Acoustic Radiation Force Based Hepatic Elasticity Quantification and Imaging

基于声辐射力的肝弹性量化和成像

• 批准号: 8520301
• 负责人: Kathryn Radabaugh Nightingale
• 金额: $ 59.36万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-10 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8520301
• 关键词: Acoustics; Adverse effects; Affect; Aftercare; Algorithms; American; Anxiety; Appointment; Asia; Benign; Biopsy; Biopsy Specimen; Blood Tests; Cause of Death; Cirrhosis; Contrast Media; Core Biopsy; Detection; Development; Diagnosis; Diagnostic Neoplasm Staging; Diffuse; Disease; Disease Progression; Elasticity; Enzymes; Europe; Evaluation; Fibrosis; Foundations; Frequencies; Functional disorder; Goals; Healthcare Systems; Hepatic; Hepatitis; Histologic; Hospitalization; Image; Imagery; Inflammation; Ionizing radiation; Kidney Diseases; Laboratories; Lesion; Literature; Liver; Liver Cirrhosis; Liver Failure; Liver Fibrosis; Liver diseases; Magnetic Resonance Imaging; Malignant - descriptor; Malignant Neoplasms; Measures; Metabolic; Metabolic syndrome; Methods; Monitor; National Institute of Diabetes and Digestive and Kidney Diseases; Obesity; Patients; Physicians; Primary carcinoma of the liver cells; Procedures; Process; Radiation; Recommendation; Reporting; Research; Resolution; Risk; Sampling; Serum; Serum Markers; Speed; Staging; System; Technology; Time; Tissues; Tumor stage; Ultrasonics; Ultrasonography; United States; United States National Institutes of Health; Visit; alpha-Fetoproteins; base; chronic liver disease; cost; disease diagnosis; elastography; imaging modality; improved; liver biopsy; next generation; nonalcoholic steatohepatitis; novel; reconstruction; response; screening; simulation; tool; tumor

DESCRIPTION (provided by applicant): Liver disease diagnosis and treatment represents a significant cost to the United States health care system. Chronic liver disease and cirrhosis affects over 2,600,000 people in the United States, leading to over 700,000 hospitalizations annually. Chronic liver diseases progress over several decades at an estimated annual cost of $1.3 billion. Definitive diagnosis of liver disease is performed by liver biopsy; however, this invasive procedure has associated risks and is not well tolerated by patients. As a result, frequent staging of disease progression is not possible, and non-specific blood tests are often used as surrogates for biopsy to determine hepatic fibrosis stage. A separate challenge for liver disease diagnosis involves characterization of focal lesions. Focal liver lesions are detected during ultrasound imaging studies both incidentally and in patients who have an underlying malignancy. Distinguishing benign from malignant lesions with ultrasound is challenging, and many patients with lesions discovered during sonograms are referred for contrast enhanced CT or MRI for further characterization. These additional imaging studies are expensive and require additional patient visits, and they increase patient anxiety. The long term goal of this research i to develop an ultrasonic, quantitative acoustic radiation force impulse (ARFI) based elastography imaging system capable of noninvasive staging of liver fibrosis and differentiation between benign and malignant liver lesions. We propose the development of novel algorithms and beam sequences using both simulation and experimental tools to achieve the required spatial resolution, accuracy, and precision. There are three specific aims: 1) To develop and implement novel stiffness reconstruction methods combining qualitative and quantitative ARFI technologies to provide structurally accurate quantitative stiffness estimates and images of hepatic tumors. 2) To develop and implement 3D shear wave speed monitoring beam sequences and algorithms using a 2D matrix array to improve the accuracy and precision of shear wave speed estimates, and 3) To evaluate this next-generation system in the context of hepatic fibrosis staging and hepatic tumor characterization.

描述（由申请人提供）：肝病诊断和治疗代表了美国卫生保健系统的重大成本。在美国，慢性肝病和肝硬化影响了260万人，每年导致700,000多人住院。慢性肝脏疾病在数十年中的进展，估计年成本为13亿美元。肝脏疾病的明确诊断是通过肝活检进行的。但是，这种侵入性程序具有与风险相关的风险，并且患者无法很好地容忍。结果，疾病进展的频繁分期是不可能的，非特异性血液检查通常被用作活检的替代物来确定肝纤维化阶段。肝病诊断​​的单独挑战涉及局灶性病变的表征。在偶然的和具有潜在恶性肿瘤的患者中，在超声成像研究中检测到局灶性肝脏病变。将良性与具有超声的恶性病变区分开是具有挑战性的，许多在超声波检查过程中发现的病变患者被转介，以增强对比度的CT或MRI，以进一步表征。这些额外的成像研究很昂贵，需要额外的患者就诊，并且会增加患者的焦虑。这项研究的长期目标是开发基于超声，定量的声学辐射力冲动（ARFI）的弹性成像成像系统，能够无创的肝纤维化分期以及良性和恶性肝脏病变之间的分化。我们建议使用模拟和实验工具来开发新型算法和光束序列，以实现所需的空间分辨率，准确性和精度。有三个特定的目的：1）开发和实施结合定性和定量ARFI技术的新型刚度重建方法，以提供结构准确的定量刚度估计值和肝肿瘤的图像。 2）使用2D矩阵阵列开发和实施3D剪切速度监测光束序列和算法，以提高剪切波速度估计的准确性和精度，3）在肝纤维化分段和肝肿瘤表征的背景下评估该下一代系统。