Advancement and Validation of Prostate Diffusion and Spectroscopic MRI

前列腺扩散和能谱 MRI 的进展和验证

• 批准号: 8446312
• 负责人: Stephan E Maier
• 金额: $ 38.28万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2017-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8446312
• 关键词: Address; Aftercare; Agreement; Anatomy; Biopsy; Cancer Patient; Cell membrane; Choline; Citrates; Clinical; Collection; Complement; Core Biopsy; Creatine; Data; Data Set; Detection; Development; Diagnostic; Diffusion; Diffusion Magnetic Resonance Imaging; Diffusion weighted imaging; Disease; Exhibits; Gland; Gleason Grade for Prostate Cancer; Histology; Image; Individual; Lesion; Lipids; Local Therapy; Location; MRI Scans; Magnetic Resonance; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Malignant Neoplasms; Malignant neoplasm of prostate; Maps; Metabolic Marker; Methods; Microscopy; Monitor; Morphologic artifacts; Motion; Nature; Normal tissue morphology; PSA level; Patient Monitoring; Patients; Pelvis; Phase; Physiologic pulse; Play; Predisposition; Procedures; Prostate; Protocols documentation; Radical Prostatectomy; Resolution; Role; Scanning; Services; Shapes; Signal Transduction; Staging; System; Techniques; Testing; Time; Tissues; Transrectal Ultrasound; Tumor Tissue; Validation; Weight; abstracting; base; cancer site; follow-up; image registration; improved; novel; novel strategies; reconstruction; spectroscopic imaging; treatment effect; tumor; tumor growth; water diffusion

Project Summary/Abstract More reliable and accurate diagnostic estimation of tumor locations, volumes, and malignancy grade with MR would provide an invaluable service towards staging prostate cancer, particularly in cases with negative transrectal ultrasound (TRUS) biopsy. MR, due to the non-invasive nature, is a promising method for repeated exams in patients under active surveillance (AS) and for monitoring treatment effects. More detailed localization is also valuable for emerging targeted local therapies. The current collection of MR methods, which includes T2-weighted MRI, dynamic contrast-enhanced (DCE) MRI, diffusion-weighted MRI (DWI) and 3D-MR spectroscopic imaging (MRSI) appears to be very useful for staging of prostate cancer, particularly if used in combination. However, the potentially most sensitive and specific of these methods, namely DWI and MRSI, exhibit several deficiencies, which will be addressed by the technical developments contemplated for this project. Moreover, a novel contrast based on the separation of the fast and slow water diffusion components present in tissues, will be explored for improved detection of prostate cancer. The specific aims are as follows: 1) To advance whole-gland MRSI by reducing scan duration to a clinically acceptable time, while improving spatial resolution and eliminating the problem of lipid contamination of spectra due to truncation artifacts. 2) To advance spatial resolution and geometric fidelity of prostate DWI with reduced field-of-view and segmented multi-shot imaging. 3) To perform MRI scans in prostate cancer patients with standard sequences and new MRSI and diffusion imaging sequences. Moreover, to attain a separation of diffusion components, which have the potential to be more sensitive and specific to tumor growth related tissue aberrations at the cellular level, it is planned to employ biexponential analysis of DWI data collected over a wider range of diffusion encoding strength (b-factor). Quantitative parameter maps will be generated from MRSI, DWI, and DCE MRI data. 4) To obtain MRI-guided biopsy data or whole-gland step section histology during clinically indicated follow-up procedures in order to validate that the improved techniques and the novel contrast permit superior detection of prostate cancer. Pre-procedural parameter maps will be co-registered to the biopsy or histology coordinate system. Gleason scores of individual biopsy cores and tumor outlines on microscopy images will be compared with findings on parameter maps. The utility of each parameter and combined parameters to differentiate tumor from normal tissue will be analyzed statistically.

项目概要/摘要 通过 MR 对肿瘤位置、体积和恶性程度进行更可靠、更准确的诊断评估，将为前列腺癌分期提供宝贵的服务，特别是在经直肠超声 (TRUS) 活检阴性的情况下。由于 MR 具有非侵入性，因此是一种很有前景的方法，可以对主动监测 (AS) 下的患者进行重复检查并监测治疗效果。更详细的定位对于新兴的靶向局部治疗也很有价值。 目前的 MR 方法包括 T2 加权 MRI、动态对比增强 (DCE) MRI、扩散加权 MRI (DWI) 和 3D-MR 光谱成像 (MRSI) 似乎对于前列腺癌的分期非常有用。特别是如果组合使用。然而，这些方法中可能最敏感和最具体的方法，即 DWI 和 MRSI，存在一些缺陷，这些缺陷将通过本项目预期的技术开发来解决。此外，将探索一种基于组织中存在的快速和慢速水扩散成分分离的新型对比，以改进前列腺癌的检测。具体目标如下： 1）通过将扫描持续时间缩短至临床可接受的时间，同时提高空间分辨率并消除由于截断伪影造成的光谱脂质污染问题，来推进全腺 MRSI。 2) 通过缩小视场和分段多镜头成像来提高前列腺 DWI 的空间分辨率和几何保真度。 3) 使用标准序列和新的 MRSI 和扩散成像序列对前列腺癌患者进行 MRI 扫描。此外，为了实现扩散成分的分离，这些成分有可能在细胞水平上对肿瘤生长相关的组织畸变更加敏感和特异，计划对在更广泛的扩散编码强度范围内收集的 DWI 数据进行双指数分析（b 因子）。定量参数图将从 MRSI、DWI 和 DCE MRI 数据生成。 4) 在临床指示的随访过程中获得 MRI 引导的活检数据或全腺阶梯切片组织学，以验证改进的技术和新颖的对比技术可以更好地检测前列腺癌。 程序前参数图将被共同配准到活检或组织学坐标系。个体活检核心的格里森评分和显微镜图像上的肿瘤轮廓将与参数图上的结果进行比较。将统计分析每个参数和组合参数区分肿瘤与正常组织的效用。