Compact Representations of Dynamic Liver MRI

动态肝脏 MRI 的紧凑表示

• 批准号: 9265796
• 负责人: Pascal Spincemaille
• 金额: $ 38.77万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-19 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9265796
• 关键词: Affect; Aftercare; Behavior; Blood flow; Bolus Infusion; Cancer Burden; Catheters; Chemoembolization; Cirrhosis; Contrast Media; Data; Detection; Diagnosis; Diagnostic; Dictionary; Disease; Early Diagnosis; Ensure; Excision; Failure; Goals; Hepatic; Image; Impairment; Incidence; Kinetics; Lesion; Liver; Liver diseases; Liver neoplasms; Magnetic Resonance Imaging; Malignant - descriptor; Malignant Neoplasms; Malignant neoplasm of liver; Manuals; Maps; Measurement; Measures; Methods; Modeling; Monitor; Motion; Outcomes Research; Pathogenicity; Pathologic; Patients; Pattern; Performance; Phase; Physiologic pulse; Plants; Play; Primary carcinoma of the liver cells; Protocols documentation; Public Health; Radiofrequency Interstitial Ablation; Reader; Reference Standards; Reproducibility; Research; Resolution; Role; Series; Signal Transduction; Techniques; Testing; Time; Tracer; Transport Process; Treatment outcome; United States National Institutes of Health; Venous; Work; base; chemotherapy; clinical practice; contrast enhanced; follow-up; image reconstruction; imaging modality; improved; liver biopsy; liver transplantation; patient population; pharmacokinetic model; public health relevance; reconstruction; respiratory; response; success; temporal measurement; tool; treatment response; tumor

DESCRIPTION (provided by applicant): Hepatocellular carcinoma (HCC), the most prevalent malignant liver cancer, has seen an increasing incidence rate over the last decade. Segmental liver resection and liver transplantation are curative options shown to be effective when the patient meets certain criteria, which rely on a sensitive and early detection and characterization of HCC lesions with imaging. Because the liver may be too diseased to tolerate a large resection or due to insufficient numbers of donor livers, these treatments are not available for a major part of the patient population. For these patients, other treatment options are considered including systemic chemotherapy. While treatment response is conventionally measured based on tumor size change, this may take several months to occur. A sensitive and early measurement of treatment response is therefore expected to significantly impact treatment as well. It is in this context that quantitative MR imaging plays an increasing role. High temporal and spatial resolution dynamic imaging has been introduced into contrast-enhanced liver MRI to overcome bolus-timing problems and to capture the desired enhancement phases traditionally used for diagnosis. However, current methods are still limited to breath-holds or very moderate amounts of respiratory motion. Additionally, the reader is presented with a large number of images, from which a manual selection of the typical arterial, portal-venous and delayed phases is necessary. Our long-term goal is to develop MRI into a robust method for the diagnosis of liver disease. As part of this goal, it is the objective of this application is to transform dynami liver contrast enhanced MRI into a quantitative measure of liver cancer presence and progression. Our central hypothesis is that a quantitative kinetic parametric map (KPM) of hepatic arterial blood flow and bolus arrival time estimated directly from the raw MRI data will have a better diagnostic performance for detecting HCC than conventional multiple phase MRI. The rationale for the proposed research is that the resulting KPMs enable a compact representation of the contrast enhancement behavior that is reproducible and lends itself to intra- and inter-patient comparisons. We plan to test our hypothesis by pursuing the following aims: (1) develop an imaging method that maps the acquired MR data directly onto quantitative kinetic parametric maps, and (2) evaluate the diagnostic performance of the developed quantitative method in patients undergoing liver transplantation. The expected outcome of this research of this research is a better method for characterizing liver tumors during initial detection and follow-up. Such a technique is likely to have a positive impact, since it is expected to allow a quantitative measure of cancer burden, allow an early measurement of treatment success or failure and reduce the need for liver biopsy.

描述（由申请人提供）：最普遍的恶性肝癌肝细胞癌（HCC）在过去十年中的发病率提高。分段肝切除和肝移植是治愈性的选择，当患者符合某些标准时，依赖于敏感的和早期检测和表征对HCC病变的特征是有效的。由于肝脏可能已经患病了，无法忍受大切除术或由于供体肝脏数量不足，因此这些治疗方法不适用于患者人群的主要部分。对于这些患者，考虑了其他治疗选择，包括全身化疗。尽管通常根据肿瘤大小的变化来测量治疗反应，但可能需要几个月的时间。因此，对治疗反应的敏感和早期测量也有望显着影响治疗。正是在这种情况下，定量MR成像起着越来越多的作用。将高的时间和空间分辨率动态成像引入了对比增强的肝脏MRI中，以克服推注的问题，并捕获传统上用于诊断的所需增强阶段。但是，当前的方法仍然仅限于呼吸或中等程度的呼吸运动。此外，还需要向读者提供大量图像，从中可以手动选择典型的动脉，门静脉和延迟相位的图像。我们的长期目标是将MRI发展为诊断肝病的强大方法。作为该目标的一部分，该应用的目的是将动态肝脏对比度改善将MRI改为对肝癌的存在和进展的定量度量。我们的中心假设是，直接从原始MRI数据中估算的肝动脉血流和推注到达时间的定量动力学参数图（KPM）将具有比常规多重阶段MRI具有更好的诊断性能来检测HCC。拟议的研究的基本原理是，由此产生的kpms可以使对比度增强行为的紧凑表示，该行为可再现，并将其自身借助内部和患者间比较。我们计划通过追求以下目的来检验假设：（1）开发一种成像方法，将所获得的MR数据直接映射到定量动力学参数图上，（2）评估正在进行肝移植的患者中开发定量方法的诊断性能。这项研究的这项研究的预期结果是在初始检测和随访期间表征肝肿瘤的更好方法。这样的技术可能会产生积极的影响，因为可以预期 为了允许定量衡量癌症负担，请尽早测量治疗成功或失败，并减少对肝活检的需求。