Towards intra-operative guidance in brain tumor surgery using real-time resting-state functional MRI

使用实时静息态功能 MRI 进行脑肿瘤手术的术中指导

基本信息

批准号：
10761498
负责人：
Clark Chin-Chung Chen
金额：
$ 37.82万
依托单位：
NEURINSIGHT, LLC
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-19 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10761498
关键词：
Anesthesia procedures Biometry Brain Brain Mapping Brain Neoplasms Clinical Clinical Trials Collaborations Complement Computer Workstations Consumption Custom Data Databases Equilibrium Evaluation Excision FDA approved Functional Magnetic Resonance Imaging Geometry Grant Head Movements Language Lesion Magnetic Resonance Magnetic Resonance Imaging Maps Methodology Minnesota Monitor Morphologic artifacts Motion Motor Nervous System Physiology Neuroanatomy Neurologic Neurosurgeon New Mexico Operative Surgical Procedures Patient Participation Patients Performance Phase Physiological Qualifying Quality Control Research Research Personnel Rest Scanning Sensitivity and Specificity Sensory Signal Transduction Slide Small Business Technology Transfer Research Software Tools Speed Statistical Data Interpretation System Technology Testing Time Tissues Validation analysis pipeline awake cerebrovascular connectome cortex mapping cost effective data quality deep learning design experience frontal lobe functional MRI scan functional disability high end computer minimally invasive neurovascular patient population preservation programs success technology validation tool tumor

项目摘要

Summary Resting-state functional MRI (rsfMRI) is a rapidly developing task-free approach for presurgical mapping. It can complement task-based functional MRI (tfMRI) in patients who have difficulties performing tasks and efficiently map resting state networks (RSNs) in regions that are not typically mapped with tfMRI due to time constraints, such as frontal cortex. It has the potential to provide iterative intra-operative guidance during progressive resection, enables connectome mapping in anesthetized patients, and holds promise for intra-operative guidance of minimally invasive surgery where intra-operative electrocortical mapping may not be possible. To achieve clinical acceptance, rsfMRI analysis needs to be highly tolerant to head movement, physiological signal pulsation, lesion-related changes of functional neuro-anatomy and cerebrovascular uncoupling; and provide data quality control metrics during the ongoing scan. Intra-operative guidance additionally requires automated online mapping of RSNs and tolerance to intra-operative brain shifts. There are currently no FDA-approved rsfMRI tools available for presurgical mapping. Here, we propose a fully automated, highly sensitive and cost-effective real-time rsfMRI analysis technology on a high-performance workstation for presurgical and intraoperative mapping. The project builds on TurboFIRE, a powerful real-time tfMRI and rsfMRI analysis software tool for high-speed fMRI, the success of a prior Phase I STTR study in 12 brain tumor patients that showed clinically acceptable concordance of real-time high-speed multi-echo rsfMRI with tfMRI, and intra-operative electrocortical stimulation (ECS); and our experience with intra-operative rsfMRI in anesthetized brain tumor patients. This technology provides online rsfMRI mapping, eliminating time-consuming postprocessing, and seamless integration into presurgical planning and intra-operative MRI. This methodology will have significant clinical and commercial potential for a wide range of neurological and psychiatric applications beyond pre-surgical mapping in patients with brain tumors. It opens up functional brain mapping to patient populations that have been difficult to study in the past.

概括静止状态功能性MRI（RSFMRI）是一种快速开发的无任务方法，用于术前映射。它可以在执行任务困难的患者中补充基于任务的功能MRI（TFMRI）有效地映射通常不与TFMRI映射的区域中的静止状态网络（RSN）约束，例如额叶皮层。它有潜力在期间提供迭代性术中指导进行性切除，在麻醉患者中启用连接映射，并有望术中侵入性手术的术中指导可能不是术中的电型皮质映射可能的。为了实现临床接受，RSFMRI分析需要高度耐受性运动，生理信号脉动，功能性神经解剖学和脑血管的病变相关变化解偶联；并在正在进行的扫描过程中提供数据质量控制指标。术中指导此外，需要自动对RSN的在线映射以及对术中大脑转移的耐受性。当前没有FDA批准的RSFMRI工具可用于术前映射。在这里，我们建议完全自动化，高度敏感且具有成本效益的实时RSFMRI分析技术术前和术中映射的工作站。该项目建立在TurbOfire，这是一个强大的实时用于高速fMRI的TFMRI和RSFMRI分析软件工具，这是先前I阶段ISTTR研究的成功脑肿瘤患者在临床上可接受的高速多回波RSFMRI的一致性用TFMRI和术中的电气刺激（ECS）；以及我们在术中RSFMRI的经验在麻醉的脑肿瘤患者中。该技术提供在线RSFMRI映射，消除耗时的后处理，并无缝整合到术前计划和术中MRI。该方法将具有广泛的临床和商业潜力神经和精神病的应用超出了脑肿瘤患者的手术前映射。它向过去难以研究的患者人群打开功能性脑图。