Automated Assessment of Leptomeningeal Collaterals on CT Angiograms

CT 血管造影上软脑膜循环的自动评估

• 批准号: 8905209
• 负责人: STEPHEN R AYLWARD
• 金额: $ 15万
• 依托单位: KITWARE, INC.
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-06-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8905209
• 关键词: Academia; Achievement; Address; Algorithms; Angiography; Award; Blood Pressure; Blood Vessels; Blood flow; Brain; Businesses; Clinical; Clinical Data; Computer software; Consult; Contracts; Development; Doctor of Medicine; Doctor of Philosophy; Effectiveness; Evaluation; Funding; Goals; Gold; Human; Hypertension; Image; Image Analysis; Industry; Intervention; Intraobserver Variability; Koreans; Literature; Malignant Neoplasms; Manuals; Measurement; Medical Imaging; Methods; Morphology; Odds Ratio; Operative Surgical Procedures; Outcome; Patients; Phase; Play; Publishing; Radiation; Recurrence; Registries; Research; Retrospective Studies; Risk; Role; Scientist; Site; Slice; Small Business Innovation Research Grant; Solutions; Stream; Stroke; System; Techniques; Testing; Thrombolytic Therapy; Tissues; Treatment Efficacy; United States National Institutes of Health; Universities; Venous; Work; X-Ray Computed Tomography; acute stroke; base; commercialization; density; digital; image guided; innovation; open source; phase 2 study; post stroke; public health relevance; research clinical testing; tool; tumor

 DESCRIPTION (provided by applicant): The primary goal of this study is to develop an automated scoring system of leptomeningeal collaterals based on CT angiography (CTA) as a quantitative assessment of acute stroke. Leptomeningeal collaterals provide an alternate path of blood flow in the setting of a proximal occlusion. The presence and effectiveness of leptomeningeal collaterals (i.e., "collateral status") will vary significantly from patient to patint. Collateral status has been shown to be correlated with both patient outcome and risk of hemorrhagic transformation, suggesting that rapid and accurate assessment of the collaterals would provide a powerful tool for treatment evaluation. The current gold standard for collateral scoring is performed by subjective analysis of retrograde filling in invasive digital subtraction angiograms (DSA). Though CTA is more limited than DSA in the direct evaluation of collaterals, the presence of collaterals may also be evaluated in CTA by the degree of vessel filling beyond the site of occlusion. Several manual assessment techniques based on CTA have been proposed in the literature, but all are subjective and require significant human intervention. Thus, we propose to develop an automated CTA-based collateral status assessment. The aims of our work are as follows: 1) adapt our vessel segmentation algorithms to collateral vessel assessment, 2) perform retrospective evaluation of the CTA derived collateral measurements against DSA in patients, and 3) conduct preliminary retrospective clinical evaluation of the CTA derived collateral measurements against patient outcome. This work brings together a strong yet diverse team, addresses a significant clinical problem with an innovative solution, and uses a two-pronged approach to commercialization involving protected IP and an open-source platform that promotes consulting revenue.

 描述（由申请人提供）：本研究的主要目标是开发基于 CT 血管造影 (CTA) 的软脑膜侧枝自动评分系统，作为急性中风的软脑膜侧枝的定量评估，为该环境中的血流提供替代路径。研究表明，软脑膜侧支循环（即“侧支状态”）的存在和有效性因患者而异。与患者的结果和出血转化的风险相关，这表明对侧支循环的快速而准确的评估将为治疗评估提供强大的工具当前侧支循环评分的黄金标准是通过侵入性数字减法中逆行充盈的主观分析来执行的。虽然 CTA 在直接评估侧支血管方面比 DSA 更有限，但 CTA 中也可以通过闭塞部位以外的血管充盈程度来评估侧支血管的存在。一些基于 CTA 的手动评估技术。文献中已经提出了这些方法，但都是主观的，并且需要大量的人工干预。因此，我们建议开发一种基于 CTA 的自动侧枝状态评估。我们工作的目标如下：1）使我们的血管分割算法适应侧枝。血管评估，2）根据患者的 DSA 对 CTA 衍生的附带测量进行回顾性评估，以及 3）根据患者结果对 CTA 衍生的附带测量进行初步回顾性临床评估这项工作汇集了一个强大而多样化的团队，解决了一个重要的问题。临床问题的创新解决方案，并使用双管齐下的商业化方法，涉及受保护的知识产权和促进咨询收入的开源平台。