Novel MRI Imaging Tools and Software for Assessing Pediatric Crohn's Disease

用于评估儿童克罗恩病的新型 MRI 成像工具和软件

• 批准号: 8613748
• 负责人: Moti Freiman
• 金额: $ 36.94万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-01-08 至 2018-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8613748
• 关键词: Abdomen; Adolescent; Adult; Affect; Algorithms; Bayesian Modeling; Biological Markers; Blood Circulation; Blood Tests; Caring; Cell Proliferation; Cellularity; Child; Childhood; Chronic; Clinical; Clinical Management; Clinical Research; Colonoscopy; Computational Science; Computer software; Computers; Crohn' s disease; Data; Diagnosis; Diagnostic; Diagnostic tests; Diffusion; Diffusion Magnetic Resonance Imaging; Disease; Disease Management; Evaluation; Excision; Fibrosis; Goals; Histology; Image; Imaging Device; Imaging Techniques; Immune system; Individual; Inflammation; Inflammatory; Inflammatory Bowel Diseases; Inflammatory disease of the intestine; Intestines; Ionizing radiation; Lead; Magnetic Resonance; Magnetic Resonance Imaging; Measurement; Medical; Medical Imaging; Medicine; Methods; Modeling; Monitor; Motion; North America; Operative Surgical Procedures; Outcome; Pathology; Patients; Pediatric Radiologist; Performance; Perfusion; Pharmaceutical Preparations; Physiological Processes; Physiology; Population; Postoperative Period; Process; Radiation; Recurrence; Reference Standards; Research; Resected; Scientist; Signal Transduction; Specimen; Structure; Surgeon; Target Populations; Techniques; Technology; Testing; Time; Tissues; Toxic effect; Translating; Ulcerative Colitis; United States; United States National Institutes of Health; Weight; Work; X-Ray Computed Tomography; base; combinatorial; density; disease diagnosis; experience; imaging modality; improved; indexing; innovation; novel; open source; practical application; prevent; public health relevance; rapid technique; reconstruction; response; treatment planning; tumor

DESCRIPTION (provided by applicant): An estimated 1.4 million people in the United States suffer from inflammatory bowel disease (IBD), half of whom are believed to have Crohn's disease (CD), one of two primary forms of IBD along with ulcerative colitis. At least 10% are <18. Our response to Innovations in Biomedical and Computational Science and Technology under PAR-07-344, "Novel MRI Imaging Tools and Software for Assessing Pediatric Crohn's Disease" (pCD), is aimed at developing and refining a new type of parametric imaging- accelerated spatially constrained incoherent motion MRI (aSCIM-MRI)-as a highly accurate quantitative biomarker for cell proliferation, density and size, and tissue perfusion-all indices tat characterize the extent of disease activity (i.e., inflammation) in the tissue micro-structure of te bowel. If successful, this non-invasive, radiation-free technique will constitute a dramatic improvement over current reference standards (i.e., magnetic resonance enterography (MRE), clinical exam, blood tests, and histology), separately, and in combination. Specifically, a-SCIM-MRI is expected to substantially improve our ability to assess inflammatory activity in pCD; monitor response-to-therapy; evaluate the need for surgical intervention; develop treatment plans that are tailored to individual disease profiles; and predict the likelihood of recurrence. T these ambitious ends, we will undertake the following Specific Aims: 1) to determine whether a spatially constrained signal decay model (SCIM-MRI) improves the reliability of fast and slow diffusion quantification from diffusion-weighted MRI (DW-MRI); 2) to accelerate SCIM-MRI acquisition time with a Bayesian model-based reconstruction (aSCIM-MRI); and 3) to assess the efficacy of fast and slow diffusion components at distinguishing active inflammation from fibrosis in pCD as determined by histopathological findings. With the support of the NIH, these anticipated research accomplishments will result in vastly improved management of a most debilitating bowel disease, the diagnosis of which is often elusive, and on diagnosis, challenging to treat; in part because optimal therapies are somewhat limited for children; and in part because the target population is developmentally fragile to begin with, and thus more susceptible to toxicity from strong biologic drugs and to the complications (both short- and long-term) associated with surgery. Given the fact that up to 75% of children with CD must undergo a bowel resection as some point in their lives, and given the fact that these surgeries are rarely curative; the demand to improve assessment capabilities has never been greater. This highly innovative imaging approach, aSCIM-MRI, is therefore expected not only to create a new reference standard by which pCD is evaluated, monitored, and treated; it is also expected to have rapid translational impact once it is introduced into routine clinical imaging. A second, important overall goal of this project is to develop and broadly disseminate open source software will enable the standardized evaluation of other diseases that are presently evaluated with DW-MRI and would benefit from the advanced diagnostic and assessment capabilities of aSCIM-MRI.

描述（由申请人提供）：美国估计有140万人患有炎症性肠病（IBD），其中一半被认为患有克罗恩病（CD），这是IBD的两种主要形式以及溃疡性结肠炎。至少10％的是<18。 Our response to Innovations in Biomedical and Computational Science and Technology under PAR-07-344, "Novel MRI Imaging Tools and Software for Assessing Pediatric Crohn's Disease" (pCD), is aimed at developing and refining a new type of parametric imaging- accelerated spatially constrained incoherent motion MRI (aSCIM-MRI)-as a highly accurate quantitative biomarker for cell proliferation, density and大小和组织灌注 - 所有指数TAT表征了TE肠组织微结构中疾病活性的程度（即炎症）。如果成功，则这种无侵入性的无辐射技术将构成与当前参考标准（即磁共振插图（MRE），临床检查，血液测试和组织学）的显着改善，并构成组合。具体而言，预计A-SCIM-MRI将大大提高我们评估PCD炎症活性的能力。监测对治疗的反应；评估手术干预的需求；制定针对个体疾病特征量身定制的治疗计划；并预测复发的可能性。 t这些雄心勃勃的目的，我们将承担以下特定目的：1）确定在空间约束的信号衰减模型（SCIM-MRI）是否可以提高从扩散加权MRI（DW-MRI）快速和缓慢扩散定量的可靠性； 2）通过基于贝叶斯的重建（ASCIM-MRI）加速粘液MRI采集时间； 3）通过组织病理学发现确定，快速和缓慢扩散成分在区分PCD的纤维化方面的快速和缓慢扩散成分的疗效。在NIH的支持下，这些预期的研究成就将大大改善对肠道疾病最令人衰弱的治疗，其诊断通常是难以捉摸的，并且在诊断方面，对治疗的挑战。部分原因是儿童最佳疗法受到限制；部分是因为目标人群在发展上是脆弱的，因此更容易受到强生物药物的毒性以及与手术相关的并发症（短期和长期）的毒性。考虑到多达75％的CD儿童必须进行肠切除作为生活中的某个点，并且鉴于这些手术很少是治愈的事实；提高评估能力的需求从未有所更大。因此，这种高度创新的成像方法ASCIM-MRI不仅可以创建一个新的参考标准，并通过该标准进行评估，监测和处理PCD。一旦将其引入常规临床成像后，它也会产生快速的翻译影响。该项目的第二个重要总体目标是开发和广泛传播开源软件将使目前使用DW-MRI评估的其他疾病进行标准化评估，并从ASCIM-MRI的先进诊断和评估能力中受益。