Tongue muscle function after cancer surgery using 4D MRI, DTI, and MR tagging

使用 4D MRI、DTI 和 MR 标记评估癌症手术后的舌肌功能

• 批准号: 8943325
• 负责人: Jerry L Prince
• 金额: $ 34.73万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-07 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8943325
• 关键词: 4D MRI; Acoustics; Address; Aftercare; Algorithms; Anatomy; Behavior; Cancer Survivor; Cine Magnetic Resonance Imaging; Complex; Data; Data Analyses; Death Rate; Deglutition; Diagnosis; Diffusion; Diffusion Magnetic Resonance Imaging; Disease; Excision; Fatigue; Fiber; Financial compensation; Future; Geometry; Glossectomy; Heart; Human Papillomavirus; Hydromorphone; Image; Image Analysis; Incidence; Investigation; Learning; Life; Magnetic Resonance Imaging; Malignant Neoplasms; Measurement; Measures; Meta-Analysis; Methods; Modeling; Morbidity - disease rate; Motion; Movement; Muscle; Muscle Fibers; Muscle function; National Cancer Institute; Operative Surgical Procedures; Oral cavity; Outcome; Outcome Measure; Patients; Pattern; Population; Quality of life; Radiation therapy; Reporting; Research; Resolution; Rest; Series; Side; Skeletal Muscle; Sleep Apnea Syndromes; Speech; Speech Intelligibility; Speech Therapy; Staging; Surface; Surgeon; Surgical Flaps; Techniques; Technology; Time; Tissues; Tongue; Tongue Neoplasms; Transplantation; Work; cancer surgery; cancer therapy; effective therapy; image processing; improved; in vivo; malignant mouth neoplasm; malignant tongue neoplasm; novel; programs; public health relevance; restraint; tumor; two-dimensional

 DESCRIPTION (provided by applicant): The National Cancer Institute estimates that over 42,000 people will be diagnosed with oral cancer and over 8,000 will die from this disease in 2014. Although these rates are low in comparison to many other cancers, unlike most other cancers the incidence of oral cancers-especially the human papillomavirus (HPV)-positive cancers-has been increasing. By some estimates there is as much as a five-fold increase in oral cancers just over the past decade. In the case of tongue cancer treatment through glossectomy (the surgical removal of part of the tongue including the cancer), which we focus on here, there is often significant post-treatment morbidity including difficulties in speech and swallowing and sleep apnea. Research connecting the tumor size and type of glossectomy surgery with tongue movement in speech after surgery has been ongoing for a number of years. These studies, most of which involve acoustic and speech intelligibility outcome measures, are beginning to reveal principles that can inform clinicians in developing optimal treatments. But very little information has been available relating tongue motion itself as an outcome, and when this is reported it almost exclusively reports measures derived from measurement of motion of the tongue surface, not its internal muscles. With advancements in technology we now have the opportunity to study the detailed patterns of tongue muscle motions in both normal controls and patients. By simultaneously analyzing data from cine magnetic resonance images, tagged magnetic resonance images, and diffusion magnetic resonance images, we will be able to observe patterns of activation throughout the tongue-observing and measuring a new type of functional connectivity-in order to better understand how patients compensate for muscle loss due to glossectomy. Specifically, we will: 1) Optimize acquisition of diffusion MRI imaging of in vivo tongue muscles; 2) Establish strain measures in the line of action of tongue muscle fibers using in vivo tagged MRI and diffusion MRI; 3) Develop models of functional connectivity in the tongue during speech; and 4) Assess tongue strategies in post-glossectomy speech. The ability of muscle fibers to create strain is crucial in the function of any muscle, but it is has not been possible to study this relationship in vivo in the past due to imaging constraints. The present research will enable simultaneous in vivo analysis in the complex muscle geometry of the tongue, a muscular hydrostat, possible for the first time. Through optimization of existing methods-both imaging and image analysis-we will enable a novel capability for the assessment of surgical outcomes in tongue cancer surgery. The study to be carried out on a spectrum of tongue cancer survivors will provide key information about the impact of tongue cancer treatment on speech, in order that significant morbidity might be avoided by modifying surgical practice or by engaging in specific speech therapies after surgery.

 DESCRIPTION (provided by applicable): The National Cancer Institute estimates that over 42,000 people will be diagnosed with oral cancer and over 8,000 will die from this disease in 2014. Although these rates are low in comparison to many other cancers, unlike most other cancers the incident of oral cancers-especially the human papillomavirus (HPV)-positive cancers-has were increasing.据某些估计，在舌癌治疗的情况下（手术清除了部分舌头在内的舌头包括癌症），我们将重点关注的是五倍，在这里，治疗后的发病率通常很大，包括言语和吞咽和睡眠呼吸暂停。将肿瘤大小和类型的八切除术手术与舌头运动相关的研究已经进行了多年。这些研究涉及声学和语音可理解性结果指标，它们开始揭示可以为临床医生开发最佳治疗的原则。但是，很少有信息将舌头运动本身作为结果，当报道舌头时，它几乎只报告了舌头运动的测量而不是其内部肌肉而得出的测量。随着技术的进步，我们现在有机会研究正常对照和患者中舌头肌肉运动的详细模式。通过简单地分析来自Cine磁共振图像，标记的磁共振图像和扩散磁共振图像的数据，我们将能够在整个舌头观察过程中观察到激活模式，并测量一种新型的功能连接性连接序列，以更好地了解患者如何赔偿因格洛治术而造成的肌肉损失。具体而言，我们将：1）优化体内舌肌的扩散MRI成像的获取； 2）使用体内标记的MRI和扩散MRI在舌肌纤维的作用线中建立应变度量； 3）在语音期间发展舌头功能连通性的模型； 4）评估舌后切除术言语中的舌头策略。肌肉纤维产生菌株的能力在任何肌肉的功能上都是至关重要的，但是由于成像限制，过去不可能在体内研究这种关系。本研究将使舌头复杂的肌肉几何形状（肌肉氢化体）首次实现简单的体内分析。通过优化现有方法和图像分析，我们将有能力评估舌癌手术中的手术结局。这项研究将在一系列舌癌存活中进行，将提供有关舌癌治疗对言语的影响的关键信息，以便通过修改手术实践或通过手术后进行特定的语音疗法来避免明显的发病率。