Ultrasensitive Doppler Ultrasound for Evaluation of Rheumatoid Arthritis

超灵敏多普勒超声评估类风湿关节炎

• 批准号: 10659056
• 负责人: Shigao Chen
• 金额: $ 20.99万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-10 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10659056
• 关键词: 3-Dimensional; Affect; Agreement; Algorithms; American; Area; Autoimmune Diseases; Benchmarking; Blood Vessels; Brain; Chronic; Clinical; Clinical Management; Clinical Research; Data; Decision Making; Dependence; Detection; Diagnosis; Disease; Disease remission; Doppler Ultrasound; Evaluation; Follow-Up Studies; Frequencies; Gadolinium; Guidelines; Hand; Image; Imaging technology; Inflammatory; Ionizing radiation; Joints; Magnetic Resonance Imaging; Measures; Methods; Morphologic artifacts; Motor; Movement; Noise; Patients; Penetration; Physiologic pulse; Pilot Projects; Process; Radiation; Reference Standards; Reproducibility; Rheumatoid Arthritis; Safety; Scanning; Scheme; Synovitis; System; Technology; Testing; Therapeutic; Three-Dimensional Imaging; Time; Training; Transducers; Translations; Ultrasonic wave; Ultrasonography; Validation; Wrist; arthropathies; care costs; contrast enhanced; contrast imaging; cost; cost effective; density; improved; in vivo; indexing; novel; quantitative ultrasound; radiological imaging; signal processing; ultrasound

PROJECT SUMMARY Rheumatoid arthritis (RA) is an autoimmune disorder of the joint affecting 1.3 million Americans, with an estimated annual care cost of 41.6 billion in the USA. Clinical management of RA requires regular assessment of synovial inflammation to guide therapy. Clinical scores of RA, radiography, and contrast-enhanced MRI are limited by low sensitivity, radiation safety, and cost, respectively. Doppler ultrasound is used clinically for synovitis evaluation, but has low sensitivity for microvessel detection (which may lead to underdiagnosis) and is operator dependent. Therefore, more advanced ultrasound Doppler technologies are critically needed for safe, cost-effective, and accurate evaluation of RA. Here we propose a novel 3D High-sensitivity Ultrasound Microvessel Imaging (HUMI) technology for more accurate and comprehensive evaluation of synovitis with less operator dependency. High frequency (14-39 MHz) plane wave imaging is combined with advanced processing algorithms to detect microvessels with high sensitivity. 3D imaging is achieved by automatic translation of the 1D linear array transducer in its elevational direction using a compact step motor. Preliminary in vivo studies show that HUMI is much more sensitive than state-of-the-art commercial Doppler and can clearly detect synovial microvessels in 3D. Aim 1: Develop and optimize HUMI for joint imaging. We will further develop and optimize 3D-HUMI on several transducers for in vivo joint imaging using phantom and patient studies. Acquisition parameters such as ultrasound frequency, pulse repetition frequency (PRF), Doppler packet size, and step motor movement scheme for 3D imaging will be optimized to maximize microvessel imaging sensitivity and penetration. Advanced signal processing algorithms including local SVD and coherent SVD will be used to improves microvessel imaging contrast and suppress noise and artifacts. 3.3 Aim 2: Patient study. The HUMI optimized in Aim 1 will be used to image 40 RA patients to study its efficacy for synovitis evaluation. Hand joints will be scanned with 3D-HUMI by two sonographers to study its reproducibility. The same joints will be imaged using both Doppler and Micro Vascular Imaging mode on the GE Logiq E10 for benchmarking. Contrast-enhanced MRI will be used as the reference standard. Common clinical scores of RA will be used as secondary validations. Synovitis of each joint will be scored as 0 (normal), 1 (mild), 2 (moderate), and 3 (severe) for MRI and ultrasound images. Intraclass correlation coefficients (ICC) will be used to evaluate inter-sonographer reproducibility and the agreement between each of the ultrasound methods with MRI. Pearson correlation will also be performed to assess the association of ultrasound scores with RA clinical scores. Similar analyses will be performed to assess the association of quantitative ultrasound parameters (such as total area of microvessels and vessel density) with MRI and clinical scores.

项目摘要 类风湿关节炎（RA）是影响130万美国人的关节自身免疫性疾病， 估计在美国，年度护理费用为416亿。 RA的临床管理需要定期评估 滑膜炎症以指导治疗。 RA，X射线照相和对比度增强MRI的临床评分为 分别受低灵敏度，辐射安全性和成本的限制。多普勒超声在临床上用于 滑膜炎评估，但对微血管检测的灵敏度较低（可能导致诊断不足）和 是依赖运营商的。因此，更高级的超声多普勒技术非常需要 安全，成本效益且准确的RA评估。 在这里，我们提出了一种新颖的3D高敏性超声微血管成像（HUMI）技术，以进行更多 与操作员依赖性较小的滑膜炎的准确和全面评估。高频（14-39 MHz）平面波成像与高级处理算法结合 灵敏度。 3D成像是通过自动翻译1D线性阵列换能器在其高度上实现的 使用紧凑的台阶电机方向。初步体内研究表明，Humi比 最先进的商业多普勒，可以清楚地检测到3D中的滑膜微血管。 目标1：开发并优化HUMI用于关节成像。我们将进一步开发并优化3D-HUMI 使用幻影和患者研究的几种用于体内关节成像的换能器。采集参数，例如 超声频率，脉冲重复频率（PRF），多普勒数据包大小和阶梯运动运动 将优化3D成像的方案，以最大程度地提高微血管成像的灵敏度和穿透性。 高级信号处理算法（包括本地SVD和相干SVD）将用于改进 微血管成像对比度并抑制噪声和伪影。 3.3 AIM 2：患者研究。 AIM 1中优化的HUMI将用于对40名RA患者进行成像，以研究其 滑膜炎评估的功效。两名超声检查员将用3D-HUMI扫描手部关节，以研究其 可重复性。使用多普勒和微血管成像模式将成像相同的关节 GE Logiq E10用于基准测试。对比增强的MRI将用作参考标准。常见的 RA的临床评分将用作辅助验证。每个关节的滑膜炎将评分为0（正常）， MRI和超声图像的1（轻度），2（中度）和3（严重）。类内相关系数（ICC） 将用于评估监察员的可重复性和每个超声之间的一致性 MRI的方法。还将进行皮尔逊相关性以评估超声分数的关联 RA临床分数。将进行类似的分析以评估定量超声的关联 具有MRI和临床评分的参数（例如微血管和血管密度的总面积）。