Establishing the validity of brain tumor perfusion imaging

建立脑肿瘤灌注成像的有效性

• 批准号: 9754786
• 负责人: Christopher Chad Quarles
• 金额: $ 26.49万
• 依托单位: ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9754786
• 关键词: Address; Adoption; Aftercare; Biopsy; Blood Vessels; Blood Volume; Blood flow; Bolus Infusion; Brain Neoplasms; Cell Density; Cell Shape; Cell Size; Clinic; Clinical; Clinical Trials; Communities; Community Clinical Oncology Program; Complex; Computer Simulation; Consensus; Contrast Media; Data; Dependence; Dose; Evaluation; Extravasation; Future; Gadolinium; Geometry; Glioma; Goals; Healthcare; Image; Imaging Techniques; Injections; Institutes; Kinetics; Lead; Local Therapy; Magnetic Resonance Imaging; Maps; Measurement; Measures; Methodology; Methods; Multi-Institutional Clinical Trial; Operative Surgical Procedures; Oxidants; Patients; Perfusion; Permeability; Physicians; Physiologic pulse; Prediction of Response to Therapy; Predisposition; Prospective Studies; Protocols documentation; Publishing; Radiation necrosis; Recommendation; Recurrence; Reference Standards; Relaxation; Research; Resources; Scheme; Series; Signal Transduction; Site; Standardization; Techniques; Time; Tissues; Validation; Vendor; base; cancer imaging; cerebral blood volume; clinical care; clinically relevant; cost effective; density; digital; ferumoxytol; image archival system; imaging modality; improved; in vivo; iron oxide; maltreatment; neuro-oncology; novel; open source; perfusion imaging; physical property; prevent; response; targeted treatment; tool; treatment effect; tumor

ABSTRACT The central goal of this proposal is to establish the accuracy of brain tumor perfusion imaging. Dynamic susceptibility contrast (DSC) MRI is one of the most widely used advanced imaging techniques in neuro- oncology. Multiple studies have shown how DSC-MRI measures of relative cerebral blood volume (rCBV) can differentiate glioma grades, tumor types and identify tumor components in non-enhancing glioma distinguish tumor recurrence from post-treatment effects, and predict tumoral response and patient survival after targeted therapy. Despite DSC-MRI's potential impact on clinical care, its broad scale integration has been slow, in large part from a lack of consensus about methodology and how to prevent potential rCBV inaccuracies. Although DSC relies on the assumption that gadolinium-based contrast agents (GBCA) remain within the vascular lumen, this condition is often violated in vivo. If not corrected for, contrast agent leakage effects lead to rCBV inaccuracy, misdiagnosis, and potentially mistreatment. While numerous leakage correction strategies exist, a fundamental limitation has prevented the standardization and wide-spread adoption of DSC-MRI methodology: To date, no study has validated the accuracy of leakage corrected rCBV measures in patients. The lack of validation impacts DSC-MRI standardization efforts, the establishment of rCBV thresholds for clinic use, multi-site comparisons and clinical trials. Given the importance of rCBV accuracy we propose to address this through two highly focused studies. First, we aim to validate rCBV accuracy by comparison to an intravascular reference standard in high-grade glioma patients. Multiple acquisition and analysis techniques will be investigated. Second, using a novel in silico digital phantom we aim to systematically define the range of DSC-MRI protocols that maintain consistent rCBV measurements. Impact on Healthcare: Our primary deliverable is to provide the neuro-oncology community with validated image acquisition and analysis methods for accurate rCBV mapping in brain tumor patients. Validated DSC-MRI techniques will improve its clinical reliability and justify its use 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 该提案的中心目标是确定脑肿瘤灌注成像的准确性。动态的 磁敏感对比 (DSC) MRI 是神经系统疾病领域使用最广泛的先进成像技术之一。 肿瘤学。多项研究表明 DSC-MRI 测量相对脑血容量 (rCBV) 如何能够 区分神经胶质瘤等级、肿瘤类型并识别非增强性神经胶质瘤中的肿瘤成分 从治疗后的效果中预测肿瘤复发，并预测靶向治疗后的肿瘤反应和患者生存率 治疗。尽管 DSC-MRI 对临床护理具有潜在影响，但其大规模整合进展缓慢， 很大程度上是由于对方法以及如何防止潜在的 rCBV 错误缺乏共识。 尽管 DSC 依赖于钆基造影剂 (GBCA) 保留在 血管腔，这种情况在体内经常受到侵犯。如果不进行校正，造影剂泄漏会导致 rCBV 不准确、误诊和潜在的虐待。虽然有许多泄漏校正策略 存在一个根本性的限制，阻碍了 DSC-MRI 的标准化和广泛采用 方法：迄今为止，尚无研究验证患者泄漏校正 rCBV 测量的准确性。 缺乏验证会影响 DSC-MRI 标准化工作以及临床 rCBV 阈值的建立 使用、多中心比较和临床试验。鉴于 rCBV 准确性的重要性，我们建议解决 这是通过两项高度集中的研究得出的。首先，我们的目标是通过与 高级别胶质瘤患者的血管内参考标准。多种采集和分析技术将 被调查。其次，使用小说数字模型，我们的目标是系统地定义 DSC-MRI 协议可保持一致的 rCBV 测量。对医疗保健的影响：我们的首要任务 可交付成果是为神经肿瘤学界提供经过验证的图像采集和分析方法 用于脑肿瘤患者的准确 rCBV 绘图。经验证的 DSC-MRI 技术将改善其临床 可靠性并证明其在一系列临床场景中的使用合理性，包括肿瘤定位、治疗反应 常规和靶向脑部的评估、手术和活检指导以及多中心临床试验 肿瘤治疗。 ！