Three-Dimensional Multi-Parametric Ultrasound for Monitoring Therapy of Liver Metastasis

三维多参数超声监测肝转移治疗

• 批准号: 10299426
• 负责人: Ahmed El Kaffas
• 金额: $ 69.33万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10299426
• 关键词: 3-Dimensional; 3D ultrasound; Abdomen; Address; Anatomy; Biological Markers; Blood Vessels; Cancer Patient; Cessation of life; Clinical; Clinical Trials; Clinical assessments; Collaborations; Colorectal; Computer software; Contrast Media; Data; Development; Disease; Early treatment; Evaluation; Foundations; Functional Imaging; Future; Goals; Grant; Healthcare; Image; Imaging Techniques; Industry; Inflammatory Response; Interobserver Variability; Lesion; Liver; Liver neoplasms; Malignant Neoplasms; Measurement; Metastatic Neoplasm to the Liver; Methods; Modality; Monitor; Morbidity - disease rate; Motion; Multi-Institutional Clinical Trial; Organ; Outcome; Patient Care; Patient Monitoring; Patients; Perfusion; Phase; Prediction of Response to Therapy; Radiation; Radiology Specialty; Reporting; Reproducibility; Research Project Grants; Resources; Sampling Errors; Savings; Scanning; Site; Spectrum Analysis; Survival Rate; System; Techniques; Technology; Therapeutic; Three-Dimensional Imaging; Tissue imaging; Tissues; Transducers; Tumor Volume; Ultrasonography; Validation; Vendor; Work; anatomic imaging; base; cancer imaging; cancer therapy; cancer type; chemotherapy; clinical application; clinical care; clinical center; clinical research site; colorectal cancer metastasis; contrast enhanced; cost; data acquisition; design; effective therapy; experience; imaging approach; improved; improved outcome; industry partner; innovation; liver visualization; metastatic colorectal; novel; novel marker; patient response; portability; quantitative ultrasound; response; side effect; success; tool; treatment response; tumor; tumor heterogeneity

PROJECT SUMMARY/ABSTRACT The ability to non-invasively predict or monitor early patient response to cancer therapy will have significant implications for patient care with the potential to spare non-responding patients the high morbidity and cost associated with failed treatments. Due to its wide accessibility, lack of radiation, relatively low cost, and excellent visualization of the liver, ultrasound is a demonstrated and potentially ideal modality to repeatedly image and monitor patient responses over the course of therapy. In the first phase of this work, we demonstrated that current 2D dynamic contrast-enhanced ultrasound (DCE-US) is fundamentally limited in quantification due to tumor heterogeneities, resulting in consecutive sampling errors with substantial over- or underestimation of treatment response in patients. We then showed that these limitations could be overcome by a novel 3D DCE-US imaging approach using innovative matrix array transducer technology to provide motion-compensated, accurate quantitative and volumetric assessment of tissue perfusion of liver metastases. In this competitive renewal proposal, framed as an industry-academic partnership with Philips who is committed to our proposal, our aim to clinically advance 3D multi-parametric tissue and perfusion characterization with ultrasound (3D MPUS) to predict or monitor early response in patients with metastatic colorectal cancers to the liver (mCRC). For this, we have proposed a set of specific aims where we will: i) work with Philips to enhance 3D DCE-US data acquisition to overcome previously reported limitations, enable simultaneous acquisition of raw RF/Bmode data for tissue characterization, and develop an analysis software suite for MPUS quantification, ii) carry-out a multi-site clinical feasibility, acquisition repeatability and quantification reproducibility assessment of 3D MPUS in 300 patients, and iii) determine whether 3D MPUS quantification can predict or monitor early therapy response. For this, baseline and early changes of tumor perfusion and tissue parameters (obtained before and at 2-3 weeks after initiation of therapy) will be correlated to treatment response. Treatment response as defined on abdominal radiological scans acquired at 2 months following treatment initiation will be determined using standard RECIST 1.1 reporting. Our proposal builds on the recent FDA approval of ultrasound contrast agents for liver tumor imaging, increased clinical availability of commercial 3D US abdominal probes, and our initial clinical validation of 3D DCE-US and extensive experiences in QUS.

项目概要/摘要 非侵入性预测或监测早期患者对癌症治疗的反应的能力将具有重大意义 对患者护理的影响，有可能使无反应的患者避免高发病率和高成本 与治疗失败有关。由于其交通方便、无辐射、成本相对较低， 肝脏的可视化效果极佳，超声是一种经过验证且可能是理想的反复检查方式 在治疗过程中对患者的反应进行成像并监测。在这项工作的第一阶段，我们 证明当前的 2D 动态对比增强超声 (DCE-US) 从根本上限制在 由于肿瘤异质性导致的定量，导致连续采样误差，严重超量或超量 低估患者的治疗反应。然后我们证明这些限制是可以克服的 通过新颖的 3D DCE-US 成像方法，使用创新的矩阵阵列换能器技术来提供 对肝转移组织灌注进行运动补偿、准确的定量和体积评估。 在这个竞争性更新提案中，与飞利浦建立了行业学术合作伙伴关系，飞利浦 致力于我们的提案，我们的目标是在临床上推进 3D 多参数组织和灌注 通过超声 (3D MPUS) 表征来预测或监测转移性患者的早期反应 结直肠癌至肝癌 (mCRC)。为此，我们提出了一系列具体目标，我们将： i) 努力 与飞利浦合作增强 3D DCE-US 数据采集，以克服之前报告的限制，使 同时采集原始 RF/B 模式数据以进行组织表征，并开发分析软件 MPUS 量化套件，ii) 进行多地点临床可行性、采集重复性和 对 300 名患者进行 3D MPUS 的量化再现性评估，以及 iii) 确定 3D MPUS 是否 量化可以预测或监测早期治疗反应。为此，肿瘤的基线和早期变化 灌注和组织参数（在治疗开始前和治疗开始后 2-3 周获得）将相关 对治疗反应。根据 2 个月时获得的腹部放射扫描定义的治疗反应 治疗开始后的时间将使用标准 RECIST 1.1 报告来确定。我们的建议建立在 最近 FDA 批准超声造影剂用于肝脏肿瘤成像，增加了临床可用性 商业 3D US 腹部探头，以及我们对 3D DCE-US 和广泛的初步临床验证 QUS 的经验。