No-Gd MRI for Monitoring Disease Status in Multiple Sclerosis

无 Gd MRI 用于监测多发性硬化症的疾病状态

• 批准号: 10468214
• 负责人: Susan A Gauthier
• 金额: $ 63.54万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10468214
• 关键词: 3-Dimensional; Accelerated Phase; Acute; Age; Biophysics; Blood; Blood - brain barrier anatomy; Brain; Chronic; Clinical; Contrast Media; Data; Deposition; Detection; Diagnosis; Diagnostic; Digestion; Disease; Disease Progression; Evaluation; Excision; Extravasation; FDA approved; Functional disorder; Gadolinium; Health; Health Professional; Healthcare; Human; Image; In Vitro; Inflammation; Injections; International; Investigation; Iron; Lesion; Longitudinal Studies; Magnetic Resonance; Magnetic Resonance Imaging; Magnetism; Measures; Medicine; Microglia; Monitor; Multicenter Studies; Multiple Sclerosis; Multiple Sclerosis Lesions; Myelin; Patient Care; Patients; Phase; Phase II Clinical Trials; Predisposition; Protocols documentation; Reader; Relapsing-Remitting Multiple Sclerosis; Reproducibility; Research; Risk; Safety; Scanning; Societies; Steroids; T2 weighted imaging; Techniques; Testing; Thinking; Tissues; Translating; Treatment Efficacy; Uncertainty; United States National Institutes of Health; base; brain tissue; chemical bond; cost; diagnostic accuracy; follow-up; improved; in vivo; insight; macrophage; multiple sclerosis patient; multiple sclerosis treatment; practice setting; prospective; response; seal; therapeutic target; treatment response

Our patients objective is to eliminate gadolinium (Gd) injections i n routine follow-up MRI of multiple sclerosis (MS) using quantitative susceptibility mapping (QSM) asa direct response to the calls issued by the NIH and FDA to re-evaluate repetitive Gd administration to patients. We have pioneered QSM that is generated by processing the often-discarded phase data from gradient echo MRI (GRE). We have discovered that iron- containing proinflammatory microglia often accumulate at the MS lesion rim. We have initiated applications of QSM in studying multiple sclerosis, and have demonstrated that QSM can detect iron rims around MS lesions. We have obtained preliminary data in MS patients that the susceptibility increase as measured on QSM can accurately indicate BBB closure, as supported by the biophysics of myelin digestion, myelin debris removal, and iron accumulation. Totranslate our pathophysiologic and biophysical insights into patient care,we propose a no-Gd MRI using QSM to follow up MS patients. We will perform an economical multicenter study by adding a 5 min GRE sequence to the current MS MRI follow-up protocol without incurring any scan costs to the NIH. We will employ a hierarchical approach to assess the technical efficacy, diagnostic accuracy, diagnostic thinking, and therapeutic efficacy of the proposed QSM based no-Gd MRI. Accordingly, we plan to achieve our objective through the following specific aims: Aim 1: Establish susceptibility increase due to myelin digestion by macrophages. Aim 2: Optimize the technical efficacy of no-Gd MRI to follow up MS patients. Aim 3: Evaluate the diagnostic accuracy, diagnostic thinking, and therapeutic efficacy of QSM based no-Gd MRI.

我们的 患者 目的是消除多发性硬化症（MS）常规随访的Gadolinium（GD）注射 使用定量敏感映射（QSM）ASA直接响应NIH发出的电话 和FDA对患者重新评估重复的GD给药。我们有先驱QSM 处理来自梯度回波MRI（GRE）的经常存在的相位数据。我们发现铁 - 含有促炎的小胶质细胞通常在MS病变边缘积聚。我们已经启动了 QSM研究多发性硬化症，并证明QSM可以检测到MS病变周围的铁缘。 我们已经在MS患者中获得了初步数据，即在QSM上测量的易感性提高 准确地表明髓磷脂消化的生物物理学，髓磷脂碎片去除，髓鞘碎片的闭合 和铁的积累。我们建议，我们提出了对患者护理的病理生理和生物物理学的见解 使用QSM的NO-GD MRI跟进MS患者。我们将通过添加 当前MS MRI随访方案的GRE顺序为5分钟，而不会产生NIH的任何扫描成本。 我们将采用层次结构方法来评估技术疗效，诊断准确性，诊断 拟议的基于QSM的NO-GD MRI的思维和治疗功效。因此，我们计划实现我们的 通过以下特定目的进行目标：目标1：确定由于髓鞘消化而提高易感性 巨噬细胞。 AIM 2：优化NO-GD MRI的技术功效以跟进MS患者。目标3：评估 基于QSM的NO-GD MRI的诊断准确性，诊断思维和治疗功效。

项目成果

ALL-Net: Anatomical information lesion-wise loss function integrated into neural network for multiple sclerosis lesion segmentation.

• DOI: 10.1016/j.nicl.2021.102854
• 发表时间: 2021
• 期刊: NeuroImage. Clinical
• 作者: Zhang H;Zhang J;Li C;Sweeney EM;Spincemaille P;Nguyen TD;Gauthier SA;Wang Y;Marcille M
• 通讯作者: Marcille M