Development and Validation of Radiation-Free Pediatric Renal Function Quantification

无辐射儿童肾功能定量的开发和验证

基本信息

批准号：
9501621
负责人：
Shreyas S Vasanawala
金额：
$ 68.34万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-04-05 至 2022-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9501621
关键词：
4D Imaging Address Adopted Adult Affect Age Aging Anatomy Antibiotics Area Biological Markers Blood Blood flow Breathing Cardiac Output Child Childhood Chronic Kidney Failure Clinical Clinical Management Clinical Research Cone Contrast Media Data Development Diagnosis Disease Drug Kinetics End stage renal failure Evaluation Evolution Failure Financial compensation Functional Magnetic Resonance Imaging Furosemide Gadolinium Glomerular Filtration Rate Gold Growth Hydronephrosis Hypertension Image Image Analysis Injections Ionizing radiation Kidney Kidney Diseases Kinetics Machine Learning Magnetic Resonance Imaging Mainstreaming Malignant Childhood Neoplasm Manuals Measurement Measures Methods Motion Motivation Neurocognitive Deficit Obstruction Patients Performance Perfusion Pharmaceutical Preparations Phase Plasma Protocols documentation Radiation Regimen Renal Blood Flow Renal Plasma Flow Renal function Reproducibility Resolution Signal Transduction Techniques Testing Time Toxic effect Urinary tract Urine Validation Venous Work antimicrobial drug base cardiovascular risk factor chemotherapeutic agent chemotherapy community setting computerized data processing contrast enhanced data acquisition experience image processing imaging Segmentation imaging modality improved kidney cortex kidney imaging loss of function nephrotoxicity novel oncology pressure reconstruction recruit spatiotemporal stem urinary urinary tract obstruction urologic

4D Imaging Address Adopted Adult Affect Age Aging Anatomy Antibiotics Area Biological Markers Blood Blood flow Breathing Cardiac Output Child Childhood Chronic Kidney Failure Clinical Clinical Management Clinical Research Cone Contrast Media Data Development Diagnosis Disease Drug Kinetics End stage renal failure Evaluation Evolution Failure Financial compensation Functional Magnetic Resonance Imaging Furosemide Gadolinium Glomerular Filtration Rate Gold Growth Hydronephrosis Hypertension Image Image Analysis Injections Ionizing radiation Kidney Kidney Diseases Kinetics Machine Learning Magnetic Resonance Imaging Mainstreaming Malignant Childhood Neoplasm Manuals Measurement Measures Methods Motion Motivation Neurocognitive Deficit Obstruction Patients Performance Perfusion Pharmaceutical Preparations Phase Plasma Protocols documentation Radiation Regimen Renal Blood Flow Renal Plasma Flow Renal function Reproducibility Resolution Signal Transduction Techniques Testing Time Toxic effect Urinary tract Urine Validation Venous Work antimicrobial drug base cardiovascular risk factor chemotherapeutic agent chemotherapy community setting computerized data processing contrast enhanced data acquisition experience image processing imaging Segmentation imaging modality improved kidney cortex kidney imaging loss of function nephrotoxicity novel oncology pressure reconstruction recruit spatiotemporal stem urinary urinary tract obstruction urologic

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项目摘要

Project Abstract Motivation: Chronic kidney disease (CKD) affects more than 500 million people. Children commonly develop CKD from urinary obstructive diseases and nephrotoxic therapies, and then suffer severe growth failure, hyper- tension, cardiovascular risks, and neurocognitive deﬁcits, and eventually end-stage kidney disease. Accurate renal function quantiﬁcation will improve clinical management of hydronephrosis (1 in 100 babies) and dos- ing/selection of chemotherapeutic regimens in oncology patients. Glomerular ﬁltration rate (GFR), the biomarker of renal function, is derived from blood or urine tests. These tests only provide global GFR and are limited in accuracy, especially in children, and even more so in children with cancer. MRI offers superb anatomic delineation without ionizing radiation, and is thus ideal for pediatric kidney imaging. However, MRI has not been widely adopted for pediatric renal function evaluation due to lack of reliability and cumbersome workﬂow. These hurdles stem from the fact that the critical components required for global and regional GFR calculation, including high spatiotemporal resolution, plasma ﬂow and arterial input function, are difﬁcult to obtain, and that accurate image segmentation of kidneys (cortex and medulla) is labor intensive. Additionally, although the same contrast agent injection can be used for obstruction evaluation, certain areas of the kidney suffer from signiﬁcant signal loss using standard MRI acquisition techniques due to high contrast agent concentrations. This project addresses these major challenges for automated comprehensive renal function evaluation in children. Approach: The project has three development aims, which are validated by clinical studies. Aim 1 will enable novel free-breathing time-resolved 3D dynamic contrast enhanced MRI that simultaneously provides accurate GFR calculation and renal plasma ﬂow. This is achieved by incorporating self-navigated motion compensation, fast acquisition with parallel imaging and compressed sensing, and phase-contrast ﬂow imaging. The second aim is to develop multiple new image analysis methods to extract GFR and renal plasma ﬂow (RPF) that lever- age novel ﬂow data of Aim 1, as well as automated new machine-learning image processing techniques for the segmentation of kidneys and ultimately global and regional GFR calculation. In Aim 3, we will develop and integrate ultrashort-echo-time techniques to address the MRI signal loss due to T2* effects from high contrast concentration for patients with obstruction, and further incorporate motion compensation and accelerated imag- ing methods to enable time-resolved high-resolution dynamic MRI for contrast washout kinetics analysis in the same MR exam. Aim 4 will determine the performance of these methods in a clinical setting. Signiﬁcance: This work will lead to robust, automated comprehensive pediatric renal MRI for safer and more accurate renal function evaluation in children. The techniques will facilitate widespread application in the com- munity setting and permit robust evaluation of renal function, for both children and adults.

项目摘要动机：慢性肾脏疾病（CKD）影响超过5亿人。儿童通常会发育尿阻塞性疾病和肾毒性疗法的CKD，然后遭受严重的生长失败，超级张力，心血管风险和神经认知效果以及最终终止肾脏疾病。准确的肾功能量化将改善肾积水的临床管理（100分之一）和DOS- 肿瘤患者中化学治疗方案的ING/选择。肾脏功能的生物标志物肾小球效果率（GFR）源自血液或尿液检查。这些测试仅提供全球GFR，并且准确性有限，尤其是在儿童中，甚至在儿童中更是如此癌症。 MRI提供出色的解剖学描述，而无需电离辐射，因此非常适合小儿肾脏成像。但是，由于缺乏，小儿肾功能评估尚未广泛采用MRI 可靠性和繁琐的工作流。这些障碍源于以下事实对于全球和区域GFR计算，包括高时空分辨率，血浆流量和动脉输入功能很难获得，肾脏的准确图像分割（皮层和髓质）是劳动密集的。此外，尽管可以使用相同的对比剂注入进行客观评估，但某些使用标准MRI获取技术，肾脏受害者的区域因高度信号损失而导致高度损失对比剂浓度。该项目应对自动综合的这些主要挑战儿童的肾功能评估。方法：该项目具有三个开发目标，这些目标是通过临床研究验证的。 AIM 1将启用新型的自由呼吸时间分辨的3D动态对比增强了MRI，仅提供准确的MRI GFR计算和肾脏等离子体流。这是通过编码自我宣传的运动补偿来实现的，通过并行成像和压缩感应以及相对对比的流成像快速获取。第二个目的是开发多种新的图像分析方法来提取杠杆的GFR和肾脏等离子体流（RPF） AIM 1的年龄新颖流量数据以及自动化的新机器学习图像处理技术肾脏的分割以及最终的全球和区域GFR计算。在AIM 3中，我们将发展和集成的超短回波时间技术以解决高对比度的T2*效应引起的MRI信号损失异议患者的浓度，并进一步纳入运动补偿和加速的想象 ING方法可以实现时间分辨的高分辨率动态MRI，以进行对比度冲洗动力学分析同一位MR考试。 AIM 4将在临床环境中确定这些方法的性能。意义上的说法：这项工作将导致强大，自动化的综合儿科肾脏MRI更安全和更多儿童的准确肾功能评估。这些技术将促进宽度应用程序的应用对儿童和成人的肾功能的设定和允许对肾功能进行强有力的评估。