Accurate DCE-MRI Measurement of Glioblastoma using Point-of-care Portable Perfusion Phantom

使用护理点便携式灌注模型准确测量胶质母细胞瘤

• 批准号: 10377323
• 负责人: Harrison Kim
• 金额: $ 7.43万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10377323
• 关键词: Adjuvant; Blood - brain barrier anatomy; Brain Diseases; Brain Pathology; Clinical; Collaborations; Contrast Media; Data; Disease; Enhancing Lesion; Error Sources; Evaluation; Glioblastoma; Goals; Image; Inflammatory; Institutes; Ischemic Stroke; Magnetic Resonance Imaging; Measurement; Measures; Monitor; Morphologic artifacts; Multi-Institutional Clinical Trial; Multiple Sclerosis; Names; Neoplasms; Outcome; Patient Care; Patients; Perfusion; Pilot Projects; Predisposition; Prognosis; Reaction; Recurrence; Reproducibility; Research Personnel; Risk Assessment; Schizophrenia; System; Techniques; Technology; Testing; Time; Tissues; Toxic effect; Trauma; Variant; base; blood perfusion; blood-brain barrier disruption; blood-brain barrier permeabilization; chemoradiation; chemotherapy; contrast enhanced; effective therapy; human tissue; improved; ineffective therapies; irradiation; neoplastic; neuro-oncology; optimal treatments; point of care; portability; quality assurance; recruit; response; risk stratification; treatment optimization; treatment response; tumor; Adjuvant; Blood - brain barrier anatomy; Brain Diseases; Brain Pathology; Clinical; Collaborations; Contrast Media; Data; Disease; Enhancing Lesion; Error Sources; Evaluation; Glioblastoma; Goals; Image; Inflammatory; Institutes; Ischemic Stroke; Magnetic Resonance Imaging; Measurement; Measures; Monitor; Morphologic artifacts; Multi-Institutional Clinical Trial; Multiple Sclerosis; Names; Neoplasms; Outcome; Patient Care; Patients; Perfusion; Pilot Projects; Predisposition; Prognosis; Reaction; Recurrence; Reproducibility; Research Personnel; Risk Assessment; Schizophrenia; System; Techniques; Technology; Testing; Time; Tissues; Toxic effect; Trauma; Variant; base; blood perfusion; blood-brain barrier disruption; blood-brain barrier permeabilization; chemoradiation; chemotherapy; contrast enhanced; effective therapy; human tissue; improved; ineffective therapies; irradiation; neoplastic; neuro-oncology; optimal treatments; point of care; portability; quality assurance; recruit; response; risk stratification; treatment optimization; treatment response; tumor

PROJECT SUMMARY / ABSTRACT The goal of this R03 study is to conduct a pilot study testing whether the variability in quantitative DCE- MRI measurement of glioblastoma across different scanners will be significantly reduced when the UAB-invented perfusion phantom, P4 (Point-of-care Portable Perfusion Phantom), is used for error correction, leading to better differentiation between pseudo-progression and true-progression. This is an essential step before validating the utility of P4 in an extended multi-site clinical trial. Pseudo-progression is known to be associated with better clinical outcomes, thus pseudo-progression mistaken for true-progression may result in discontinuation of an effective therapy. Pseudo-progression is a local inflammatory reaction caused by irradiation and enhanced by concurrent chemotherapy, which leads to transient increase of blood brain barrier (BBB) permeability. The BBB, however, is also disrupted by neoplasm, thus both pseudo- and true-progressions appear with increased contrast enhancement in MRI, and there are no established techniques to differentiate between them. The contrast- enhancing lesions of pseudo-progression are due to inflammatory BBB disruption, whereas those of true- progression are caused by neoplastic BBB disruption. Thus, true-progression typically presents higher perfusion than pseudo-progression does. DCE-MRI has the potential to differentiate between pseudo- and true- progressions of glioblastoma, as it can assess the blood perfusion with minimal susceptibility artifacts, but the measurement variability remains a major concern. The P4 is small enough to be imaged concurrently in the bore of a standard MRI scanner with a patient, serving as an internal reference to measure and compensate the scanner-dependent variation in quantitating perfusion parameters. The P4 successfully reduces the variability in DCE-MRI measurement of various human tissues in our previous studies. We now hypothesize that the variability in quantitative DCE-MRI measurement of glioblastoma across different scanners will also be significantly reduced when MRI system-driven error is corrected using the P4. In this study, a total of 12 patients with a newly (or enlarged) enhancing glioblastoma after adjuvant chemoradiation therapy will be recruited. Each patient will be imaged with two different 3T MRI scanners within a 3-day period, and the two DCE-MRI measurements will be compared to determine the data reproducibility before and after P4-based error correction and to validate the utility of the P4 for accurate quantitative DCE-MRI measurement of glioblastoma. Also it will be examined whether the differentiation between pseudo- and true-progressions of glioblastoma can be improved in quantitative DCE-MRI measurement when the P4 is used for error correction.

项目摘要 /摘要 这项R03研究的目的是进行一项试点研究，以测试定量DCE的变异性是否存在 当UAB发明时，将显着降低跨不同扫描仪的胶质母细胞瘤的MRI测量 灌注幻影，P4（护理点便携式灌注幻影），用于校正，导致更好 伪产生和真实发展之间的区分。这是验证验证之前的重要步骤 P4在扩展的多站点临床试验中的实用性。已知伪建筑与更好的相关 临床结果，因此误认为是真正发展的伪产生可能导致中断 有效的疗法。伪产生是由照射引起的局部炎症反应，并增强了 并发化疗，这会导致血脑屏障（BBB）渗透性的短暂增加。 BBB， 然而，肿瘤也被破坏了，因此伪和真实构成都会出现增加的对比度 MRI的增强，并且没有建立的技术可以区分它们。对比 - 增强伪产生病变是由于炎症性BBB的破坏，而真实的损害 进展是由肿瘤BBB破坏引起的。因此，真正的过程通常会呈现更高的灌注 比伪产生。 DCE-MRI有可能区分伪和true- 胶质母细胞瘤的进展，因为它可以用最小的易感性伪像评估血液灌注，但 测量变异性仍然是一个主要问题。 P4足够小，可以同时成像 带有患者的标准MRI扫描仪的孔，作为内部参考，以衡量和补偿 定量灌注参数的扫描仪依赖性变化。 P4成功降低了可变性 在我们先前的研究中，在DCE-MRI测量各种人体中。我们现在假设 跨不同扫描仪的胶质母细胞瘤的定量DCE-MRI测量的可变性也将是 使用P4纠正MRI系统驱动误差时，大大减少了。在这项研究中，共有12例患者 辅助化学放疗治疗后新近（或扩大）增强的胶质母细胞瘤。每个 患者将在3天的时间内使用两个不同的3T MRI扫描仪成像，并且两个DCE-MRI 将比较测量以确定基于P4的误差校正之前和之后的数据可重复性 并验证P4的实用性，以准确定量DCE-MRI测量胶质母细胞瘤。也会 可以检查胶质母细胞瘤的伪和真实产生之间的区分是否可以是 当使用P4进行误差校正时，定量DCE-MRI测量改进。