Improved MRI guidance of pediatric catheterization via autonomous multi-beat data synthesis

通过自主多节拍数据合成改进儿科导管插入术的 MRI 指导

• 批准号: 10646226
• 负责人: Francisco J Contijoch
• 金额: $ 66.5万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-15 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10646226
• 关键词: Acceleration; Address; Adoption; Adult; Anatomy; Angioplasty; Area; Arrhythmia; Biopsy; Blood Vessels; Cardiac; Cardiac Catheterization Procedures; Cardiovascular system; Catheterization; Catheters; Child; Childhood; Clinical; Clinical Data; Complex; Contrast Media; Data; Data Collection; Device Designs; Devices; Diagnostic; Drainage procedure; Evaluation; Event; Fluoroscopy; Genetic Complementation Test; Goals; Heart; Heating; Image; Image Analysis; Imaging Device; Imaging Techniques; In Vitro; Intervention; Interventional Imaging; Ionizing radiation; Magnetic Resonance Imaging; Measures; Methods; Motion; Noise; Outcome; Performance; Phase; Positioning Attribute; Predisposition; Procedures; Radiation; Research; Resolution; Roentgen Rays; Sampling; Signal Transduction; Stenosis; Stents; Techniques; Testing; Time; Visual; Visualization; Work; anatomic imaging; clinical imaging; data acquisition; data space; design; diagnostic catheterization; experience; experimental study; first-in-human; hemodynamics; image guided; image reconstruction; implantable device; improved; in silico; in vivo; minimally invasive; novel; novel strategies; patient population; pediatric cardiologist; pediatric patients; real-time images; soft tissue; spatiotemporal; success

Project Summary Cardiovascular catheterization is a minimally-invasive approach to measure hemodynamics and treat abnormalities, such as vascular stenosis. Conventionally, X-ray fluoroscopy guides catheterizations, but it uses ionizing radiation and suffers from poor soft tissue contrast even with the use of exogenous contrast agents. This is problematic in children as they are particularly susceptible to radiation, often require repeat assessments, and can have complex anatomy that is difficult to navigate. MRI guidance provides a non- ionizing alternative that can improve soft tissue contrast and enhance evaluations. In addition to guiding diagnostic catheterization, first-in-human studies 15 years ago demonstrated that MRI could guide cardiac interventions such as coarctation angioplasty. However, clinical adoption since then has been limited by 1) few MRI-safe interventional devices and 2) the relatively poor real-time MRI image quality available during procedures. The number of MRI-safe devices is increasing, and low-field MRI has emerged as a new way to significantly reduce device heating. Yet, poor real-time image quality remains a significant barrier. Despite parallel imaging and accelerated image reconstructions, image quality is constrained by the limited set of MRI samples available for image reconstruction in a single-shot, real-time acquisition. The solution: This proposal aims to leverage multi-beat information to improve real-time MRI image quality during pediatric interventions. The goal is to improve image quality by increasing data available for image reconstruction and improve device visualization by highlighting motion between beats. The central hypothesis is that, in the interventional setting, multi-beat information will improve real-time MRI image quality and device visualization, leading to improved operator confidence and performance. To test this hypothesis, multi-beat’s impact on interventional image quality (Aim 1), impact on device visualization (Aim 2), and clinical utility in pediatric patients (Aim 3) are evaluated. The proposal is supported by a team that includes pediatric cardiologists at the forefront of MRI-guided interventions and prior research experience developing a closed- loop MRI data collection technique which robustly identifies similar heartbeats. The platform was originally designed for a different application – improving non-interventional MRI imaging of adults with arrythmia. Here, it is adapted to explore a new imaging paradigm (interventional imaging) in a new patient population (pediatric patients) for the PI. The work is expected to establish a new approach for real-time MRI-guided cardiovascular interventions by addressing the areas that currently limit image guided confidence: poor anatomic and device visualization. Success would not only improve MRI guidance of cardiovascular interventions in children but also create new opportunities for MRI guidance of cardiovascular and non-cardiovascular (biopsy, drainage, thermal therapy) procedures for adults.

项目摘要 心血管导管插入术是一种测量血液动力学和治疗的最小侵入性方法 异常，例如血管狭窄。从传统上，X射线荧光镜指导导管，但它使用 电离辐射和软组织不良遭受对比，即使使用外源性对比剂。 这在儿童中特别容易受到辐射的影响，这是有问题的，通常需要重复 评估，并且可能很难进行复杂的解剖结构。 MRI指南提供了非 电离替代方案可以改善软组织对比度并增强评估。除了指导 诊断导管插入术，15年前的首次人类研究表明，MRI可以指导心脏 干预措施，例如缩短血管成形术。但是，从那以后的临床采用受到限制1）很少 MRI-SAFE介入设备和2）可用的相对差的实时MRI图像质量 程序。 MRI-SAFE设备的数量正在增加，低场MRI已成为一种新方法 显着降低设备加热。但是，实时图像质量差仍然是一个重大障碍。尽管 平行成像和加速图像重建，图像质量受到有限的MRI的限制 单次实时获取的样品可用于图像重建。 解决方案：该提案旨在利用多基础信息来改善实时MRI图像 小儿干预期间的质量。目标是通过增加可用数据来提高图像质量 图像重建并通过突出节拍之间的运动来改善设备可视化。中央 假设是，在介入的环境中，多基础信息将改善实时MRI图像质量 和设备可视化，从而提高了操作员的信心和性能。为了检验这一假设， 多基础对介入图像质量的影响（AIM 1），对设备可视化的影响（AIM 2）和临床 评估小儿患者的效用（AIM 3）。该提案得到包括小儿在内的团队的支持 心脏病专家处于MRI引导干预措施和先前的研究经验的最前沿 循环MRI数据收集技术，可稳健地识别类似的心跳。该平台最初是 专为不同的应用而设计 - 改善了患有雅利氏病的成年人的非差异MRI成像。这里， 它适应了新的患者人群中的新成像范式（介入成像）（小儿 患者）pi。预计这项工作将建立一种新的方法，用于实时MRI引导的心血管 通过解决当前限制图像指导信心的区域的干预措施：解剖和设备差 可视化。成功不仅会改善儿童心血管干预措施的MRI指导，还会改善 还为心血管和非心血管的MRI指导创造了新的机会（活检，排水，， 成人的热疗法）。