Establishing the clinical utility of a consensus DSC-MRI Protocol

建立共识 DSC-MRI 协议的临床实用性

• 批准号: 10725276
• 负责人: Jerrold L Boxerman
• 金额: $ 61.79万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10725276
• 关键词: 19q; Acceleration; Address; Admixture; Adoption; Aftercare; Benchmarking; Biopsy; Brain Neoplasms; Classification; Clinical; Clinical Trials; Committee Members; Consensus; Data; Europe; Excision; Functional Imaging; Future; Glioma; Goals; Guidelines; Healthcare; Histologic; Image; Imaging Techniques; Institution; International; Magnetic Resonance Imaging; Maps; Measures; Meta-Analysis; Methodology; Methods; Multi-Institutional Clinical Trial; Mutation; Patient Care Management; Patients; Perfusion; Phase; Positioning Attribute; Prediction of Response to Therapy; Predisposition; Protocols documentation; Publications; Publishing; Quality Control; Radiation necrosis; Recommendation; Recurrence; Recurrent tumor; Repeat Surgery; Reporting; Reproducibility; Research Personnel; Scanning; Site; Societies; Standardization; Tissue imaging; Translations; Update; Validation; brain tumor imaging; cerebral blood volume; clinical application; clinical decision-making; clinical practice; cohort; digital; drug development; improved; in silico; in vivo; longitudinal analysis; neuro-oncology; prospective; radiation effect; serial imaging; standard of care; targeted treatment; tool; treatment effect; tumor; tumor diagnosis; tumor heterogeneity; 19q; Acceleration; Address; Admixture; Adoption; Aftercare; Benchmarking; Biopsy; Brain Neoplasms; Classification; Clinical; Clinical Trials; Committee Members; Consensus; Data; Europe; Excision; Functional Imaging; Future; Glioma; Goals; Guidelines; Healthcare; Histologic; Image; Imaging Techniques; Institution; International; Magnetic Resonance Imaging; Maps; Measures; Meta-Analysis; Methodology; Methods; Multi-Institutional Clinical Trial; Mutation; Patient Care Management; Patients; Perfusion; Phase; Positioning Attribute; Prediction of Response to Therapy; Predisposition; Protocols documentation; Publications; Publishing; Quality Control; Radiation necrosis; Recommendation; Recurrence; Recurrent tumor; Repeat Surgery; Reporting; Reproducibility; Research Personnel; Scanning; Site; Societies; Standardization; Tissue imaging; Translations; Update; Validation; brain tumor imaging; cerebral blood volume; clinical application; clinical decision-making; clinical practice; cohort; digital; drug development; improved; in silico; in vivo; longitudinal analysis; neuro-oncology; prospective; radiation effect; serial imaging; standard of care; targeted treatment; tool; treatment effect; tumor; tumor diagnosis; tumor heterogeneity

Abstract This multi-site study aims to establish best practice recommendations and clinical value of a new consensus protocol for dynamic susceptibility contrast (DSC) MRI. DSC-MRI is one of the most widely used physiologic imaging techniques in neuro-oncology, with a reported use in 85% of all routine brain tumor scans at sites across the US and Europe. DSC-MRI measures of relative cerebral blood volume (rCBV) can differentiate glioma grades, identify tumor components in non-enhancing glioma, distinguish tumor recurrence from post-treatment effects (including pseudoprogression and radiation necrosis) and predict treatment response and patient survival after targeted therapy. Despite this demonstrated value, translation of consistent clinical DSC-MRI guidelines across multiple institutions remains challenging owing to variability in acquisition and post-processing protocols. To improve the accuracy, repeatability, and multi-site consistency of DSC-MRI, the team of investigators on this proposal identified and validated a DSC-MRI protocol that has since become a consensus recommendation for patients with glioma. Accordingly, we are well positioned to address critical gaps in this field that, once solved, will accelerate the widespread adoption of the consensus protocol and direct its use in clinical practice. We first aim to establish best practices for the pre- and post-processing methods for DSC-MRI. We will then leverage our expertise with image-localized biopsies and matched image-tissue correlations to establish guidelines for interpreting rCBV maps generated with the consensus protocol, specifically applied to the differentiation of low- from high-grade glioma, and progression of high-grade glioma from post-treatment effects. Finally, we aim to establish the clinical value added of the consensus DSC-MRI protocol for impacting brain tumor patient management. These studies will address key practical and clinical unmet needs that will directly facilitate the future use of DSC-MRI in glioma patients, thereby promoting widespread adoption of the consensus DSC-MRI protocol.

抽象的 这项多站点研究旨在建立新共识的最佳实践建议和临床价值 动态敏感性对比度（DSC）MRI方案。 DSC-MRI是使用最广泛的生理学之一 神经肿瘤学的成像技术，据报道在所有常规脑肿瘤扫描中的85％在整个部位扫描 美国和欧洲。 DSC-MRI的相对脑血容量（RCBV）可以区分神经胶质瘤 等级，确定非增强神经胶质瘤中的肿瘤成分，将肿瘤复发与治疗后区分开 影响（包括假孕和辐射坏死）并预测治疗反应和患者存活率 靶向治疗后。尽管有了这一价值，但一致的临床DSC-MRI指南的翻译 由于采集和后处理方案的可变性，多个机构在多个机构中仍然具有挑战性。 为了提高DSC-MRI的准确性，可重复性和多站点的一致性，研究人员团队对此 提案确定并验证了DSC-MRI协议，此后已成为共识的建议 神经胶质瘤患者。因此，我们有好处解决该领域的关键差距，一旦解决， 将加速共识方案的广泛采用，并指导其在临床实践中的使用。我们首先 旨在为DSC-MRI的预处理和后处理方法建立最佳实践。然后我们将利用 我们在图像定位的活检和匹配的图像组织相关性方面的专业知识，以建立指导方针 解释使用共识方案生成的RCBV映射，专门用于分化低 - 的分化 从高级神经胶质瘤和治疗后效应的高级神经胶质瘤的进展。最后，我们的目标是 建立用于影响脑肿瘤患者的共识DSC-MRI方案的临床增值 管理。这些研究将解决关键的实用和临床未满足需求，这将直接促进 DSC-MRI在神经胶质瘤患者中的未来使用，从而促进了共识DSC-MRI的广泛采用 协议。