Time Resolved Breast Imaging Using a Combined MRI and Optical Tomography Approach

使用 MRI 和光学断层扫描相结合的方法进行时间分辨乳腺成像

• 批准号: 7871749
• 负责人: Stefan Alexandru Carp
• 金额: $ 9.53万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-10 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7871749
• 关键词: Adipose tissue; Algorithms; Biological Markers; Biomechanics; Blood Volume; Blood flow; Breast; Caliber; Cancer Patient; Characteristics; Choline; Classification Scheme; Clinical; Clinical Trials; Custom; Data; Diagnostic; Diffusion; Disease; Early treatment; Exhibits; Fatty acid glycerol esters; Functional Imaging; Goals; Hemoglobin; Image; Imaging Techniques; Joints; Lesion; Lipids; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Malignant - descriptor; Mammary Gland Parenchyma; Mammary Ultrasonography; Maps; Measurement; Measures; Medical; Metabolic; Metabolic Marker; Metabolism; Methods; Modality; Monitor; Near-Infrared Spectroscopy; Neoadjuvant Therapy; Normal tissue morphology; Operative Surgical Procedures; Optical Tomography; Optics; Outcome; Oxygen; Oxygen Consumption; Patients; Positron-Emission Tomography; Predictive Value; Procedures; Protocols documentation; ROC Curve; Residual state; Resolution; Scanning; Specificity; Staging; System; Techniques; Testing; Time; Tissues; Tumor Volume; Validation; Variant; Water; Weight; Work; blood oxygen level dependent; breast lesion; cancer diagnosis; chemotherapy; chromophore; healthy volunteer; hemodynamics; improved; instrumentation; malignant breast neoplasm; novel; optical fiber; optical imaging; public health relevance; reconstruction; response; success; therapy outcome; tomography; tumor

DESCRIPTION (provided by applicant): Primary systemic (neoadjuvant) therapy is routinely used for locally advanced breast cancer patients before surgery to down-stage the disease and increase the chances of a successful outcome. Many patients though do not respond to neoadjuvant therapy, and may be better off switching to a different treatment regime, or progressing to surgery immediately. However, therapy monitoring is difficult because current clinical examination and x-ray/ultrasound mammography follow-ups correlate poorly with final therapy pathological outcome. Both magnetic resonance imaging (MRI) and positron emission tomography (PET) have been evaluated as early predictors of response, with studies showing that 18F-FDG PET as well as diffusion weighted (DW) MRI and choline-compounds MR spectroscopy (tCho-MRS) measurements correspond well with therapy success within a few weeks from the beginning of treatment. Unfortunately, availability (PET), complexity (tCho-MRS), and specificity (MRI) limit the applicability of these methods. Consequently, there is a need to develop non-invasive specific early prediction approaches that more easily integrate into medical practice. A potential answer may be offered by near infrared spectroscopy and tomography (NIRS-DOT). NIRS-DOT is a novel functional imaging technique that can offer images of tissue chromophores such as oxy (HbO) and deoxy hemoglobin (HbR), water and lipids, and small studies have hinted at its potential to predict therapy outcome with high accuracy as early as one week after the start of treatment. Further, recent technological advancements have permitted DOT to reach high time resolution (> 1Hz), allowing new types of functional information to be probed by dynamic imaging. In particular, our group has obtained promising initial results monitoring the response of breast tissue to external compression. Tissue viscoelastic response to compression causes hemodynamic (blood volume) changes with bi-phasic temporal profiles likely to differentiate healthy tissues from breast lesions. Further, the interplay of hemodynamics and tissue oxygen metabolism leads to hemoglobin oxygenation transients that offer the opportunity to estimate tissue oxygen consumption (OC) and blood flow (BF) from time-resolved optical data. The overall goal of this proposal is to combine MRI and NIRS-DOT to characterize the predictive value of compression-enabled measurements of tissue hemodynamics, blood flow and oxygen consumption as new biomarkers sensitive to therapy progress and quantify their relationship to final pathological outcome. Structural information from the MRI scans will be used as prior information for the optical reconstructions and dynamic optical and HbR-related MR blood oxygen level dependent (BOLD) images will be simultaneously acquired enabling a fusion approach for reconstructing time-resolved hemodynamic maps and BF/OC distributions. Difference BOLD images will be cross-validated against corresponding HbR maps. The work will culminate with a clinical trial to assess the early therapy outcome predictive ability of the new biomarkers. PUBLIC HEALTH RELEVANCE: We propose to use fast optical tomography during breast compression to investigate biomechanical and metabolic characteristics of normal and lesion tissues, with the goal of improving specificity for cancer diagnosis and non-invasively monitoring chemotherapy progress.

描述（由申请人提供）：局部晚期乳腺癌患者在手术前常规使用主要全身（新辅助）治疗，以降低疾病阶段并增加成功结果的机会。然而，许多患者对新辅助治疗没有反应，最好改用不同的治疗方案，或立即进行手术。然而，治疗监测很困难，因为当前的临床检查和 X 射线/超声乳腺 X 线摄影随访与最终治疗病理结果的相关性较差。磁共振成像 (MRI) 和正电子发射断层扫描 (PET) 均已被评估为反应的早期预测因子，研究表明 18F-FDG PET 以及扩散加权 (DW) MRI 和胆碱化合物 MR 波谱 (tCho-MRS) ）测量结果与治疗开始后几周内的治疗成功程度非常吻合。不幸的是，可用性（PET）、复杂性（tCho-MRS）和特异性（MRI）限制了这些方法的适用性。因此，需要开发更容易融入医疗实践的非侵入性特定早期预测方法。近红外光谱和断层扫描（NIRS-DOT）可能会提供一个潜在的答案。 NIRS-DOT 是一种新型功能成像技术，可以提供组织发色团的图像，例如氧 (HbO) 和脱氧血红蛋白 (HbR)、水和脂质，小型研究已暗示其具有尽早高精度预测治疗结果的潜力治疗开始后一周。此外，最近的技术进步使 DOT 能够达到高时间分辨率 (> 1Hz)，从而允许通过动态成像探测新型功能信息。特别是，我们的小组在监测乳腺组织对外部压力的反应方面取得了有希望的初步结果。组织对压缩的粘弹性反应会导致血流动力学（血容量）变化，并产生双相时间曲线，可能将健康组织与乳腺病变区分开来。此外，血流动力学和组织氧代谢的相互作用导致血红蛋白氧合瞬变，这提供了根据时间分辨光学数据估计组织耗氧量（OC）和血流量（BF）的机会。 该提案的总体目标是结合 MRI 和 NIRS-DOT 来表征组织血流动力学、血流量和耗氧量的压缩测量的预测价值，作为对治疗进展敏感的新生物标志物，并量化它们与最终病理结果的关系。来自 MRI 扫描的结构信息将用作光学重建的先验信息，同时采集动态光学和 HbR 相关 MR 血氧水平相关 (BOLD) 图像，从而实现用于重建时间分辨血流动力学图和 BF/ 的融合方法。 OC 发行版。差异粗体图像将与相应的 HbR 图进行交叉验证。这项工作将以一项临床试验结束，以评估新生物标志物的早期治疗结果预测能力。 公共健康相关性：我们建议在乳房压迫期间使用快速光学断层扫描来研究正常组织和病变组织的生物力学和代谢特征，目的是提高癌症诊断的特异性和非侵入性监测化疗进展。