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）：肝细胞癌（HCC）是最常见的恶性肝癌，在过去十年中发病率不断增加。当患者满足某些标准时，节段性肝切除和肝移植是有效的治疗选择，这些标准依赖于通过影像学手段对 HCC 病变进行灵敏、早期的检测和表征。由于肝脏可能病情严重而无法承受大范围切除，或者由于供体肝脏数量不足，因此这些治疗方法不适用于大部分患者群体。对于这些患者，可以考虑其他治疗方案，包括全身化疗。虽然治疗反应通常是根据肿瘤大小的变化来衡量的，但这可能需要几个月的时间才能发生。因此，对治疗反应进行敏感且早期的测量预计也会对治疗产生重大影响。正是在这种背景下，定量磁共振成像发挥着越来越重要的作用。高时间和空间分辨率动态成像已被引入对比增强肝脏 MRI 中，以克服推注时间问题并捕获传统上用于诊断的所需增强阶段。然而，目前的方法仍然仅限于屏气或非常适度的呼吸运动。此外，读者会看到大量图像，需要从中手动选择典型的动脉期、门静脉期和延迟期。我们的长期目标是将 MRI 发展成为诊断肝病的可靠方法。作为该目标的一部分，该应用程序的目标是将动态肝脏对比增强 MRI 转化为肝癌存在和进展的定量测量。我们的中心假设是，直接根据原始 MRI 数据估计的肝动脉血流和推注到达时间的定量动力学参数图 (KPM) 将比传统的多时相 MRI 具有更好的 HCC 诊断性能。拟议研究的基本原理是，由此产生的 KPM 能够紧凑地表示对比度增强行为，该行为是可重复的，并且适合患者内部和患者之间的比较。我们计划通过实现以下目标来检验我们的假设：（1）开发一种成像方法，将采集的 MR 数据直接映射到定量动力学参数图上，（2）评估所开发的定量方法对接受肝移植的患者的诊断性能。这项研究的预期结果是在初始检测和随访期间提供更好的表征肝脏肿瘤的方法。这种技术可能会产生积极的影响，因为预计 定量测量癌症负担，早期测量治疗成功或失败，并减少肝活检的需要。