Virtual Biopsy with Ultrasound for Liver Fibrosis Staging

超声虚拟活检用于肝纤维化分期

• 批准号: 7726313
• 负责人: Shigao Chen
• 金额: $ 33.81万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7726313
• 关键词: Address; American; Animal Experiments; Biopsy; Cardiovascular system; Chronic; Cirrhosis; Clinical; Clinical Management; Clinical Research; Computer software; Data; Detection; Diagnosis; Elasticity; Evaluation; Family suidae; Fibrosis; Frequencies; Generations; Goals; Gold; Health; Histocompatibility Testing; Housing; Human; In Vitro; Literature; Liver; Liver Fibrosis; Liver diseases; Magnetic Resonance Imaging; Manufacturer Name; Measurement; Measures; Mechanics; Medical; Medical Imaging; Methods; Modeling; Modification; Monitor; Motion; Obesity; Pathology; Patients; Penetration; Performance; Physiologic pulse; Populations at Risk; Property; Reporting; Research; Research Proposals; Safety; Schedule; Screening procedure; Sensitivity and Specificity; Serum Markers; Speed; Staging; Striated Muscles; Surrogate Markers; Techniques; Testing; Tissues; Transducers; Ultrasonography; Viscosity; diagnosis standard; drug development; follow-up; human study; in vivo; indexing; instrumentation; liver biopsy; meetings; novel; prototype; public health relevance; research study; respiratory; soft tissue; vibration; virtual

DESCRIPTION (provided by applicant): Liver fibrosis/cirrhosis afflicts hundreds of millions of patients worldwide and 900,000 Americans. Liver biopsy, currently the gold standard for the diagnosis of liver fibrosis, is invasive and may occasionally cause significant complications, which limits the screening of at-risk populations, treatment monitoring, and follow-up. Current serum markers and classic medical imaging such as ultrasound, CT, or MRI do not have sufficient sensitivity/specificity for fibrosis evaluation. Recent studies show that tissue elasticity (i.e. stiffness) may be used for liver fibrosis staging. Herein we propose a novel ultrasound method, Shearwave Ultrasound Dispersion Vibrometry (SDUV), for noninvasive, biopsy-like quantification of elasticity as well as viscosity for liver fibrosis staging. Method: SDUV uses an ultrasound "push" beam within FDA safety limits to stimulate formation of propagating harmonic shear waves in the studied tissue. The propagation speed of induced shear waves is frequency dependent (dispersive) and relates to the tissue's mechanical properties. Shear wave speeds at multiple frequencies (typically hundreds of Hertz) are measured by a separate ultrasound "detect" beam in pulse echo mode and fit with a theoretical dispersion model to inversely solve for tissue elasticity and viscosity. Preliminary studies in tissue-mimicking phantom and striated muscle are very promising. A special pulse sequence has been developed to facilitate a single ultrasound array transducer for both push and detect function, which makes SDUV compatible with current ultrasound scanners. Feasibility of this pulse sequence has been validated with in vivo measurements in normal porcine liver using in-house instrumentation. Aims: 1. Implement SDUV on a commercial ultrasound scanner. 2. Calibrate and optimize the prototype with phantom, in vitro tissue, and in vivo animal experiments. 3. Conduct a clinical research on patients with suspected hepatic fibrosis who are scheduled to have a clinically indicated liver biopsy. Successful completion of this project should result in a new clinical technique, SDUV for noninvasive, fast, economical, and reliable "virtual biopsy" for fibrosis staging. PUBLIC HEALTH RELEVANCE: Successful completion of this project should result in a new ultrasound technique for safe, fast, economical, and reliable staging of liver fibrosis/cirrhosis, which afflicts hundreds of millions of patients worldwide and 900,000 Americans. This technique can be used as a noninvasive alternative to liver biopsy for the screening of at-risk populations, treatment monitoring, and follow-up of patients with chronic liver diseases.

描述（由申请人提供）：肝纤维化/肝硬化遭受了全世界数亿名患者和90亿美国人的困扰。肝活检（目前是诊断肝纤维化的金标准）是侵入性的，有时可能引起严重的并发症，这限制了筛查处于危险的人群，治疗监测和随访。当前的血清标记和经典的医学成像，例如超声，CT或MRI，对纤维化评估没有足够的敏感性/特异性。最近的研究表明，组织弹性（即刚度）可用于肝纤维化分期。本文中，我们提出了一种新型的超声方法，即剪力波超声色散振动（SDUV），用于无创，活检样的弹性定量，以及用于肝纤维化分期的粘度。方法：SDUV在FDA安全极限内使用超声“推动”束来刺激研究组织中传播谐波剪切波的形成。诱导剪切波的传播速度取决于频率（分散），并且与组织的机械性能有关。通过多个频率（通常为数百个赫兹）处于脉冲回波模式下的单独的超声“检测”梁来测量剪切波速度，并与理论分散模型拟合，以反相反地求解组织弹性和粘度。在模拟组织的幻影和横纹肌肉中的初步研究非常有前途。已经开发了一个特殊的脉冲序列，以促进单个超声阵列传感器以用于推送和检测功能，这使SDUV与当前的超声扫描仪兼容。该脉冲序列的可行性已通过使用内部仪器在正常猪肝中的体内测量得到验证。目的：1。在商业超声扫描仪上实施SDUV。 2。用幻影，体外组织和体内动物实验校准和优化原型。 3。对疑似肝纤维化患者进行临床研究，该患者计划进行临床指示的肝活检。该项目的成功完成应导致一种新的临床技术，用于非侵入性，快速，经济和可靠的“虚拟活检”，用于纤维化分期。公共卫生相关性：该项目的成功完成应导致一种新的超声技术，以实现肝纤维化/肝硬化的安全，快速，经济和可靠的分期，这折磨了全球数亿名患者和90亿美国人。该技术可用作肝活检的无创替代方法，用于筛查处于危险的人群，治疗监测以及对慢性肝病患者的随访。