Tongue muscle function after cancer surgery using 4D MRI, DTI, and MR tagging

使用 4D MRI、DTI 和 MR 标记评估癌症手术后的舌肌功能

• 批准号: 9319686
• 负责人: Jerry L Prince
• 金额: $ 32.56万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-07 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9319686
• 关键词: 4D MRI; Acoustics; Address; Aftercare; Algorithms; Anatomy; Behavior; Cancer Survivor; Cine Magnetic Resonance Imaging; Complex; Data; Data Analyses; Death Rate; Deglutition; Diagnosis; Diffusion; Diffusion Magnetic Resonance Imaging; Disease; Excision; Fatigue; Fiber; Financial compensation; Future; Geometry; Glossectomy; Heart; Human Papillomavirus; Hydromorphone; Image; Image Analysis; Incidence; Investigation; Learning; Magnetic Resonance Imaging; Malignant Neoplasms; Measurement; Measures; Meta-Analysis; Methods; Modeling; Morbidity - disease rate; Motion; Movement; Muscle; Muscle Fibers; Muscle function; Muscular Atrophy; National Cancer Institute; Operative Surgical Procedures; Oral cavity; Outcome; Outcome Measure; Patients; Pattern; Population; Quality of life; Radiation therapy; Reporting; Research; Resolution; Rest; Series; Side; Skeletal Muscle; Sleep Apnea Syndromes; Speech; Speech Intelligibility; Speech Therapy; Surface; Surgeon; Surgical Flaps; Techniques; Technology; Time; Tissues; Tongue; Tongue Neoplasms; Transplantation; cancer surgery; cancer therapy; dimensional analysis; effective therapy; image processing; imaging study; improved; in vivo; malignant mouth neoplasm; malignant tongue neoplasm; novel; programs; public health relevance; restraint; tumor; two-dimensional

 DESCRIPTION (provided by applicant): The National Cancer Institute estimates that over 42,000 people will be diagnosed with oral cancer and over 8,000 will die from this disease in 2014. Although these rates are low in comparison to many other cancers, unlike most other cancers the incidence of oral cancers-especially the human papillomavirus (HPV)-positive cancers-has been increasing. By some estimates there is as much as a five-fold increase in oral cancers just over the past decade. In the case of tongue cancer treatment through glossectomy (the surgical removal of part of the tongue including the cancer), which we focus on here, there is often significant post-treatment morbidity including difficulties in speech and swallowing and sleep apnea. Research connecting the tumor size and type of glossectomy surgery with tongue movement in speech after surgery has been ongoing for a number of years. These studies, most of which involve acoustic and speech intelligibility outcome measures, are beginning to reveal principles that can inform clinicians in developing optimal treatments. But very little information has been available relating tongue motion itself as an outcome, and when this is reported it almost exclusively reports measures derived from measurement of motion of the tongue surface, not its internal muscles. With advancements in technology we now have the opportunity to study the detailed patterns of tongue muscle motions in both normal controls and patients. By simultaneously analyzing data from cine magnetic resonance images, tagged magnetic resonance images, and diffusion magnetic resonance images, we will be able to observe patterns of activation throughout the tongue-observing and measuring a new type of functional connectivity-in order to better understand how patients compensate for muscle loss due to glossectomy. Specifically, we will: 1) Optimize acquisition of diffusion MRI imaging of in vivo tongue muscles; 2) Establish strain measures in the line of action of tongue muscle fibers using in vivo tagged MRI and diffusion MRI; 3) Develop models of functional connectivity in the tongue during speech; and 4) Assess tongue strategies in post-glossectomy speech. The ability of muscle fibers to create strain is crucial in the function of any muscle, but it is has not been possible to study this relationship in vivo in the past due to imaging constraints. The present research will enable simultaneous in vivo analysis in the complex muscle geometry of the tongue, a muscular hydrostat, possible for the first time. Through optimization of existing methods-both imaging and image analysis-we will enable a novel capability for the assessment of surgical outcomes in tongue cancer surgery. The study to be carried out on a spectrum of tongue cancer survivors will provide key information about the impact of tongue cancer treatment on speech, in order that significant morbidity might be avoided by modifying surgical practice or by engaging in specific speech therapies after surgery.

 描述（由申请人提供）：美国国家癌症研究所估计，2014 年将有超过 42,000 人被诊断患有口腔癌，超过 8,000 人将死于这种疾病。尽管与许多其他癌症相比，这些比率较低，但与大多数其他癌症不同的是，口腔癌——尤其是人乳头瘤病毒（HPV）阳性癌症——的发病率一直在增加，据估计，口腔癌的发病率增加了五倍多。在过去的十年中，我们在此重点关注的是通过舌切除术（手术切除部分舌头，包括癌症）治疗舌癌，治疗后通常会出现严重的并发症，包括言语和吞咽困难以及睡眠呼吸暂停。将舌切除手术的肿瘤大小和类型与术后言语运动联系起来的研究已经进行了多年，这些研究大部分涉及声音和言语清晰度结果测量，正在开始揭示可以为大众提供信息的原则。但开发最佳治疗方法的却很少。已经有关于舌头运动本身作为结果的信息，并且当报告这一点时，它几乎只报告来自舌头表面运动测量的测量结果，而不是其内部肌肉。随着技术的进步，我们现在有机会研究详细的信息。通过同时分析电影磁共振图像、标记磁共振图像和扩散磁共振图像的数据，我们将能够观察整个舌头观察和测量舌头肌肉运动的模式。新型功能连接——以便更好地理解如何具体来说，我们将： 1) 优化体内舌肌的扩散 MRI 成像；2) 使用体内标记 MRI 和扩散 MRI 建立舌肌纤维作用线的应变测量。 ；3) 开发言语过程中舌头的功能连接模型；以及 4) 评估舌切除术后言语中的舌头策略 肌纤维产生应变的能力对于任何肌肉的功能都至关重要，但事实并非如此。由于成像限制，过去可以在体内研究这种关系，而本研究将首次通过优化现有方法，对舌头（肌肉静水器）的复杂肌肉几何结构进行同步体内分析。成像和图像分析——我们将启用一种新的功能来评估舌癌手术的手术结果。这项针对一系列舌癌幸存者进行的研究将提供有关舌癌治疗对言语的影响的关键信息。为了通过改变手术实践或通过手术后进行特定的言语治疗。