Noninvasive measurement of oxygenation using quantitative susceptibility mapping

使用定量磁化率图无创测量氧合

基本信息

批准号：
10322146
负责人：
Pascal Spincemaille
金额：
$ 83.07万
依托单位：
WEILL MEDICAL COLL OF CORNELL UNIV
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-01-01 至 2025-12-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10322146
关键词：
3-Dimensional Activities of Daily Living Address Adult Affect Agreement Ally Anatomy Blood Breathing Calibration Cardiac Cardiac Catheterization Procedures Cardiac Output Catheterization Cellular Morphology Cessation of life Clinical Clinical Research Complex Data Decision Making Disease Disease Progression Dose Dyspnea Early Diagnosis Erythrocytes Evaluation Exercise Test Financial compensation Genes Goals Heart Hospitalization Imaging Techniques Impairment Ionizing radiation Knowledge Left Life Liver diseases Lung Magnetic Resonance Imaging Magnetism Measurement Measures Methods Modeling Monitor Motion Organ Outcome Outcomes Research Oxygen Patient-Focused Outcomes Patients Perfusion Phase Physics Physiologic Monitoring Physiologic pulse Predisposition Prevalence Property Protons Pulmonary Hypertension Radiation exposure Reference Standards Relaxation Reproducibility Research Risk Scanning Severities Signal Transduction Symptoms Techniques Technology Testing Therapeutic Time Tissues Transplantation Treatment outcome United States Validation Vascular Diseases Walking base cell water clinical practice clinical prognosis cohort computerized data processing data acquisition end stage disease follow-up heart function hemodynamics human old age (65+)hypertension treatment improved improved outcome indexing insight mortality nervous system disorder novel predict clinical outcome pressure prospective pulmonary arterial pressure reconstruction respiratory stem treatment optimization

项目摘要

PROJECT SUMMARY/ABSTRACT The goal of this research is to develop cardiac quantitative susceptibility mapping (QSM) for non-invasive meas- urement of blood oxygen saturation, towards the long-term objective of improving early diagnosis, therapeutic decision-making, and clinical outcomes for patients with pulmonary hypertension (PH). PH is a progressive and life shortening disorder affecting ~10% of adults over age 65. Given that PH can be irreversible in its later stages, early diagnosis and physiologic monitoring are critically important. Impaired oxygenation of the lungs and heart chambers (cardiac oxygenation) is a key manifestation of PH that impacts symptoms and clinical outcomes. Increased pulmonary arterial pressure in PH impairs pulmonary oxygen exchange, decreasing delivery of oxy- genated blood to the left heart. Systemic cardiac output is often compromised in PH, resulting a larger differential blood oxygen saturation between the left and right heart. Invasive catheterization (cath) is currently used to measure cardiac oxygenation but entails procedural risks, ionizing radiation exposure, and is impractical for early diagnosis and serial monitoring - a non-invasive method to accurately measure blood oxygenation would be of substantial utility. MRI is well suited for PH assessment as it enables integrated evaluation of pulmonary anat- omy, pressure, as well as cardiac function and remodeling - blood oxygenation is a key gap in MRI evaluation of PH. This gap stems from limitations in current pulse sequence technology rather than fundamental MRI physics. It is well known that deoxygenation changes the magnetic susceptibility of blood. These changes have tradition- ally been probed using a magnitude property of the MR signal: the transverse relaxation time (T2). However, this requires patient-specific calibration that is difficult in clinical practice. In contrast, QSM relies on the phase of the MR signal to directly measure susceptibility and thus cardiac oxygenation. We have obtained highly encouraging preliminary data for QSM measurement of cardiac blood oxygenation, with close agreement between QSM and oxygenation measured invasively. We have identified key challenges for developing cardiac QSM, including motion suppression and prolonged scan times. The current research proposes to develop an accelerated cardiac QSM method, and to test QSM in relation to oxygenation on invasive cath, as well as effort tolerance and clinical prognosis. Study Aims are as follows: (1) Develop accelerated cardiac QSM using free-breathing acquisition and optimized reconstruction. (2) Test accelerated and current cardiac QSM among PH patients in comparison to T2-based cardiac oxygenation and the reference standard of invasive cardiac catheterization. (3) Determine whether cardiac QSM stratifies clinical severity and predicts PH disease progression. The expected outcome of this research is a non-invasive method for measuring cardiac oxygenation – a critically important marker in PH that currently relies on invasive testing. Given the increasing prevalence and therapeutic options for this serious condition, non-invasive oxygenation assessment by cardiac QSM holds broad significance towards the goal of early diagnosis, therapy optimization, and improved clinical outcomes for millions of patients with PH.

项目概要/摘要本研究的目标是开发用于非侵入性测量的心脏定量磁敏图（QSM）血氧饱和度的测定，以实现改善早期诊断、治疗的长期目标肺动脉高压 (PH) 患者的决策和临床结果是一种进行性且持续的过程。缩短寿命的疾病影响约 10% 的 65 岁以上成年人。鉴于 PH 在后期可能是不可逆转的，早期诊断和生理监测至关重要。心室（心脏氧合）是 PH 的一个关键表现，影响症状和临床结果。肺动脉高压时肺动脉压升高会损害肺氧交换，减少氧输送 PH 时，流向左心的全身心输出量通常会受到影响，从而导致较大的差异。目前使用侵入性导管插入术（cath）来测量左右心脏之间的血氧饱和度。测量心脏氧合，但会带来程序风险、电离辐射暴露，并且对于早期来说是不切实际的诊断和连续监测 - 一种准确测量血氧的非侵入性方法将是 MRI 非常适合 PH 评估，因为它可以对肺部解剖进行综合评估。心肌、压力以及心脏功能和重塑——血氧是 MRI 评估的一个关键差距 PH：这种差距源于当前脉冲序列技术的限制，而不是基础 MRI 物理学。众所周知，脱氧会改变血液的磁化率，这些变化有传统—— 可以使用 MR 信号的幅度特性来探测：横向弛豫时间 (T2)。需要针对患者进行校准，这在临床实践中是困难的，相反，QSM 依赖于相位。 MR 信号直接测量磁敏感度，从而测量心脏氧合，我们获得了高度鼓舞。 QSM 测量心脏血氧饱和度的初步数据，QSM 与我们已经确定了开发心脏 QSM 的关键挑战，包括当前的研究建议开发加速心脏。 QSM 方法，并测试 QSM 与侵入导管氧合的关系，以及努力耐受性和临床研究目标如下： (1) 利用自由呼吸采集和开发加速心脏 QSM。 (2) 与 PH 患者相比测试加速和当前的心脏 QSM。 (3)确定心脏 QSM 是否对临床严重程度进行分层并预测 PH 疾病进展的预期结果。这项研究是一种测量心脏氧合的非侵入性方法——心脏氧合是肺动脉高压的一个极其重要的标志物鉴于这种严重疾病的患病率和治疗选择不断增加，目前依赖于侵入性检测。心脏 QSM 的无创氧合评估对于实现以下目标具有广泛意义：早期诊断、优化治疗并改善数百万 PH 患者的临床结果。