Establishing the clinical utility of a consensus DSC-MRI Protocol

建立共识 DSC-MRI 协议的临床实用性

基本信息

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
项目类别：
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

项目摘要

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.

抽象的这项多中心研究旨在建立最佳实践建议和新共识的临床价值动态磁敏对比 (DSC) MRI 协议。 DSC-MRI 是应用最广泛的生理学检查之一据报道，85% 的常规脑肿瘤扫描都使用了神经肿瘤学成像技术美国和欧洲。相对脑血容量 (rCBV) 的 DSC-MRI 测量可以区分神经胶质瘤分级，识别非增强神经胶质瘤中的肿瘤成分，区分治疗后的肿瘤复发影响（包括假性进展和放射性坏死）并预测治疗反应和患者生存靶向治疗后。尽管已经证明了这一价值，但一致的临床 DSC-MRI 指南的翻译由于采集和后处理协议的可变性，跨多个机构仍然具有挑战性。为了提高 DSC-MRI 的准确性、重复性和多部位一致性，研究人员团队对此进行了研究该提案确定并验证了 DSC-MRI 协议，该协议已成为以下领域的共识建议：神经胶质瘤患者。因此，我们有能力解决该领域的关键差距，一旦解决，将加速共识协议的广泛采用并指导其在临床实践中的使用。我们首先旨在建立 DSC-MRI 预处理和后处理方法的最佳实践。然后我们将利用我们在图像定位活检和匹配图像组织相关性方面的专业知识为解释用共识协议生成的 rCBV 图，特别适用于区分低高级神经胶质瘤的进展，以及治疗后影响高级神经胶质瘤的进展。最后，我们的目标是建立影响脑肿瘤患者的共识 DSC-MRI 方案的临床附加值管理。这些研究将解决关键的实际和临床未满足的需求，这将直接促进未来 DSC-MRI 在神经胶质瘤患者中的应用，从而促进共识 DSC-MRI 的广泛采用协议。