Noninvasive measurement of oxygenation using quantitative susceptibility mapping

使用定量磁化率图无创测量氧合

• 批准号: 10322146
• 负责人: Pascal Spincemaille
• 金额: $ 83.07万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-01 至 2025-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10322146
• 关键词: 3-Dimensional; Activities of Daily Living; Address; Adult; Affect; Agreement; Ally; Anatomy; Blood; Breathing; Calibration; Cardiac; Cardiac Catheterization Procedures; Cardiac Output; Catheterization; Cellular Morphology; Cessation of life; Clinical; Clinical Research; Complex; Data; Decision Making; Disease; Disease Progression; Dose; Dyspnea; Early Diagnosis; Erythrocytes; Evaluation; Exercise Test; Financial compensation; Genes; Goals; Heart; Hospitalization; Imaging Techniques; Impairment; Ionizing radiation; Knowledge; Left; Life; Liver diseases; Lung; Magnetic Resonance Imaging; Magnetism; Measurement; Measures; Methods; Modeling; Monitor; Motion; Organ; Outcome; Outcomes Research; Oxygen; Patient-Focused Outcomes; Patients; Perfusion; Phase; Physics; Physiologic Monitoring; Physiologic pulse; Predisposition; Prevalence; Property; Protons; Pulmonary Hypertension; Radiation exposure; Reference Standards; Relaxation; Reproducibility; Research; Risk; Scanning; Severities; Signal Transduction; Symptoms; Techniques; Technology; Testing; Therapeutic; Time; Tissues; Transplantation; Treatment outcome; United States; Validation; Vascular Diseases; Walking; base; cell water; clinical practice; clinical prognosis; cohort; computerized data processing; data acquisition; end stage disease; follow-up; heart function; hemodynamics; human old age (65+); hypertension treatment; improved; improved outcome; indexing; insight; mortality; nervous system disorder; novel; predict clinical outcome; pressure; prospective; pulmonary arterial pressure; reconstruction; respiratory; stem; treatment optimization

PROJECT SUMMARY/ABSTRACT The goal of this research is to develop cardiac quantitative susceptibility mapping (QSM) for non-invasive meas- urement of blood oxygen saturation, towards the long-term objective of improving early diagnosis, therapeutic decision-making, and clinical outcomes for patients with pulmonary hypertension (PH). PH is a progressive and life shortening disorder affecting ~10% of adults over age 65. Given that PH can be irreversible in its later stages, early diagnosis and physiologic monitoring are critically important. Impaired oxygenation of the lungs and heart chambers (cardiac oxygenation) is a key manifestation of PH that impacts symptoms and clinical outcomes. Increased pulmonary arterial pressure in PH impairs pulmonary oxygen exchange, decreasing delivery of oxy- genated blood to the left heart. Systemic cardiac output is often compromised in PH, resulting a larger differential blood oxygen saturation between the left and right heart. Invasive catheterization (cath) is currently used to measure cardiac oxygenation but entails procedural risks, ionizing radiation exposure, and is impractical for early diagnosis and serial monitoring - a non-invasive method to accurately measure blood oxygenation would be of substantial utility. MRI is well suited for PH assessment as it enables integrated evaluation of pulmonary anat- omy, pressure, as well as cardiac function and remodeling - blood oxygenation is a key gap in MRI evaluation of PH. This gap stems from limitations in current pulse sequence technology rather than fundamental MRI physics. It is well known that deoxygenation changes the magnetic susceptibility of blood. These changes have tradition- ally been probed using a magnitude property of the MR signal: the transverse relaxation time (T2). However, this requires patient-specific calibration that is difficult in clinical practice. In contrast, QSM relies on the phase of the MR signal to directly measure susceptibility and thus cardiac oxygenation. We have obtained highly encouraging preliminary data for QSM measurement of cardiac blood oxygenation, with close agreement between QSM and oxygenation measured invasively. We have identified key challenges for developing cardiac QSM, including motion suppression and prolonged scan times. The current research proposes to develop an accelerated cardiac QSM method, and to test QSM in relation to oxygenation on invasive cath, as well as effort tolerance and clinical prognosis. Study Aims are as follows: (1) Develop accelerated cardiac QSM using free-breathing acquisition and optimized reconstruction. (2) Test accelerated and current cardiac QSM among PH patients in comparison to T2-based cardiac oxygenation and the reference standard of invasive cardiac catheterization. (3) Determine whether cardiac QSM stratifies clinical severity and predicts PH disease progression. The expected outcome of this research is a non-invasive method for measuring cardiac oxygenation – a critically important marker in PH that currently relies on invasive testing. Given the increasing prevalence and therapeutic options for this serious condition, non-invasive oxygenation assessment by cardiac QSM holds broad significance towards the goal of early diagnosis, therapy optimization, and improved clinical outcomes for millions of patients with PH.

项目摘要/摘要 这项研究的目的是为非侵入性测量方法开发心脏定量易感映射（QSM） 血液氧气疾病的尿液，以改善早期诊断，治疗的长期目标 肺高血压患者（pH）的决策和临床结局。 pH是一个进步的 寿命缩短障碍影响65岁以上成年人的约10％。鉴于pH在其后期可能是不可逆转的， 早期诊断和身体监测至关重要。肺和心脏的氧合受损 腔室（心脏氧合）是影响症状和临床结局的pH值的关键表现。 pH中肺动脉压的增加会损害肺氧交换，从而减少氧气的递送 左心心脏的血液。系统性心脏输出通常在pH中受到损害，导致较大的差异 左心和右心之间的血氧安全性。侵入性导管插入术（CATH）目前习惯 测量心脏氧合，但需要进行程序风险，电离辐射暴露，并且对早期是不切实际的 诊断和串行监测 - 准确测量血液氧合的一种非侵入性方法是 实质性的实用性。 MRI非常适合pH评估，因为它可以综合评估肺部的ANAT- OMY，压力以及心脏功能和重塑 - 血液氧合是MRI评估的关键差距 ph。该差距源于当前脉冲序列技术的局限性，而不是基本的MRI物理学。 众所周知，脱氧改变了血液的磁敏感性。这些变化具有传统 - 使用MR信号的大小特性证明了盟友：横向松弛时间（T2）。但是，这个 需要在临床实践中困难的患者特定校准。相反，QSM依赖于 MR信号直接测量敏感性，从而测量心脏氧合。我们获得了极大的鼓励 QSM测量心脏血液氧合的初步数据，QSM和 氧合性侵入性测量。我们已经确定了开发心脏QSM的关键挑战，包括 运动抑制和延长扫描时间。当前的研究提案旨在发展加速心脏 QSM方法，并测试与侵入性CATH上氧合的QSM，以及努力公差和临床 预后。研究目的如下：（1）使用自由呼吸获取和 优化的重建。 （2）与pH患者的测试加速和当前心脏QSM相比 基于T2的心脏氧合和侵入性心脏导管插入术的参考标准。 （3）确定 心脏QSM是否分层临床严重程度和预测pH疾病进展。预期的结果 这项研究是一种测量心脏氧合的非侵入性方法 - pH中至关重要的标志物 目前，这依赖于侵入性测试。考虑到这种严重的患病率和治疗选择的越来越多 条件，通过心脏QSM评估的非侵入氧合评估对目标的目标具有广泛的意义 数百万pH患者的早期诊断，优化治疗优化和改善的临床结果。