Towards intra-operative guidance in brain tumor surgery using real-time resting-state functional MRI

使用实时静息态功能 MRI 进行脑肿瘤手术的术中指导

基本信息

批准号：
10761498
负责人：
Clark Chin-Chung Chen
金额：
$ 37.82万
依托单位：
NEURINSIGHT, LLC
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-19 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10761498
关键词：
Anesthesia procedures Biometry Brain Brain Mapping Brain Neoplasms Clinical Clinical Trials Collaborations Complement Computer Workstations Consumption Custom Data Databases Equilibrium Evaluation Excision FDA approved Functional Magnetic Resonance Imaging Geometry Grant Head Movements Language Lesion Magnetic Resonance Magnetic Resonance Imaging Maps Methodology Minnesota Monitor Morphologic artifacts Motion Motor Nervous System Physiology Neuroanatomy Neurologic Neurosurgeon New Mexico Operative Surgical Procedures Patient Participation Patients Performance Phase Physiological Qualifying Quality Control Research Research Personnel Rest Scanning Sensitivity and Specificity Sensory Signal Transduction Slide Small Business Technology Transfer Research Software Tools Speed Statistical Data Interpretation System Technology Testing Time Tissues Validation analysis pipeline awake cerebrovascular connectome cortex mapping cost effective data quality deep learning design experience frontal lobe functional MRI scan functional disability high end computer minimally invasive neurovascular patient population preservation programs success technology validation tool tumor

项目摘要

Summary Resting-state functional MRI (rsfMRI) is a rapidly developing task-free approach for presurgical mapping. It can complement task-based functional MRI (tfMRI) in patients who have difficulties performing tasks and efficiently map resting state networks (RSNs) in regions that are not typically mapped with tfMRI due to time constraints, such as frontal cortex. It has the potential to provide iterative intra-operative guidance during progressive resection, enables connectome mapping in anesthetized patients, and holds promise for intra-operative guidance of minimally invasive surgery where intra-operative electrocortical mapping may not be possible. To achieve clinical acceptance, rsfMRI analysis needs to be highly tolerant to head movement, physiological signal pulsation, lesion-related changes of functional neuro-anatomy and cerebrovascular uncoupling; and provide data quality control metrics during the ongoing scan. Intra-operative guidance additionally requires automated online mapping of RSNs and tolerance to intra-operative brain shifts. There are currently no FDA-approved rsfMRI tools available for presurgical mapping. Here, we propose a fully automated, highly sensitive and cost-effective real-time rsfMRI analysis technology on a high-performance workstation for presurgical and intraoperative mapping. The project builds on TurboFIRE, a powerful real-time tfMRI and rsfMRI analysis software tool for high-speed fMRI, the success of a prior Phase I STTR study in 12 brain tumor patients that showed clinically acceptable concordance of real-time high-speed multi-echo rsfMRI with tfMRI, and intra-operative electrocortical stimulation (ECS); and our experience with intra-operative rsfMRI in anesthetized brain tumor patients. This technology provides online rsfMRI mapping, eliminating time-consuming postprocessing, and seamless integration into presurgical planning and intra-operative MRI. This methodology will have significant clinical and commercial potential for a wide range of neurological and psychiatric applications beyond pre-surgical mapping in patients with brain tumors. It opens up functional brain mapping to patient populations that have been difficult to study in the past.

概括静息态功能 MRI (rsfMRI) 是一种快速发展的无任务术前绘图方法。它可以对执行任务有困难的患者进行基于任务的功能性 MRI (tfMRI) 的补充在由于时间原因通常无法使用 tfMRI 进行映射的区域中有效地映射静息状态网络 (RSN) 限制，例如额叶皮层。它有可能在手术期间提供迭代的术中指导渐进式切除，能够在麻醉患者中进行连接组图谱分析，并有望微创手术的术中指导，其中术中皮层电图可能无法进行可能的。为了获得临床认可，rsfMRI 分析需要对头部运动具有高度耐受性，生理信号脉动、功能神经解剖学和脑血管的病变相关变化脱钩；并在持续扫描期间提供数据质量控制指标。术中指导此外还需要 RSN 的自动在线映射和对术中大脑变化的耐受性。目前尚无 FDA 批准的可用于术前绘图的 rsfMRI 工具。在这里，我们提出一个基于高性能的全自动、高灵敏度和经济高效的实时 rsfMRI 分析技术用于术前和术中绘图的工作站。该项目建立在 TurboFIRE 之上，这是一个强大的实时用于高速 fMRI 的 tfMRI 和 rsfMRI 分析软件工具，之前的 I 期 STTR 研究在 12 年取得成功实时高速多回波 rsfMRI 表现出临床可接受一致性的脑肿瘤患者 tfMRI 和术中皮层电刺激 (ECS)；以及我们在术中 rsfMRI 方面的经验在麻醉的脑肿瘤患者中。该技术提供在线 rsfMRI 映射，消除耗时的后处理，以及无缝集成到术前计划和术中 MRI 中。该方法将具有广泛的临床和商业潜力除了脑肿瘤患者的术前绘图之外，神经学和精神病学应用。它为过去难以研究的患者群体开辟了功能性大脑图谱。