Accurate DCE-MRI Measurement of Glioblastoma using Point-of-care Portable Perfusion Phantom

使用护理点便携式灌注模型准确测量胶质母细胞瘤

• 批准号: 10377323
• 负责人: Harrison Kim
• 金额: $ 7.43万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10377323
• 关键词: Adjuvant; Blood - brain barrier anatomy; Brain Diseases; Brain Pathology; Clinical; Collaborations; Contrast Media; Data; Disease; Enhancing Lesion; Error Sources; Evaluation; Glioblastoma; Goals; Image; Inflammatory; Institutes; Ischemic Stroke; Magnetic Resonance Imaging; Measurement; Measures; Monitor; Morphologic artifacts; Multi-Institutional Clinical Trial; Multiple Sclerosis; Names; Neoplasms; Outcome; Patient Care; Patients; Perfusion; Pilot Projects; Predisposition; Prognosis; Reaction; Recurrence; Reproducibility; Research Personnel; Risk Assessment; Schizophrenia; System; Techniques; Technology; Testing; Time; Tissues; Toxic effect; Trauma; Variant; base; blood perfusion; blood-brain barrier disruption; blood-brain barrier permeabilization; chemoradiation; chemotherapy; contrast enhanced; effective therapy; human tissue; improved; ineffective therapies; irradiation; neoplastic; neuro-oncology; optimal treatments; point of care; portability; quality assurance; recruit; response; risk stratification; treatment optimization; treatment response; tumor

PROJECT SUMMARY / ABSTRACT The goal of this R03 study is to conduct a pilot study testing whether the variability in quantitative DCE- MRI measurement of glioblastoma across different scanners will be significantly reduced when the UAB-invented perfusion phantom, P4 (Point-of-care Portable Perfusion Phantom), is used for error correction, leading to better differentiation between pseudo-progression and true-progression. This is an essential step before validating the utility of P4 in an extended multi-site clinical trial. Pseudo-progression is known to be associated with better clinical outcomes, thus pseudo-progression mistaken for true-progression may result in discontinuation of an effective therapy. Pseudo-progression is a local inflammatory reaction caused by irradiation and enhanced by concurrent chemotherapy, which leads to transient increase of blood brain barrier (BBB) permeability. The BBB, however, is also disrupted by neoplasm, thus both pseudo- and true-progressions appear with increased contrast enhancement in MRI, and there are no established techniques to differentiate between them. The contrast- enhancing lesions of pseudo-progression are due to inflammatory BBB disruption, whereas those of true- progression are caused by neoplastic BBB disruption. Thus, true-progression typically presents higher perfusion than pseudo-progression does. DCE-MRI has the potential to differentiate between pseudo- and true- progressions of glioblastoma, as it can assess the blood perfusion with minimal susceptibility artifacts, but the measurement variability remains a major concern. The P4 is small enough to be imaged concurrently in the bore of a standard MRI scanner with a patient, serving as an internal reference to measure and compensate the scanner-dependent variation in quantitating perfusion parameters. The P4 successfully reduces the variability in DCE-MRI measurement of various human tissues in our previous studies. We now hypothesize that the variability in quantitative DCE-MRI measurement of glioblastoma across different scanners will also be significantly reduced when MRI system-driven error is corrected using the P4. In this study, a total of 12 patients with a newly (or enlarged) enhancing glioblastoma after adjuvant chemoradiation therapy will be recruited. Each patient will be imaged with two different 3T MRI scanners within a 3-day period, and the two DCE-MRI measurements will be compared to determine the data reproducibility before and after P4-based error correction and to validate the utility of the P4 for accurate quantitative DCE-MRI measurement of glioblastoma. Also it will be examined whether the differentiation between pseudo- and true-progressions of glioblastoma can be improved in quantitative DCE-MRI measurement when the P4 is used for error correction.

项目摘要/摘要 这项R03研究的目标是进行一项先导性研究，测试定量DCE- 当UAB发明后，不同扫描仪对胶质母细胞瘤的MRI测量将显著减少 灌注模体P4(Point-of-Care便携式灌流模体)用于纠错，从而获得更好的效果 伪级数与真级数的区别。这是在验证 P4在一项扩展的多点临床试验中的应用众所周知，伪级数与更好的 临床结果，因此被错误地认为是真进展的假进展可能导致一种 有效的治疗。假性进展是一种局部炎症反应，由辐射引起，并由 同时化疗，导致血脑屏障(BBB)通透性一过性增加。BBB， 然而，肿瘤也破坏了肿瘤，因此假性和真性进展都出现了增强的对比度。 MRI中的增强，并且没有确定的技术来区分它们。与之相反的是- 假性进展的增强性损害是由于炎性血脑屏障的破坏，而真性进展的损害是由于炎性的BBB破坏。 进展是由肿瘤性血脑屏障破坏引起的。因此，真正的进展通常表现为更高的血流灌注。 而不是伪级数。DCE-MRI有可能区分假性和真性- 胶质母细胞瘤的进展，因为它可以用最小的敏感伪影来评估血液灌流，但 测量的可变性仍然是一个主要问题。P4足够小，可以同时在 标准磁共振扫描仪与患者的内径，用作测量和补偿 定量灌注参数的依赖于扫描仪的变异。P4成功地降低了变异性 在我们之前的研究中，我们对各种人体组织进行了DCE-MRI测量。我们现在假设 不同扫描仪对胶质母细胞瘤DCE-MRI定量测量的可变性也将 当使用P4纠正MRI系统驱动的错误时，显著降低。在这项研究中，共有12名患者 随着新的(或扩大的)增强的胶质母细胞瘤后，辅助化疗和放射治疗将被招募。每个人 患者将在3天内接受两种不同的3T磁共振成像，以及两种DCE-MRI 将对测量结果进行比较，以确定基于P4的纠错前后的数据再现性 并验证P4在胶质母细胞瘤DCE-MRI准确定量测量中的应用价值。它也会 是否可以区分假性和真性进展的胶质母细胞瘤 当P4用于纠错时，改进了定量DCE-MRI测量。