Ultrasound-induced Thermal Strain Imaging for Arterial Plaque Characterization

用于动脉斑块表征的超声诱导热应变成像

• 批准号: 8236892
• 负责人: KANG KIM
• 金额: $ 37.5万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-05 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8236892
• 关键词: Accounting; Algorithms; American; Amputation; Angiography; Angioscopy; Arterial Fatty Streak; Arteries; Arteriogram; Atherosclerosis; Autopsy; Biology; Blood Clot; Blood Vessels; Blood coagulation; Blood flow; Cardiovascular Diseases; Carotid Arteries; Carotid Artery Plaques; Carotid Endarterectomy; Cholesterol; Clinic; Clinical; Color; Computer Simulation; Coronary; Coronary artery; Data; Dependence; Development; Diagnosis; Direct Costs; Facilities and Administrative Costs; Goals; Heating; Heterogeneity; Histopathology; Image; Imaging Device; Imaging Techniques; In Vitro; Intervention; Lesion; Link; Lipids; Magnetic Resonance Imaging; Maps; Measurement; Measures; Medical; Methods; Modeling; Monitor; Morphology; Motion; Myocardial Infarction; Optical Coherence Tomography; Oryctolagus cuniculus; Phase; Physiologic pulse; Process; Property; Resolution; Risk; Rupture; Safety; Scheme; Source; Specimen; Speed; Stenosis; Stroke; System; Systemic disease; Techniques; Temperature; Therapeutic; Thrombus; Tissues; Translating; Ultrasonic Therapy; Ultrasonics; Ultrasonography; United States; Validation; Water; X-Ray Computed Tomography; absorption; acute coronary syndrome; base; clinical practice; computerized data processing; data acquisition; design; feeding; high risk; human subject; human tissue; imaging modality; improved; microwave electromagnetic radiation; novel; operation; prevent; public health relevance; research study; sound; stem; submicron; tool; vascular bed

DESCRIPTION (provided by applicant): Validation of US-induced thermal strain imaging (TSI) technique to detect lipid contents in carotid artery plaques is proposed. Plaques characterized by a large lipid core and a thin fibrous cap have been identified as "vulnerable plaques", or "rupture-prone plaques. Identification of these potentially fatal plaques before their disruption is clinically desirable and will help predict vascular risk and guide therapies. Current imaging methods for identifying high risk features of plaque are either invasive or limited. TSI may provide alternative imaging technique to non-invasively and reliably identify and characterize atherosclerotic plaques (APs). Lipids have a negative temperature dependence of the sound speed, whereas water-based tissues have positive temperature dependence. TSI uses heating to induce a temperature rise in tissue and then determines the temperature change from local changes in sound speed using a phase-sensitive, correlation-based speckle tracking algorithm. TSI features strong contrast between lipids and water-based tissues, which stems primarily from sound speed contrast. The fundamental concept and feasibility has been demonstrated by several groups in the last decade mostly in vitro. For practicality and reliability of TSI in clinic, controlled heating source is important. We propose US-induced TSI using a single linear probe connected to a commercial ultrasound system. The overall goal proposed in this study is to develop and evaluate US-induced TSI to characterize carotid plaques. The fundamental hypotheses are: 1. An US linear probe can be designed and integrated into a commercial US imaging system to provide controlled US energy delivery to tissue to induce and image thermal strain 2. Within AP, the local TSI contrast indicates the presence of local lipid core and TSI intensity map measures lipid concentration and distribution. 3. US-induced TSI can provide a robust, reliable, and noninvasive tool for characterizing an AP, and in particular assessing its quantity of lipid, which is an important component that confers vulnerability. This technique should be easily translatable into a clinical tool for the diagnosis and management of carotid vulnerable plaques. A wide range of technical and scientific issues must be investigated to fully exploit the capabilities and practicality of the techniques proposed. Therefore, the three specific aims of this application are: 1. Develop an optimized US heating source fully integrated with an US imaging system to provide controlled energy delivery to tissue during routine US scanning. 2. Develop a robust US heating/imaging pulse sequence and data acquisition scheme. 3. Establish the relationship between US- induced TSI and the histopathology of APs, especially the assessment of the lipid core. This correlation will serve as an indication of the feasibility of applying this technique as a localized plaque characterization tool. The study will include computer simulations for beamforming and tissue thermal model, water tank experiments using the tissue mimicking phantoms, the human tissue specimens from autopsy, amputation and carotid endarterectomy (CEA), and high cholesterol-fed rabbit model. PUBLIC HEALTH RELEVANCE: Over 60 million Americans have some type of cardiovascular disease, and the estimated direct and indirect cost totals $368.4 billion in 2004, a significant burden on the economy. Atherosclerotic plaques, the most dangerous form of cardiovascular disease, can become unstable and rupture, releasing thrombogenic material such as lipid leading to blood clots totally blocking blood flow in the artery. These high-risk plaques, often called "vulnerable plaques," account for important clinical manifestations such as stroke and heart attack. Current imaging methods for identifying high risk features of plaque are either invasive or limited. Ultrasound- induced thermal strain imaging (TSI) may provide alternative imaging technique to non-invasively and reliably identify and characterize these vulnerable plaques. If successful, this method integrated into a commercial ultrasound scanner can be rapidly translated into clinical practice since it is based upon novel processing of ultrasound data that can be obtained conveniently and non-invasively from human subjects.

描述（由申请人提供）：提出了对颈动脉斑块中检测脂质含量的验证，以检测颈动脉斑块中的脂质含量。以大脂质核心和薄纤维帽为特征的斑块已被确定为“脆弱的斑块”或“易受破裂的斑块”。在临床上造成这些潜在的致命斑块识别这些潜在的致命斑块，在临床上是可取的，并将有助于预测较高的危险方法。无创和可靠地识别和表征动脉粥样硬化的斑块（AP）。水基组织主要源于声音速度对比。对于TSI在诊所中的实用性和可靠性，受控加热来源很重要。我们使用连接到商业超声系统的单个线性探针提出了US诱导的TSI。这项研究提出的总体目标是开发和评估美国引起的TSI以表征颈动脉斑块。基本假设是：1。可以设计并集成到商用的美国成像系统中，以提供受控的美国能量到组织的能量传递，以诱导和图像热应变2。在AP中，局部TSI对比度表明存在局部脂质核心和TSI强度图测量脂质浓度和分布。 3。美国诱导的TSI可以提供一个可靠，可靠和无创的工具来表征AP，尤其是评估其脂质的数量，这是赋予脆弱性的重要组成部分。该技术应很容易被翻译成用于诊断和管理颈动脉脆弱斑块的临床工具。必须研究广泛的技术和科学问题，以充分利用所提出的技术的能力和实用性。因此，该应用程序的三个具体目的是：1。开发与美国成像系统完全集成的优化的美国加热源，以在常规US扫描过程中向组织提供受控的能量输送。 2。开发强大的美国加热/成像脉冲序列和数据采集方案。 3。建立了美国诱导的TSI与AP的组织病理学之间的关系，尤其是对脂质核心的评估。这种相关性将表明将该技术应用于局部斑块表征工具​​的可行性。该研究将包括用于光束形成和组织热模型的计算机模拟，使用模仿幻影的组织实验，尸检，截肢和颈动脉内膜切除术（CEA）的人体组织标本以及高胆固醇喂养的兔模型。 公共卫生相关性：超过6000万美国人患有某种类型的心血管疾病，估计的直接和间接成本总计为3684亿美元，这对经济负担很大。动脉粥样硬化斑块是心血管疾病的最危险形式，可能会变得不稳定和破裂，释放出血栓形成材料，例如脂质，导致血凝块完全阻断了动脉中的血液流动。这些高风险的斑块，通常称为“脆弱的斑块”，描述了重要的临床表现，例如中风和心脏病发作。当前用于识别斑块高风险特征的成像方法是侵入性或有限的。超声诱导的热应变成像（TSI）可能会提供替代成像技术，以无创，可靠地识别和表征这些脆弱的斑块。如果成功，则可以将这种方法集成到商业超声扫描仪中，可以迅速转化为临床实践，因为它基于对超声数据的新处理，可以从人类受试者中方便和非侵入性地获得。