Development of a combined ARFI/SWEI ultrasound elasticity imaging system for targeted prostate biopsy guidance

开发用于靶向前列腺活检引导的组合 ARFI/SWEI 超声弹性成像系统

• 批准号: 10580038
• 负责人: Derek Yu Xuan Chan
• 金额: $ 1.6万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-01 至 2023-05-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10580038
• 关键词: 3-Dimensional; 3D ultrasound; Acoustics; Algorithms; Anatomy; Appearance; Benign; Biopsy; Cancer Detection; Cancer Etiology; Cessation of life; Clinic; Clinic Visits; Clinical; Contrast Media; Core Biopsy; Custom; Data; Development; Diagnosis; Diagnostic Sensitivity; Disease; Early Diagnosis; Elasticity; Elements; Geometry; Gland; Goals; Guidelines; Health Care Costs; Heating; Human; Image; Imaging Techniques; In Vitro; Location; Magnetic Resonance Imaging; Malignant Neoplasms; Malignant neoplasm of prostate; Maps; Measures; Methods; Microbubbles; Modality; Modeling; Morphologic artifacts; Nature; PSA level; Patients; Penetration; Performance; Predisposition; Procedures; Prostate; Radiation; Radical Prostatectomy; Recommendation; Rectum; Research; Resolution; Risk; Sampling; Screening for Prostate Cancer; Serum; Signal Transduction; Speed; Staging; System; Techniques; Three-Dimensional Imaging; Time; Tissues; Transducers; Transrectal Ultrasound; Ultrasonics; Ultrasonography; United States; Work; accurate diagnosis; advanced system; attenuation; clinic ready; clinically significant; contrast enhanced; cost; design; diagnostic accuracy; diagnostic tool; digital; effective therapy; elastography; human subject; image guided; image reconstruction; imaging modality; imaging system; improved; in vivo; in vivo imaging system; insight; men; portability; prostate biopsy; rectal; research clinical testing; signal processing; simulation; standard of care; tool; ultrasound; validation studies; vector

ABSTRACT Prostate cancer is the most common cancer among men in the United States, and early detection is crucial for effective treatment or management. Following an initial screening for prostate cancer based on elevated prostate-specific antigen (PSA) levels or suspicious digital rectal exam, the current clinical standard of care for diagnosis is a transrectal ultrasound (TRUS)-guided biopsy, in which 10 to 12 systematically sampled cores are taken and examined. Because the TRUS procedure is guided by conventional B-mode ultrasound imaging, in which prostate cancer does not typically have a unique appearance, the biopsy cores are sampled from a predetermined grid of locations throughout the gland, and are not specifically targeted to cancer-suspicious regions. As a result, there is often a need for repeat biopsies when the first biopsy fails to detect cancer. Recent studies have demonstrated the ability of alternative imaging modalities, such as multiparametric MRI (mpMRI) or contrast-enhanced ultrasound (CEUS), to provide imaging guidance for a targeted prostate biopsy. These techniques have drawbacks, however, including challenges with registering the mpMRI volume with the real- time B-mode ultrasound image during the biopsy, or the need to inject microbubble contrast agents into the patient’s vasculature for CEUS imaging. The goal of this proposal is to develop a low-cost, clinic-ready 3D ultrasound elasticity imaging system to guide a targeted biopsy that is specific for clinically significant disease in the prostate. Previous work has demonstrated that prostate cancer is stiffer than the surrounding healthy tissue and can thus be imaged using ultrasonic acoustic radiation force-based techniques. The proposed system will simultaneously acquire two elasticity imaging modes: acoustic radiation force impulse (ARFI) imaging and shear wave elasticity imaging (SWEI), in order to create high-resolution, quantitative stiffness maps of the prostate. I hypothesize that using combined 3D ARFI/SWEI prostate volumes to guide a targeted biopsy for prostate cancer will result in improved diagnostic sensitivity and staging accuracy compared to current transrectal ultrasound standard-of-care biopsy. In this proposed work, I will develop advanced ARFI/SWEI reconstruction methods in order to examine the tradeoff between the number and intensity of acoustic radiation force excitations, transducer heating, and reconstructed image quality. In particular, I will use specialized finite-element simulation tools to compare different ultrasonic imaging sequences and implement these sequences on a state-of-the-art commercial ultrasound scanner. In order to evaluate these sequences in an in vitro setting, I will acquire combined ARFI/SWEI data in custom tissue-mimicking prostate anatomy phantoms. From here, I will assess the performance of the 3D ARFI/SWEI imaging system in a clinical setting, by using the system to obtain targeted biopsy cores in patients with suspected prostate cancer and comparing the diagnostic accuracy of the ultrasound targeting system with standard-of-care procedures.

抽象的 前列腺癌是美国男性中最常见的癌症，早期发现对于预防前列腺癌至关重要 基于升高的前列腺癌初步筛查后的有效治疗或管理。 前列腺特异性抗原（PSA）水平或可疑的直肠指检，目前的临床护理标准 诊断是经直肠超声 (TRUS) 引导的活检，其中 10 至 12 个系统采样的核心 因为 TRUS 手术是由传统的 B 型超声成像引导的。 对于这种癌症通常不具有独特的前列腺外观，活检核心是从 整个腺体中预先确定的位置网格，并且不是专门针对可疑癌症的 因此，当第一次活检未能检测到癌症时，通常需要重复活检。 研究已经证明了替代成像方式的能力，例如多参数 MRI (mpMRI) 或对比增强超声 (CEUS)，为靶向前列腺活检提供成像指导。 然而，这些技术也有缺点，包括将 mpMRI 体积与真实体积配准方面存在挑战。 活检过程中定时B超图像，或者需要向活检组织中注射微泡造影剂 该提案的目标是开发一种低成本、临床就绪的 3D 成像。 超声弹性成像系统可引导特定于临床意义的靶向活检 先前的研究表明，前列腺癌比周围的癌症更坚硬。 因此可以使用基于超声辐射力的技术对健康组织进行成像。 系统将同时获取两种弹性成像模式：声辐射力脉冲（ARFI）成像 和剪切波弹性成像 (SWEI)，以便创建高分辨率、定量的刚度图 我使用组合 3D ARFI/SWEI 前列腺体积来指导有针对性的活检。 与目前的经直肠癌相比，前列腺癌的诊断敏感性和分期准确性将得到提高 在这项拟议的工作中，我将开发先进的 ARFI/SWEI 重建。 方法来检查声辐射力激励的数量和强度之间的权衡， 特别是，我将使用专门的有限元模拟。 比较不同超声成像序列并在最先进的技术上实现这些序列的工具 为了在体外环境中评估这些序列，我将购买商用超声扫描仪。 结合 ARFI/SWEI 数据定制模拟组织前列腺解剖模型 从这里，我将评估 通过使用获得的系统来确定 3D ARFI/SWEI 成像系统在临床环境中的性能 对疑似前列腺癌患者进行活检并比较超声诊断的准确性 具有标准护理程序的瞄准系统。