Concurrent Optical Spectroscopy and Breast MRI to Improve Diagnosis without Contrast Injection

同步光学光谱和乳腺 MRI 无需注射造影剂即可改善诊断

• 批准号: 9816241
• 负责人: SHUDONG JIANG
• 金额: $ 56.4万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9816241
• 关键词: Adhesives; Area Under Curve; Axilla; Biomedical Engineering; Brain; Breast; Breast Cancer Detection; Breast Magnetic Resonance Imaging; Clinical; Clinical Management; Clinical Research; Clinical Trials; Collaborations; Contrast Media; Curiosities; Data; Data Quality; Deposition; Development; Diagnosis; Diagnostic; Diagnostic Specificity; Diagnostic radiologic examination; Diffusion Magnetic Resonance Imaging; Dose; Fiber; Frequencies; Funding; Gadolinium; Geometry; Goals; Hemoglobin; Human; Image; Imaging technology; Impairment; Infrastructure; Injections; Ionizing radiation; Ions; Kidney; Letters; Light; Lipids; Magnetic Resonance Imaging; Modality; Near-Infrared Spectroscopy; Nephrogenic Systemic Fibrosis; Optics; Outcome; Oxygen; Paper; Patients; Performance; Perfusion; Procedures; Publishing; ROC Curve; Renal function; Research Personnel; Risk; Safety; Scanning; Sensitivity and Specificity; Signal Transduction; Specificity; Spectrum Analysis; System; Techniques; Technology; Time; Tissues; Translating; United States Food and Drug Administration; Update; Water; Weight-Bearing state; Woman; Work; base; bone; breast cancer diagnosis; breast exam; breast imaging; clinical practice; contrast enhanced; cost; data acquisition; design; diagnostic accuracy; high risk; human data; imaging approach; imaging modality; imaging platform; improved; innovation; interest; malignant breast neoplasm; medication safety; multimodality; optical imaging; radiologist; research clinical testing; screening; spectroscopic imaging; volunteer

PROJECT SUMMARY While dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) is recognized as the most sensitive examination for breast cancer detection, it has a substantial false positive rate and injection of gadolinium (Gd) contrast agents appears to have safety risks. Thus, alternatives to diagnosing breast cancer based on endogenous contrast are of growing interest. The overall goal of this proposal is to develop and evaluate a concurrent near-infrared spectroscopy (NIRS) and MRI imaging platform to explore whether the combined modality, which does not require contrast injection or involve ionizing radiation, can achieve acceptable diagnostic performance. The scientific premise of this proposal is underpinned by data from preliminary clinical studies that show MR-guided (MRg) NIRS adds much needed diagnostic specificity to breast MRI. We will also explore the exciting hypothesis that MRg NIRS serves as a surrogate for DCE MRI, and similar or the same diagnostic performance can be obtained by adding MRg NIRS to non-contrast MRI sequences, thereby eliminating the need for contrast injection. In preliminary studies, sensitivity, specificity, accuracy, and AUC of non-contrast MRI when combined with T2-guided NIRS were 94%, 100%, 96%, and 0.95, respectively, whereas these values were 94%, 63%, 88%, and 0.81 for DCE-MRI alone. This performance can be improved even further through direct regularization from images (DRI) methods and multi objective priors we propose to investigate in Aim 2. Equally important, we found the diagnostic performance of MRg NIRS is not degraded when CW signals are used to form NIRS images as long as subject specific scattering estimates are obtained (in Aim 1). Indeed, the practical utility of our current MRg NIRS system is undermined by its reliance on FD data, and the long, large-core fiber bundles that transmit light to/from data acquisition hardware to the breast inside the scanner. Elimination of these bulky weight-bearing fiber cables also simplifies the breast optical imaging interface, and opens the door to development of new options for the innovative, clinical-friendly design proposed in Aim 1. We will validate this platform iteratively in phantoms and volunteers (in Aim 3) and evaluate the new MRg NIRS + MRI technology when combined with and without contrast injection in a clinical study of 60 patients with breast abnormalities. The project leverages an extensive infrastructure we have developed for translational breast imaging where investigators from diagnostic radiology and biomedical engineering have collaborated to develop and evaluate advanced technology for more than two decades.

项目摘要 虽然动态对比增强的磁共振成像（DCE MRI）被认为是最敏感的 检查乳腺癌检测，它具有巨大的假阳性率和gadolinium（GD）的注射 对比剂似乎有安全风险。因此，基于诊断乳腺癌的替代方法 内源性对比越来越感兴趣。该提案的总体目标是开发和评估 并发近红外光谱（NIRS）和MRI成像平台，以探索合并 不需要对比度注入或涉及电离辐射的方式可以实现可接受 诊断性能。该提案的科学前提是初步临床数据的基础 表明MR引导（MRG）NIRS的研究为乳房MRI增加了急需的诊断特异性。我们也会 探索MRG NIRS作为DCE MRI的替代物的令人兴奋的假设，并且相似或相同 诊断性能可以通过在非对比度MRI序列中添加MRG NIR来获得 消除对对比度注入的需求。在初步研究中，灵敏度，特异性，准确性和AUC 与T2指导的NIR合并时，非对比度MRI分别为94％，100％，96％和0.95 仅DCE-MRI的这些值是94％，63％，88％和0.81。这种表演可以改善 通过来自图像（DRI）方法和多目标先验的直接正则化的进一步正规化，我们建议 在AIM 2中进行调查。同样重要，我们发现MRG NIR的诊断性能没有降解 只要获得主题特定的散射估计，使用CW信号用于形成NIRS图像 （在AIM 1中）。实际上，我们当前MRG NIRS系统的实际实用性因其对FD的依赖而破坏了 数据以及将光传输到/从数据采集硬件传输到乳房的长核纤维束 在扫描仪内部。消除这些笨重的承重纤维电缆也简化了乳房光学 成像界面，并为开发创新，临床友好设计的新选择开发了大门 在AIM 1中提出的。我们将在幻影和志愿者（在AIM 3中）进行迭代验证该平台并评估 在一项临床研究中，新的MRG NIRS + MRI技术在 60例乳房异常患者。该项目利用了我们为 翻译乳房成像，来自诊断放射学和生物医学工程的研究人员具有 合作开发和评估高级技术已有二十多年了。