Improved whole-brain spectroscopic MRI for radiation therapy planning

改进的全脑光谱 MRI 用于放射治疗计划

• 批准号: 10443355
• 负责人: Lee Cooper
• 金额: $ 66.12万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-05 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10443355
• 关键词: 3-Dimensional; Acceleration; Adoption; Adult; American College of Radiology; American College of Radiology Imaging Network; Area; Award; Back; Brain; Brain Neoplasms; Chemotherapy and/or radiation; Choline; Clinical; Clinical Treatment; Clinical Trials; Clinical Trials Cooperative Group; Collaborations; Computer software; Data; Data Display; Detection; Development; Diagnosis; Diagnostic; Disease Progression; Dose; Eastern Cooperative Oncology Group; Engineering; Environment; Excision; Funding; Genomics; Glioblastoma; Goals; Grant; Head; Histologic; Hour; Image; Imaging technology; Infiltration; Lead; Left; Life; Lipids; Magnetic Resonance Imaging; Maps; Measures; Metabolic; Metabolism; Methods; Morphologic artifacts; Motion; Multimodal Imaging; N-acetylaspartate; National Clinical Trials Network; Nature; Network-based; Newly Diagnosed; Online Systems; Operative Surgical Procedures; Outcome; Patient-Focused Outcomes; Patients; Performance; Phase; Physicians; Pilot Projects; Predisposition; Primary Brain Neoplasms; Radiation Dose Unit; Radiation therapy; Radiology Specialty; Randomized; Reading; Recurrence; Reporting; Research; Resolution; Scanning; Sensitivity and Specificity; Site; Software Tools; Survival Analysis; System; Systems Integration; Techniques; Technology; Time; Tissues; Treatment outcome; Update; Vendor; Visualization; Work; base; brain tissue; clinical decision-making; clinical imaging; clinical implementation; cloud based; contrast enhanced; data analysis pipeline; data management; data visualization; follow-up; high risk; image reconstruction; imaging modality; imaging platform; improved; improved outcome; magnetic resonance spectroscopic imaging; metabolic imaging; multidimensional data; neoplastic cell; neovasculature; neural network; novel; predictive modeling; prototype; reconstruction; safety and feasibility; software development; software systems; spectroscopic data; spectroscopic imaging; standard of care; tool; treatment planning; treatment response; tumor; tumor progression; two-dimensional; user-friendly

Identifying the extent of brain tumor margins for radiation treatment planning remains a challenging task due to the infiltrative nature of these tumors and limitations in current standard imaging methods. Multiple studies including our own have demonstrated that an MR technique for detecting metabolites in tissue, MR spectroscopic imaging or spectroscopic MRI (sMRI), can detect areas of infiltrating tumor with a high degree of sensitivity and specificity, enabling better radiation treatment of areas that lead to early recurrence and extending life. sMRI enables the identification of tumor extent that is marked by increased Choline/N-Acetylaspartate ratios, including regions that are not detectable by diagnostic MRI and that are normally left untreated. By allowing these previously undetected regions to be treated, sMRI has the potential to improve the efficacy of radiation treatment and significantly delay recurrence. In our 3-site sMRI-guided radiation dose escalation pilot study which was completed in 2019, we were able to demonstrate feasibility and safety. Survival analysis of all 30 GBM patients shows a promising median overall survival (OS) of 23 months compared to 16 months OS for GBM patients receiving standard-of-care. Our trial has been approved as a National Clinical Trial Network (ECOG-ACRIN) trial (EAF211). This is a great opportunity to disseminate this technique with staff support from ACRIN and American College of Radiology (ACR). We will achieve the goal in the renewal funding period of our current project by leveraging diverse expertise at three research sites and collaboration with Siemens Healthineers to engineer and validate technological improvements needed to improve sMRI acquisition, analysis, and clinical integration. These improvements include: (1) updated rapid and motion-robust sMRI for improved image quality; (2) new accelerated data processing pipelines to return Cho/NAA ratio maps to PACS for clinically timely radiology reporting; (3) new processing, display, and analysis methods that will present metabolite maps in an efficient manner with a clinician-friendly interface that enables integration with radiation treatment planning software systems; and (4) development of new tools to predict the optimal baseline RT planning strategies using sMRI. The completion of this study will provide robust sMRI acquisition methods and software tools that are ready to be deployed in clinical use and which will help guide important treatment decisions.

确定放射治疗计划的脑肿瘤边缘范围仍然是一项具有挑战性的任务，因为 这些肿瘤的浸润性质以及当前标准成像方法的局限性。多项研究 包括我们自己已经证明了一种用于检测组织中代谢物的 MR 技术，MR 光谱 成像或光谱 MRI (sMRI)，可以高度灵敏地检测浸润性肿瘤区域， 特异性，能够对导致早期复发和延长生命的区域进行更好的放射治疗。磁共振成像 能够识别以胆碱/N-乙酰天冬氨酸比率增加为标志的肿瘤范围，包括 诊断性 MRI 无法检测到且通常未经治疗的区域。通过允许这些 以前未检测到的待治疗区域，sMRI 有潜力提高放射治疗的疗效 并显着延缓复发。在我们的 3 点 sMRI 引导辐射剂量递增试点研究中， 于 2019 年完成，我们能够证明可行性和安全性。所有 30 名 GBM 患者的生存分析 显示 GBM 患者的中位总生存期 (OS) 有望达到 23 个月，而 OS 为 16 个月 接受标准护理。我们的试验已被批准为国家临床试验网络（ECOG-ACRIN） 试验（EAF211）。这是在 ACRIN 和 ACRIN 员工支持下传播该技术的绝佳机会 美国放射学院 (ACR)。我们将在当前的续期资助期内实现这一目标 该项目利用三个研究中心的不同专业知识并与西门子医疗公司合作 设计并验证改进 sMRI 采集、分析和临床所需的技术改进 一体化。这些改进包括：(1) 更新了快速且运动鲁棒的 sMRI，以提高图像质量； (2) 新的加速数据处理管道，将 Cho/NAA 比率图返回至 PACS，以便临床及时使用 放射学报告； (3) 新的处理、显示和分析方法，以直观的方式呈现代谢图谱 具有临床医生友好界面的高效方式，可与放射治疗计划集成 软件系统； (4) 开发新工具来预测最佳基线 RT 规划策略 磁共振成像。这项研究的完成将提供强大的 sMRI 采集方法和软件工具 准备在临床使用中部署，这将有助于指导重要的治疗决策。