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）：Riverside Research 和夏威夷大学及其附属 Kuakini 医疗中心提议结合其资助的新型定量超声研究，评估应用定量光声 (QPA) 方法检测淋巴结转移的可行性（QUS）用于区分癌症患者的含癌淋巴结和无癌淋巴结的方法。淋巴结转移癌的检测对于准确分期、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在 25% 至 30% 的解剖节点和 50% 的微转移节点中检测转移的失败率。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，以识别需要仔细组织学检查的节点区域。通过开发一种高度灵敏、特异性强的纯超声方法，以精细的空间分辨率对淋巴结中的转移性疾病进行成像，我们已经在实现这一目标方面取得了令人兴奋的进展。我们的超声结果显示出在多种癌症类型的解剖淋巴结中检测癌症的卓越能力，并且它们有望提供一种可靠的方法来引导病理学家找到解剖淋巴结中含有癌症的区域。当淋巴结实际上含有微转移性疾病时，我们的超声方法精确定位转移性癌症的能力可能会大大减少或消除不可接受的假阴性测定的发生。这些发现鼓舞了我们提出的将新型 QPA 方法与 QUS 方法相结合的研究可能能够同时实现接近 100% 的敏感性和特异性值。因此，我们计划结合 QUS 信号数据来获取 QPA 信号数据，并以多特征方法使用这些数据的分析结果来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，可以为未来开发用于病理实验室的原型节点评估仪器奠定基础。在更遥远的将来，我们还将研究这些 QPA 和 QUS 技术在较低超声频率下的应用，用于检查或手术室，以确定需要活检或解剖的淋巴结。总之，该项目可以有益于所有类型癌症（例如乳腺癌、结直肠癌、胃癌、胰腺癌、肺癌、甲状腺癌、前列腺癌等）以及前哨淋巴结的分期、预后和治疗计划的淋巴结评估解剖程序， 例如，乳腺癌。我们正在开发的方法显然可以对术前或术中检查的淋巴结的原位评估、包括前哨淋巴结在内的区域淋巴结的术中评估以及解剖淋巴结的术后评估产生显着的有益影响。这些方法也可用于评估非癌症疾病，例如心脏病、肌肉骨骼疾病等。 公共卫生相关性：淋巴结转移的检测对于癌症分期和治疗至关重要；然而，标准的淋巴结评估方法可能会漏掉多达 50% 的小转移淋巴结。所提出的光声方法可以可靠地检测临床上显着的淋巴结转移。我们将评估使用先进的定量光声方法进行节点评估的可行性。