AN INNOVATIVE ULTRASOUND-BASED PROSPECTIVE-GATING TECHNIQUE FOR CARDIAC COMPUTED

一种创新的基于超声的心脏计算前瞻性门控技术

• 批准号: 8092286
• 负责人: Srini Tridandapani
• 金额: $ 18.05万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-01 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8092286
• 关键词: Abdomen; Advisory Committees; American Heart Association; Americas; Angiography; Arteries; Biomedical Engineering; Cardiac; Cardiology; Catheters; Cessation of life; Clinical; Clinical Research; Clinical Trials; Computer software; Computers; Coronary; Coronary Angiography; Coronary Arteriosclerosis; Coronary artery; Coronary heart disease; Cost Savings; Data; Development; Diagnosis; Diagnostic; Digital Signal Processing; Dose; Educational workshop; Electrical Engineering; Electrocardiogram; Engineering; Environment; Evaluation; Gold; Health Care Costs; Healthcare; Heart; Heart Rate; Image; Institutes; Instruction; Lead; Location; Low Dose Radiation; Master of Science; Mechanics; Medical Imaging; Medicine; Mentorship; Methods; Morphologic artifacts; Motion; North America; Patients; Phase; Physicians; Positron-Emission Tomography; Principal Investigator; Procedures; Process; Radiation; Radiation therapy; Radiology Specialty; Relative (related person); Research; Research Design; Research Personnel; Resolution; Resources; Risk; Savings; Scanning; Scholarship; Scientist; Signal Transduction; Signs and Symptoms; Societies; Speed; Stenosis; Techniques; Technology; Testing; Time; Training; Ultrasonography; Universities; X-Ray Computed Tomography; base; bioimaging; cardiovascular imaging; career development; computerized data processing; coronary computed tomography angiography; cost; design; experience; heart motion; improved; innovation; medical complication; multidisciplinary; professor; programs; prospective; prototype; radiologist; reconstruction; respiratory; simulation; statistics

DESCRIPTION (provided by applicant): This K-23 proposal describes a multidisciplinary, cross-cutting career development program, which will enable the Principal Investigator, a Cardiothoracic and Abdominal Radiologist, and an Electrical Engineer, to become a productive independent translational researcher in cardiovascular imaging. The objective of the proposed research is to merge the unique capabilities of computed tomography (CT) and real-time ultrasound (US) to provide a gating signal in order to obtain motion-free CT images of coronary arteries. The PI hypothesizes that US, which provides real-time data similar to electrocardiography (ECG), can directly evaluate cardiac mechanical motion and would be more reliable than ECG at determining relative cardiac akinesia within a cardiac cycle. Coronary artery disease is a significant national healthcare issue, and the evaluation of coronary artery disease is currently based on either (1) catheter coronary angiography (CCA), which is very expensive and invasive with known significant complications or (2) CT coronary angiography (CTCA), which, in its current forms, is either radiation-intensive or unreliable due to motion artifacts. In Aim 1, the PI will evaluate US-gating relative to ECG-gating in determining relative cardiac quiescence. In Aim 2, the PI will evaluate the efficacy of US-derived gating parameters relative to ECG-gating in generating motion-free CTCA from retrospectively-gated CT scans. For Aim 3, the PI will initiate the design and simulation of prototype hardware based on Digital Signal Processing and Field Programmable Gate Array technologies to provide an optimal, prospective real-time trigger for CTCA. The rationale for building hardware is that the stringent temporal resolution requirements for prospective triggering of cardiac CT dictate that the US analysis be performed in real-time on a large volume of data; this cannot be accomplished by software in real-time. The proposed method of gating based on mechanical signals is a paradigm-shift for CTCA and could result in an economical, low-radiation, rapid, non-invasive and reliable technique for evaluating coronary arteries. The most important implication of this development will be a reduction in the number of diagnostic, invasive CCAs that reveal "normal" arteries, and their associated complications, resulting in dramatic healthcare cost savings. More broadly, the potential impact of this US-based gating technique is that it can be applied directly to other diagnostic problems including respiratory gating for positron-emission tomography-CT and radiation therapy. The proposed K23 scholarship takes advantage of the PI's background combining engineering and medicine and the carefully selected, diverse mentorship/advisory committee which is comprised of world- renowned scientists, and physician-scientists. The career development program has three major components: a technical component, a translational component and a clinical component. The technical component involves the development of a hardware-based triggering technique which will be performed under the mentorship of a leading scientist in biomedical imaging and an engineering professor with extensive academic and industrial experience. Additional focused didactic instruction in image/signal processing and hardware design will be obtained from the Electrical and Computer Engineering and the Biomedical Engineering Departments of the Georgia Institute of Technology. The translational component involves a didactic component, provided by Emory University's Master of Science in Clinical Research program and an Imaging Clinical Trials workshop offered by the Radiological Society of North America. Finally, a clinical research component that involves gathering and analyzing US, ECG and CT data will be performed under the mentorship of internationally recognized pioneers in cardiovascular imaging from the Departments of Radiology and Cardiology at Emory University. The program would take place in an environment which is at the cutting edge of medical imaging, cardiology, and biomedical engineering, with extensive clinical, educational and research resources. PUBLIC HEALTH RELEVANCE: Catheter coronary angiography, while the current gold standard for evaluation of coronary arteries, is nonetheless highly invasive and has major associated medical complications and an unacceptably high rate of 'normal' diagnostic findings. To overcome this procedure's risks and to reduce the associated high costs, real- time ultrasound could be used as a gating signal to drastically reduce motion artifacts in cardiac computerized tomography. This will lead to a reliable, rapid, low-radiation dose, non-invasive alternative technique for evaluating coronary arteries, and potentially decrease health care costs by several billion dollars annually.

描述（由申请人提供）：这份 K-23 提案描述了一个多学科、跨领域的职业发展计划，该计划将使首席研究员、心胸和腹部放射科医生和电气工程师成为心血管领域富有成效的独立转化研究员成像。 拟议研究的目标是融合计算机断层扫描 (CT) 和实时超声 (US) 的独特功能，提供门控信号，从而获得冠状动脉的自由运动 CT 图像。 PI 假设 US 提供类似于心电图 (ECG) 的实时数据，可以直接评估心脏机械运动，并且在确定心动周期内的相对心运动不能方面比 ECG 更可靠。冠状动脉疾病是一个重要的国家医疗保健问题，目前对冠状动脉疾病的评估基于 (1) 导管冠状动脉造影 (CCA)，这种方法非常昂贵且具有侵入性，并存在已知的严重并发症，或 (2) CT 冠状动脉造影（ CTCA），目前的形式要么辐射密集，要么由于运动伪影而不可靠。在目标 1 中，PI 将评估 US 门控相对于 ECG 门控的情况，以确定相对心脏静止状态。在目标 2 中，PI 将评估 US 衍生的门控参数相对于 ECG 门控在从回顾性门控 CT 扫描生成无运动 CTCA 方面的功效。对于目标 3，PI 将启动基于数字信号处理和现场可编程门阵列技术的原型硬件的设计和仿真，为 CTCA 提供最佳的、前瞻性的实时触发。构建硬件的基本原理是，心脏 CT 前瞻性触发的严格时间分辨率要求要求对大量数据实时执行 US 分析；这无法通过软件实时完成。所提出的基于机械信号的门控方法是 CTCA 的范式转变，可以产生一种经济、低辐射、快速、无创且可靠的冠状动脉评估技术。这一发展最重要的意义将是减少揭示“正常”动脉及其相关并发症的诊断性、侵入性 CCA 的数量，从而显着节省医疗成本。更广泛地说，这种美国门控技术的潜在影响是，它可以直接应用于其他诊断问题，包括正电子发射断层扫描-CT 和放射治疗的呼吸门控。 拟议的 K23 奖学金利用了 PI 结合工程和医学的背景，以及由世界知名科学家和医师科学家组成的精心挑选的多元化导师/咨询委员会。职业发展计划由三个主要部分组成：技术部分、转化部分和临床部分。技术部分涉及基于硬件的触发技术的开发，该技术将在生物医学成像领域领先科学家和具有丰富学术和工业经验的工程教授的指导下进行。图像/信号处理和硬件设计方面的其他重点教学指导将从佐治亚理工学院的电气和计算机工程以及生物医学工程系获得。转化部分涉及教学部分，由埃默里大学临床研究理学硕士项目和北美放射学会提供的影像临床试验研讨会提供。最后，涉及收集和分析超声、心电图和 CT 数据的临床研究部分将在埃默里大学放射学和心脏病学系的国际公认的心血管成像先驱的指导下进行。该项目将在医学成像、心脏病学和生物医学工程最前沿的环境中进行，拥有广泛的临床、教育和研究资源。 公众健康相关性：导管冠状动脉造影虽然是目前评估冠状动脉的金标准，但其侵入性极强，并且具有严重的相关医疗并发症，并且“正常”诊断结果的比率高得令人无法接受。为了克服该过程的风险并降低相关的高成本，可以使用实时超声作为门控信号，以大大减少心脏计算机断层扫描中的运动伪影。这将带来一种可靠、快速、低辐射剂量、非侵入性的评估冠状动脉的替代技术，并可能每年减少数十亿美元的医疗保健费用。