Quantitative Photoacoustic Detection of Lymph-node Metastases

淋巴结转移的定量光声检测

• 批准号: 8402077
• 负责人: Ernest Joseph Feleppa
• 金额: $ 17.99万
• 依托单位: RIVERSIDE RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-01 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8402077
• 关键词: Academic Medical Centers; Area; Asses; Biopsy; Breast; Cancer Patient; Cancerous; Classification; Colorectal; Data; Data Analyses; Detection; Development; Diagnostic Neoplasm Staging; Disease; Dissection; Disseminated Malignant Neoplasm; Distant; Evaluation; Failure; Fostering; Foundations; Frequencies; Funding; Future; Goals; Gold; Grant; Hawaii; Heart Diseases; Histologic; Histology; Histopathology; Image; In Situ; Laboratories; Lasers; Light; Lung; Lymph Node Tissue; Lymph node excision; Malignant Lymph Node Neoplasm; Malignant Neoplasms; Malignant neoplasm of abdomen; Medical center; Methods; Micrometastasis; Microtomy; Musculoskeletal Diseases; Neoplasm Metastasis; Nodal; Noise; Operating Rooms; Operative Surgical Procedures; Optics; Pancreas; Paris, France; Pathologist; Pathology; Performance; Postoperative Period; Procedures; Property; Prostate; ROC Curve; Research; Resolution; Scanning; Sensitivity and Specificity; Sentinel Lymph Node; Signal Transduction; Specific qualifier value; Staging; Stomach; System; Techniques; Thyroid Gland; Tissues; Ultrasonics; Ultrasonography; United States National Institutes of Health; Universities; absorption; base; cancer therapy; cancer type; clinically significant; imaging modality; improved; instrument; instrumentation; lymph nodes; malignant breast neoplasm; novel; outcome forecast; prototype; quantitative ultrasound; theories; treatment planning; validation studies

DESCRIPTION (provided by applicant): Riverside Research and the University of Hawaii and its affiliated Kuakini Medical Center propose to assess the feasibility of applying quantitative photoacoustic (QPA) methods to detection of metastases in lymph nodes in conjunction with its funded studies of novel quantitative ultrasound (QUS) methods for discriminating between cancer-containing and cancer-free lymph nodes of cancer patients. Detection of metastatic cancer in lymph nodes is crucial for accurate staging, prognosis, and treatment planning. Our goal is to reduce markedly the failure of existing methods to detect metastases in 25% to 30% of dissected nodes and 50% in nodes with micrometastases. To achieve our goal, we propose to develop QPA methods used alone or in combination with high-frequency QUS to identify regions of nodes that warrant careful histologic examination. We already have made exciting progress toward this goal by developing a highly sensitive and specific, purely ultrasonic method of imaging metastatic disease in lymph nodes with fine spatial resolution. Our ultrasonic results show a remarkable ability to detect cancer in dissected lymph nodes for a broad range of cancer types, and they promise a reliable means of guiding pathologists to cancer-containing regions of dissected lymph nodes. The ability of our ultrasonic methods to pinpoint metastatic cancer potentially can reduce or eliminate the occurrence of unacceptable false-negative determinations drastically when nodes actually contain micrometastatic disease. These findings provide encouragement that our proposed studies combining novel QPA methods with our QUS methods may be able to achieve simultaneous sensitivity and specificity values approaching 100%. Therefore, we plan to acquire QPA-signal data in conjunction with acquisition of QUS- signal data, and to use the results of analyses of these data in a multifeature approach to classification of lymph-node tissue as cancerous or non-cancerous. If the proposed studies establish the feasibility of using QPA alone or in combination with QUS, then we will propose to undertake validation studies that, if successful, can provide a foundation for future development of a prototype node-evaluation instrument for use in the pathology laboratory. In the more-distant future, we also will investigate application of these QPA and QUS techniques at lower ultrasound frequencies for use in the examination or operating room to identify nodes that warrant biopsy or dissection. In conclusion, this project can benefit lymph-node evaluations for staging, prognosis, and treatment planning of all types of cancers, e.g., breast, colorectal, gastric, pancreatic, lung, thyroid, prostate, etc., as well as sentinel-node dissection procedures, e.g., for breast cancer. The methods we are developing clearly can have a significant beneficial impact on in situ evaluations of lymph nodes examined prior to or during surgery, intra-operative evaluations of regional nodes including sentinel-nodes, and post- operative evaluations of dissected nodes. These methods also may be of use in evaluations of non-cancerous diseases such as cardiac disease, musculoskeletal disease, etc. PUBLIC HEALTH RELEVANCE: Detection of metastases in lymph nodes is essential for cancer staging and treatment; however, standard methods of node evaluation may miss small metastases in as many as 50% of nodes that have them. The proposed photoacoustic methods may reliably detect clinically significant lymph-node node metastases. We will assess the feasibility of using advanced quantitative photoacoustic methods for node evaluation.

描述（由申请人提供）：河滨研究和夏威夷大学及其隶属的Kuakini医学中心建议评估使用定量光声（QPA）方法的可行性（QPA）方法来检测淋巴结中的转移酶，以与新的定量超声（QUS）方法进行癌症癌症和癌症癌症的癌症研究中的基础研究。淋巴结中转移性癌症的检测对于准确的分期，预后和治疗计划至关重要。我们的目标是显着减少现有方法未能检测到25％至30％的解剖节点中的转移和50％的带有微型转移的淋巴结。为了实现我们的目标，我们建议开发单独使用或与高频QUS结合使用的QPA方法，以确定保证仔细组织学检查的节点区域。我们已经通过开发一种具有精细空间分辨率的淋巴结中的高度敏感，纯粹的超声化转移性疾病的超声测试方法，从而取得了令人兴奋的进步。我们的超声波结果表明，对于广泛的癌症类型，在解剖淋巴结中检测癌症的能力显着，并且他们承诺将病理学家指导含癌症淋巴结的癌症区域的可靠手段。当节点实际上含有微转移性疾病时，我们的超声方法可能会降低或消除不可接受的假阴性确定的能力可能会大大减少或消除不可接受的假阴性确定。这些发现提供了鼓励，我们提出的研究将新型QPA方法与我们的QUS方法相结合，可能能够达到100％接近100％的敏感性和特异性值。因此，我们计划与获取QUS-Signal数据一起获取QPA信号数据，并将这些数据分析的结果以多种方法的分析结果将淋巴结组织分类为癌性或非癌性。如果拟议的研究确定了单独使用QPA或与QUS结合使用QPA的可行性，那么我们将建议进行验证研究，如果成功，可以为未来开发原型节点评估工具提供基础，以在病理实验室中使用。在更远的将来，我们还将调查这些QPA和QUS技术在较低的超声频率上的应用，以用于检查或手术室，以识别保证活检或解剖的节点。总之，该项目可以使淋巴结评估受益于所有类型的癌症的分期，预后和治疗计划，例如乳腺癌，大肠，胃，胃，胰腺，肺，肺，甲状腺，前列腺等，以及哨兵节解剖程序，以及 例如，用于乳腺癌。我们正在开发的方法可以对在手术前或手术前检查的淋巴结的原位评估产生重大的有益影响，对包括前哨节点在内的区域节点的术中评估以及对解剖节点的手术后评估。这些方法也可能用于评估非癌性疾病，例如心脏病，肌肉骨骼疾病等。 公共卫生相关性：检测淋巴结中的转移剂对于癌症分期和治疗至关重要；但是，节点评估的标准方法可能会错过多达50％的具有它们的节点的转移。提出的光声方法可以可靠地检测到临床上显着的淋巴结淋巴结转移。我们将评估使用先进的定量光声学方法进行节点评估的可行性。