校正方面不完整 传输损失。因此，使用适当的放射夹作为校准目标将提供 QUS估计值的出色偏差和差异，导致确定LABC响应的精度提高。 拟议研究的科学前提是用于X射线和常规的放射学标记 超声也可以用作原位校准目标，以改善体内QUS估计值。新颖的校准 在幻影研究，动物癌症模型中将测试和完善程序，并最终在 人类乳腺癌患者使用QUS进行新辅助化疗，以识别早期反应者 治疗。为了验证这一科学前提，我们提出了三个具体目标。 1）开发和完善原位 幻影研究中的校准方法对QUS估计的分层影响说明，从而改善 Q估计准确性。 2）验证癌症动物模型中的原位校准方法并量化 纵向研究中的校准特性。 3）在早期收集纵向QUS患者数据 新辅助化疗的过程使用新型原位校准程序，并量化 通过原位校准方法改善QUS分类器精度。