Quantitative Structural and Functional Imaging of the Lung

肺的定量结构和功能成像

基本信息

批准号：
7473038
负责人：
RAHIM R RIZI
金额：
$ 65.33万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-08-12 至 2013-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7473038
关键词：
Academic Medical Centers Accident and Emergency department Address Adoption Affect Alkali Metals American Area Autopsy Biological Markers Biomedical Engineering Blood Bronchoconstriction Cause of Death Cessation of life Characteristics Chronic Chronic Bronchitis Chronic Disease Chronic Obstructive Airway Disease Cigarette Classification Clinical Clinical Research Clinical Trials Clinical assessments Cohort Studies Condition Correlation Studies Data Defect Detection Development Diagnosis Diffusion Disease Disease Progression Enrollment Environmental Risk Factor Evaluation Evolution Exhalation Forced expiratory volume function Functional Imaging Funding Future Gases Genetic Predisposition to Disease Gland Goals Heart Heart Diseases Hospitalization Hyperplasia Image Individual Institutes Lasers Lead Lesion Localized Lung Lung diseases Magnetic Resonance Imaging Malignant Neoplasms Measurement Measures Methods Metric Modality Monitor Morbidity - disease rate Mortality Decline Mucous body substance Nose Operative Surgical Procedures Outcome Oxygen Partial Pressure Pathogenesis Pathology Patients Pennsylvania Performance Pharmacotherapy Physiology Plant Roots Production Protocols documentation Public Health Pulmonary Emphysema Pulmonary Function Test/Forced Expiratory Volume 1 Pulmonary function tests Radiology Specialty Rate Recommendation Recording of previous events Recruitment Activity Reproducibility Research Respiratory physiology Risk Risk Factors Rosa Scanning Severity of illness Signal Transduction Site Smoke Smoker Smoking Specimen Spirometry Staging Structure Surface Sweden System Techniques Technology Testing Time Tobacco smoke Translations Treatment Efficacy United States United States National Center for Health Statistics University Hospitals Variant Visit Vital capacity Work X-Ray Computed Tomography airway inflammation airway obstruction base cohort concept cost disability experience human subject improved in vivo insight longitudinal human study lung imaging mortality non-smoker novel outcome forecast programs prospective response size skills tool wasting

项目摘要

DESCRIPTION (provided by applicant): Chronic Obstructive Pulmonary Disease (COPD), a group of disorders characterized by limitations in airflow, affects over 14 million Americans and is the fourth leading cause of death in the United States. COPD is also a major cause of disability and was the primary cause of 726,000 hospitalizations and 1.5 million emergency room visits in 2000. Current treatment and detection strategies have made little impact on the disease's mortality and morbidity. These observations prompted the National Heart, Lung, and Blood Institute to organize a Working Group, "Clinical Research in COPD: Needs and Opportunities." This Working Group recommended characterizing the development and progression of COPD with measures and biomarkers related to current concepts of pathogenesis, anticipating that these biomarkers could be used in the discovery and development of drugs and therapies for COPD. In view of these recommendations, we propose to obtain fundamentally new, detailed information about localized changes in the structure of emphysematous lungs and the physiology of gas exchange by employing 3He MRI to assess COPD patients and subjects at risk for developing COPD. We recently implemented a novel method for measuring the regional partial pressure of oxygen and furthered the development of a method for evaluating emphysema using the measurement of the apparent diffusion coefficient of 3He. The central hypothesis of this proposal is that quantitative assessments derived from MR imaging can detect early alterations in structure and function that precede clinically apparent COPD and predict progression of disease earlier and better than established clinical methods. The successful completion of this research will lead to significant improvements in the understanding of COPD and to faster, more economical methods for characterizing disease response to therapy. Our research has four specific aims. The first is to further develop the techniques for MR imaging of 3He so that it becomes a more robust modality which is better suited for research and clinical use. The second aim is to determine the reproducibility of structural and functional assessments in healthy non-smokers, asymptomatic smokers, and COPD patients. The third aim is to determine which of these assessments can best predict the decline in lung performance which may lead to the development of COPD. The final specific aim is to measure variations in the imaging and clinical assessments over the course of the study and correlations among the rates of change of the different assessments. PUBLIC HEALTH RELEVANCE MR biomarkers, alone or in combination with conventional pulmonary function tests, can: A) distinguish among different forms of COPD, B) detect early alterations in structure and function which are precursors to clinically apparent COPD, and C) detect progression of disease earlier than established clinical methods. These novel markers will significantly improve understanding of COPD and will be critical to characterizing disease response to therapy.

描述（由申请人提供）：慢性阻塞性肺病 (COPD) 是一组以气流受限为特征的疾病，影响超过 1400 万美国人，是美国第四大死因。 COPD 也是导致残疾的主要原因，是 2000 年 726,000 例住院治疗和 150 万例急诊室就诊的主要原因。目前的治疗和检测策略对该疾病的死亡率和发病率影响甚微。这些观察结果促使国家心肺血液研究所组织了一个工作组，“慢性阻塞性肺病的临床研究：需求和机遇”。该工作组建议使用与当前发病机制概念相关的措施和生物标志物来描述慢性阻塞性肺病的发展和进展，预计这些生物标志物可用于发现和开发慢性阻塞性肺病的药物和疗法。鉴于这些建议，我们建议通过采用 3He MRI 评估 COPD 患者和有患 COPD 风险的受试者，获得有关肺气肿肺结构局部变化和气体交换生理学的全新详细信息。我们最近实施了一种测量局部氧分压的新方法，并进一步开发了一种通过测量 3He 表观扩散系数来评估肺气肿的方法。该提案的中心假设是，源自 MR 成像的定量评估可以检测到临床明显慢性阻塞性肺病之前的结构和功能的早期变化，并比现有的临床方法更早、更好地预测疾病进展。这项研究的成功完成将显着提高对慢性阻塞性肺病的认识，并提供更快、更经济的方法来表征疾病对治疗的反应。我们的研究有四个具体目标。首先是进一步开发 3He MR 成像技术，使其成为一种更强大的模式，更适合研究和临床使用。第二个目标是确定健康非吸烟者、无症状吸烟者和慢性阻塞性肺病患者的结构和功能评估的可重复性。第三个目标是确定这些评估中哪一个能够最好地预测可能导致慢性阻塞性肺病（COPD）发展的肺功能下降。最终的具体目标是测量研究过程中成像和临床评估的变化以及不同评估变化率之间的相关性。公共卫生相关性 MR 生物标志物单独或与传统肺功能测试相结合，可以：A) 区分不同形式的 COPD，B) 检测结构和功能的早期改变，这是临床上明显的 COPD 的先兆，C) 检测慢性阻塞性肺病的进展疾病早于既定的临床方法。这些新的标记物将显着提高对慢性阻塞性肺病的了解，并且对于表征疾病对治疗的反应至关重要。