Establishing the Validity of Brain Tumor Perfusion Imaging

建立脑肿瘤灌注成像的有效性

• 批准号: 10734997
• 负责人: Christopher Chad Quarles
• 金额: $ 36.99万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-03 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10734997
• 关键词: 3-Dimensional; Address; Adopted; Aftercare; Algorithms; Anatomy; Benchmarking; Biopsy; Brain Neoplasms; Clinical; Clinical Trials; Communities; Computer software; Consensus; Contrast Media; Data; Differential Diagnosis; Dose; Dropout; Echo-Planar Imaging; Europe; Exhibits; Functional Imaging; Funding; Future; Glioblastoma; Glioma; Goals; Healthcare; Image; Imaging Techniques; Magnetic Resonance Imaging; Manuscripts; Maps; Measures; Methods; Morphologic artifacts; Multi-Institutional Clinical Trial; Operative Surgical Procedures; Patients; Perfusion; Physiologic pulse; Physiological; Population; Predisposition; Property; Protocols documentation; Radiation necrosis; Recommendation; Recurrence; Recurrent tumor; Reporting; Reproducibility; Scanning; Signal Transduction; Site; Slide; Techniques; Tissues; Validation; Work; anatomic imaging; arm; brain tumor imaging; clinical application; clinical practice; clinically relevant; contrast enhanced; design; digital; improved; neuro-oncology; perfusion imaging; population based; prognostic; prospective; radiation effect; reconstruction; response; success; targeted treatment; tool; treatment effect; treatment response; tumor; 3-Dimensional; Address; Adopted; Aftercare; Algorithms; Anatomy; Benchmarking; Biopsy; Brain Neoplasms; Clinical; Clinical Trials; Communities; Computer software; Consensus; Contrast Media; Data; Differential Diagnosis; Dose; Dropout; Echo-Planar Imaging; Europe; Exhibits; Functional Imaging; Funding; Future; Glioblastoma; Glioma; Goals; Healthcare; Image; Imaging Techniques; Magnetic Resonance Imaging; Manuscripts; Maps; Measures; Methods; Morphologic artifacts; Multi-Institutional Clinical Trial; Operative Surgical Procedures; Patients; Perfusion; Physiologic pulse; Physiological; Population; Predisposition; Property; Protocols documentation; Radiation necrosis; Recommendation; Recurrence; Recurrent tumor; Reporting; Reproducibility; Scanning; Signal Transduction; Site; Slide; Techniques; Tissues; Validation; Work; anatomic imaging; arm; brain tumor imaging; clinical application; clinical practice; clinically relevant; contrast enhanced; design; digital; improved; neuro-oncology; perfusion imaging; population based; prognostic; prospective; radiation effect; reconstruction; response; success; targeted treatment; tool; treatment effect; treatment response; tumor

ABSTRACT The principal goal of this competitive renewal is to establish clinical brain tumor perfusion imaging protocols strategically designed for high accuracy, physiologic sensitivity and clinical applicability. Dynamic susceptibility contrast (DSC) MRI is one of the most widely used advanced imaging techniques in neuro-oncology, with a reported use of 85% in all routine brain tumor scans at sites across the US and Europe. During the previous funding cycle, the singular aim of the project was to identify the most accurate DSC-MRI acquisition protocol(s) by developing, validating and applying a population-based digital reference object (DRO) and then verifying these protocols in patients with brain tumors. The most significant finding of this effort was the identification and clinical validation of an accurate single contrast agent dose and single-echo DSC-MRI protocol, which has now been adopted as the consensus recommendation by the brain tumor imaging community. Another key result of this project was the validation, using the DRO and a prospective patient study, of a single-dose, dual-echo DSC- MRI sequence, an approach that enables simultaneous assessment of DSC and dynamic contrast enhanced (DCE)-MRI data, as the protocol with highest accuracy, even across variable pulse sequence parameters and tissue properties. Building on the success of this prior work, we now aim to overcome two obstacles that still limit DSC-MRI’s clinical utility, accuracy, and multi-site consistency: i) a reliance on echo planar imaging (EPI) based pulse sequences that undermine the geometric fidelity, reliable colocalization of perfusion and anatomic images and accuracy of derived DCE-MRI data, and ii) lack of validation of, and a benchmark for, brain tumor DSC/DCE- MRI post-processing algorithms and software, for both single- and dual-echo acquisitions. These limitations represent critical and clinically relevant challenges that urgently need to be addressed. To address these issues, we propose to: 1) establish an anthropomorphic benchmark for validating brain tumor DSC DCE-MRI analysis tools and 2) develop a three-dimensional, dual-echo pulse sequence for simultaneous DSC/DCE MRI. In this project we will provide the neuro-oncology community with validated image acquisition and analysis methods for accurate, physiologic sensitive and clinically applicable DSC/DCE-MRI mapping methods in brain tumor patients. We will provide the first DSC/DCE-MRI anthropomorphic benchmark that can be used to validate existing and future algorithms and software, thereby improving multi-site and clinical trial consistency. Ultimately, validated DSC-MRI techniques will improve its reliability and relevancy across a range of clinical scenarios, including tumor localization, therapy response assessment, surgical and biopsy guidance, and multi-site clinical trials of conventional and targeted brain tumor therapies.

抽象的 这种竞争性更新的主要目标是建立临床脑肿瘤灌注成像方案 策略性设计，以高精度，生理敏感性和临床适用性。动态敏感性 对比度（DSC）MRI是神经肿瘤学中使用最广泛的高级成像技术之一， 据报道，在美国和欧洲的所有常规脑肿瘤扫描中使用85％。在上一个 资金周期，该项目的单一目的是确定最准确的DSC-MRI采集协议 通过开发，验证和应用基于人群的数字参考对象（DRO），然后验证 这些方案中的脑肿瘤患者。这项工作的最重要发现是识别和 精确的单对比剂剂量和单回波DSC-MRI方案的临床验证，该方案现已 被脑肿瘤成像社区通过作为共识建议。另一个关键结果 该项目是使用DRO和前瞻性患者研究的验证，是单剂量的双回声DSC- MRI序列，一种能够同时评估DSC和动态对比度增强的方法 （DCE）-MRI数据，作为具有最高精度的协议，即使在可变脉冲序列参数和 组织特性。在这项先前工作的成功基础上，我们现在旨在克服仍然限制的两个障碍 DSC-MRI的临床实用性，准确性和多站点一致性：i）依赖基于回声的平面成像（EPI） 破坏了几何忠诚度，可靠的灌注共定位和解剖图像的脉冲序列 并准确地衍生DCE-MRI数据，ii）缺乏对脑肿瘤DSC/DCE-的验证和基准 MRI后处理算法和软件，用于单回波采集。这些限制 代表迫切需要解决的关键和临床相关挑战。为了解决这些问题， 我们建议：1）建立一个拟人化基准，用于验证脑肿瘤DSC DCE-MRI分析 工具和2）为简单的DSC/DCE MRI开发了三维双回波脉冲序列。在这个 项目我们将为神经肿瘤学社区提供经过验证的图像获取和分析方法 精确，身体敏感且临床适用的DSC/DCE-MRI映射方法在脑肿瘤患者中。 我们将提供第一个DSC/DCE-MRI拟人化基准，可用于验证现有和 未来的算法和软件，从而提高了多站点和临床试验的一致性。最终，经过验证 DSC-MRI技术将在包括肿瘤在内的各种临床情况下提高其可靠性和相关性 定位，治疗反应评估，手术和活检指导以及多站点的临床试验 常规和靶向脑肿瘤疗法。