Inside-Out Nonlinear Gradients to Improve Diffusion MRI

由内而外的非线性梯度可改善扩散 MRI

• 批准号: 10445300
• 负责人: GIGI GALIANA
• 金额: $ 37.55万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-06 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10445300
• 关键词: 3D Print; Adopted; Anatomy; Biopsy; Brain; Breast; Clinical; Clinical Trials; Consensus; Custom; Data; Devices; Diagnosis; Diagnostic; Diffusion; Diffusion Magnetic Resonance Imaging; Disease; Epithelial; Erectile dysfunction; Future; Geometry; Gleason Grade for Prostate Cancer; Histologic; Histopathology; Human; Image; Image Analysis; Incontinence; Lead; Leg; Lesion; Liver; Magnetic Resonance Imaging; Malignant Neoplasms; Malignant neoplasm of prostate; Medical; Methods; Monitor; Noise; Organ; Outcome; Pathology; Patient imaging; Patients; Performance; Physiologic pulse; Population; Population Analysis; Positioning Attribute; Prostate; Prostatectomy; Radical Prostatectomy; Reader; Reproducibility; Research; Safety; Scanning; Sensitivity and Specificity; Signal Transduction; Slice; Technology; Time; Tissues; Weight; Work; base; clinical practice; clinically significant; connectome; cost; design; high resolution imaging; imaging approach; imaging modality; improved; in vivo; innovation; interest; lifetime risk; men; non-invasive imaging; overtreatment; patient population; portability; premature; prostate cancer risk; prostate lesions; prototype; radiologist; simulation

Project Summary/Abstract The lifetime risk of prostate cancer is 1 in 9 and it remains the 2nd leading cancer killer of men. Yet many patients with low grade disease receive premature or excessive treatment, which can lead to decades of incontinence and erectile dysfunction. One reason for the simultaneous over- and under- diagnosis of prostate cancer is that current imaging methods are unreliable, which in turn make biopsies unreliable. A noninvasive imaging method with good sensitivity and specificity is one of the greatest needs in prostate cancer management, and diffusion weighted MRI (DWI) is the most promising candidate. However, prostate MRI has extremely low image quality due to the long echo times needed for adequate diffusion encoding. To improve DWI of prostate, we introduce a new concept in MRI hardware: an accessory whose sole purpose is to provide diffusion encoding to a target organ. Unlike imaging gradients which are volume-encompassing and stringently linear, this “inside-out” diffusion gradient is a wand placed between the upper legs which creates strong nonlinear fields at the prostate. The geometry allows for standard spatial encoding, standard receiver placement, and portability between scanners. For prostate imaging, this approach achieves a gradient that is >10-fold stronger over the region of interest, increasing both overall SNR and sensitivity to epithelial/cellular volume, a hallmark of malignancy. The increase in field strength is predicted to double contrast in DWI of prostate, improving active surveillance, biopsy hit rates, and treatment monitoring. Taken together, the preliminary data on (1) achievable hardware specs, (2) prostate imaging simulations, and (3) phantom experimental results make a strong case for the feasibility of this project and the significant impact it will have on prostate DWI. Approach: Aim 1 will install and characterize a custom diffusion gradient to demonstrate DWI in a prostate lesion phantom which is consistent with conventional methods, but with higher reproducibility and CNR. Aim 2 applies the new method to prostate of healthy controls to establish positioning, PNS thresholds, accuracy, and improved image quality (precision, contrast, reproducibility and qualitative ratings) in vivo. Aim 3 will image patients with biopsy-naïve suspected lesions, which will be outlined and scored by multiple radiologists to quantify contrast, diagnostic confidence and inter-reader variability in a realistic population. Aim 4 will acquire, in radical prostatectomy patients, coregistered presurgical in vivo MRI, ex vivo MRI of the excised prostate, and whole-mount pathology to show correlation between ADC and true Gleason score. Together, these aims will provide strong evidence for the increased precision, contrast, diagnostic confidence, and clinical validity of DWI acquired with this hardware.

项目摘要/摘要 前列腺癌的终身风险是9 9中的1个，它仍然是男性的第二个领先的癌症杀手 低年级疾病的患者接受预先治疗或过度治疗，这可能导致数十年 尿失禁和勃起功能障碍。 癌症是当前的成像方法是不可靠的，这又使活检不可靠。 具有良好灵敏度和特异性的成像方法在前列腺癌中的需求最大 管理和扩散加权MRI（DWI）是最有前途的候选人。 由于足够的扩散编码所需的较长回声时，图像质量极低。 为了改善前列腺的DWI，我们在MRI硬件中介绍了一个新概念：一个配件，其唯一目的 是为目标器官提供扩散的编码。 严格地线性，这个“内而外”的扩散梯度是放在上腿之间的魔杖 在前列腺上创建强的非线性场。 接收器放置和扫描仪之间的可移植性。 对于前列腺成像，这种方法实现了一个梯度，该梯度比感兴趣的区域强10倍， 增加了整体SNR和对上皮/细胞体积的敏感性，这是恶性的标志 预计在前列腺的DWI中，撞击的场增加将两倍，从而改善主动监视， 活检率和治疗监测。 规格，（2）前列腺成像模拟和（3）幻影实验结果为该模拟提供了有力的案例。 这对此的可行性 方法： AIM 1将安装并表征自定义扩散梯度，以在前列腺病变幻影中演示DWI 与方法的通信持续不断，但是高繁殖和CNR。 AIM 2将新方法应用于健康控制的前列腺以建立定位，PNS阈值， 体内精度和图像质量（精度，对比度，繁殖和定性评级）。 AIM 3会为没有活检的怀疑病变的患者形象，哪个会？ 放射科医生在现实人群中量化对比度，诊断信心和国际阅读者的变异性。 AIM 4将在根治性前列腺切除术患者中获取，并在体内MRI中进行核对象的前疗法，该病毒均为体内MRI 切除的前列腺和整体病理学，以显示ADC与真正的毛发之间的相关性。 这些目标共同为提高精度，对比度，诊断信心提供了有力的证据 DWI的临床有效性使用了此硬件。