Advanced Imaging Tools to Assess Cancer Therapeutics in Pediatric

用于评估儿科癌症治疗的先进成像工具

基本信息

批准号：
10360372
负责人：
Heike Elizabeth Daldrup-Link
金额：
$ 64.6万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-02-11 至 2027-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10360372
关键词：
Address Adult Aftercare Anatomy Artificial Intelligence Attention Biological Markers Cancer Detection Child Childhood Clinical Custom Data Data Set Development Diagnostic Neoplasm Staging Diffusion Diffusion Magnetic Resonance Imaging Disease Dose Emission-Computed Tomography Ensure Generations Glucose Goals Health Image Imaging Device Imaging Techniques Imaging technology Immunotherapy Injections Ionizing radiation Ions Life Link MRI Scans Magnetic Resonance Imaging Malignant Childhood Neoplasm Malignant Neoplasms Malignant neoplasm of brain Malignant neoplasm of thyroid Measurement Measures Medical Imaging Metabolic Metabolism Mission Monitor National Cancer Institute Oncology Organ Outcome Patient imaging Patients Pediatric Hospitals Pediatric Neoplasm Pediatric Oncology Pharmaceutical Preparations Physiology Population Study Positioning Attribute Positron-Emission Tomography Protons Radiation Radiation Dose Unit Radiation exposure Radioactive Research Research Personnel Risk Scanning Second Primary Cancers Sensitivity and Specificity Staging Standardization Techniques Technology Testing Therapeutic Thoracic Radiography Time X-Ray Computed Tomography anticancer research artificial intelligence algorithm base cancer diagnosis cancer imaging cancer immunotherapy cancer therapy chemotherapy clinical application clinical imaging convolutional neural network diagnostic accuracy diagnostic value fluorodeoxyglucose image reconstruction imaging approach improved irradiation leukemia minimally invasive nanoparticle neoplasm immunotherapy novel novel imaging technology pediatric patients quantitative imaging radiation risk radiological imaging response treatment effect treatment response tumor tumor metabolism tumor progression uptake whole body imaging

项目摘要

Advanced Imaging Tools to Assess Cancer Therapeutics in Pediatric Patients Imaging tests are essential for cancer diagnoses in children. However, computed tomography (CT) and positron emission tomography (PET)/CT are associated with considerable radiation exposure. Several large population studies have demonstrated that cumulative radiation doses from CT scans significantly increase the risk of children developing leukemia, thyroid cancer, and brain cancer later in life. Thus, there is an urgent need to reduce the radiation exposure of children caused by medical imaging procedures. To this end, we have developed a radiation-free imaging test for pediatric tumor staging, based on advanced whole body diffusion-weighted magnetic resonance imaging (WB-DW MRI) technology. Our team was the first to integrate tumor physiology information (proton diffusion) with an MRI technique for anatomical orientation (nanoparticle- enhanced T1-weighted MRI), based on the concept of integrated PET/CT scans (Lancet Oncology). While DW MRI has demonstrated high sensitivity and specificity for cancer detection, the value of DW MRI for cancer therapy monitoring in children has not yet been extensively studied. Current approaches for assessing tumor therapy responses in children often measure changes in tumor metabolism using PET after the injection of radioactive glucose (18F-FDG). Previous comparisons of WB-DW MRI and 18F-FDG PET for cancer therapy monitoring have been inconclusive, possibly because the scans were not obtained at the same time. Thus, apparent differences may be due to differences in the timing of the scan. We are in a unique position to address this problem by simultaneously measuring therapy-induced changes in tumor metabolism and diffusion in children. These measurements have only recently become possible due to novel integrated PET/MRI technology, which is available at our pediatric hospital. The overall goal of our project is to compare the diagnostic value of DW MRI with that of 18F-FDG PET-based imaging tests for tumor therapy response assessment in children with cancer. In our pursuit of an improved and immediately clinically applicable approach for a minimally invasive imaging test, we will first apply artificial intelligence algorithms to develop ultra-low-dose 18F-FDG PET/MR scans. Next, we will determine the value of ultra-low- dose 18F-FDG PET and DW-MRI scans for monitoring tumor response to classical chemotherapy: We will determine which pediatric tumor type should be monitored with 18F-FDG PET only, DW-MRI only or a combined approach. Finally, we will determine the value of ultra-low-dose 18F-FDG PET and advanced DW- MRI techniques for monitoring tumor response to immunotherapies. Both radiation-free WB-DW MRI and ultra- low-dose 18F-FDG PET/MRI entail significantly less radiation exposure than traditional 18F-FDG PET/CT scans. The results of this project will yield customized cancer therapy response assessments for children with substantially reduced radiation exposure compared with current clinical imaging tests, thus eliminating associated risks of secondary cancer development later in life.

用于评估儿科患者癌症治疗的先进成像工具影像学检查对于儿童癌症诊断至关重要。然而，计算机断层扫描 (CT) 和正电子发射断层扫描 (PET)/CT 与大量辐射暴露相关。几个大的人群研究表明，CT 扫描的累积辐射剂量显着增加儿童在以后的生活中患白血病、甲状腺癌和脑癌的风险。因此，有一个紧急的需要减少儿童因医学成像程序引起的辐射暴露。为此，我们基于先进的全身，开发了一种用于儿童肿瘤分期的无辐射成像测试扩散加权磁共振成像（WB-DW MRI）技术。我们的团队是第一个整合的肿瘤生理学信息（质子扩散）与 MRI 技术的解剖定位（纳米粒子- 增强型 T1 加权 MRI），基于集成 PET/CT 扫描的概念（柳叶刀肿瘤学）。而DW MRI对癌症检测表现出高敏感性和特异性，DW MRI对癌症的价值儿童治疗监测尚未得到广泛研究。目前评估肿瘤的方法儿童的治疗反应通常使用 PET 测量注射后肿瘤代谢的变化放射性葡萄糖（18F-FDG）。之前 WB-DW MRI 和 18F-FDG PET 用于癌症治疗的比较监测尚未得出结论，可能是因为扫描不是同时获得的。因此，明显的差异可能是由于扫描时间的差异造成的。我们处于独特的地位通过同时测量治疗引起的肿瘤代谢变化和在儿童中扩散。由于新颖的集成技术，这些测量最近才成为可能 PET/MRI 技术，我们的儿科医院提供。我们项目的总体目标是比较 DW MRI 与基于 18F-FDG PET 的肿瘤成像测试的诊断价值癌症儿童的治疗反应评估。为了追求改进和立即临床适用的微创影像测试方法，我们将首先应用人工智能开发超低剂量 18F-FDG PET/MR 扫描的算法。接下来，我们将确定超低值剂量 18F-FDG PET 和 DW-MRI 扫描用于监测肿瘤对经典化疗的反应：我们将确定哪种儿童肿瘤类型应仅使用 18F-FDG PET、仅 DW-MRI 或组合方法。最后，我们将确定超低剂量 18F-FDG PET 和先进 DW- 用于监测肿瘤对免疫疗法的反应的 MRI 技术。无辐射 WB-DW MRI 和超与传统的 18F-FDG PET/CT 扫描相比，低剂量 18F-FDG PET/MRI 所需的辐射暴露明显减少。该项目的结果将为儿童提供定制的癌症治疗反应评估与当前的临床成像测试相比，辐射暴露大大减少，因此消除晚年继发性癌症发展的相关风险。