Quantitative magnetic resonance imaging and automated textural radiomics for assessment of human placenta accreta spectrum

项目概要 侵入性胎盘 (PAS) 疾病是一种胎盘未能部分分离的病症 或完全来自子宫壁，导致产时产妇发病率和死亡率显着增加。 根据胎盘侵入周围组织的程度，子宫切除术可能会挽救生命。 分娩前评估 PAS 严重程度对于多学科手术计划和患者至关重要 咨询。然而，对异常的定量、客观测量的临床需求尚未得到满足。 胎盘植入可以作为侵袭和子宫切除术风险的预测因子。拟议的总体目标 该项目旨在使用定量多参数前瞻性评估高危女性妊娠期的 PAS 磁共振 (MR) 成像和自动纹理放射组学，并将结果与手术相关联 结果。 来自 MR 化学、生物学和物理学的高度跨学科背景， 候选人的长期职业目标是成为一名具有深入知识和技能的独立调查员 进行转化胎盘成像研究。候选人的短期目标是完成试点 在跨学科咨询委员会的指导下进行的研究，旨在评估高危女性的 PAS 使用多参数 MRI 和纹理放射组学进行妊娠。 为了实现这些目标，提出以下研究目标：1）评估胎盘侵袭 在 PAS 中使用多参数 MR 成像和基于深度学习的新型量化工具进行妊娠 风险妊娠，以及 2) 提取高风险 PAS 胎盘妊娠期间的放射组学模式并确定 其与临床手术结果的关系。这些研究目标将作为职业平台 发展计划和培训目标包括： 1) 获得转化前瞻性研究的知识 设计，2) 提高高级临床 MR 采集开发的技术技能，3) 采集应用 统计和数据分析技能，以及 4) 在培训期间培养指导和领导技能。 研究和培训目标共同为以下人员提供培训、经验和初步数据： R01 应用程序。未来R01将开发针对高风险的临床和手术结果预测模型 PAS 妊娠可能会改善孕产妇和胎儿的结局。培训将使候选人能够 成为转化胎盘成像研究的领导者。

PROJECT SUMMARY Placenta Accreta Spectrum (PAS) disorder is a condition in which the placenta fails to separate partially or totally from the uterine wall, resulting in significant intrapartum maternal morbidity and mortality at delivery. Depending on the extent of the placental invasion into surrounding tissue, hysterectomy may be lifesaving. Assessment of PAS severity prior to delivery is crucial for multidisciplinary surgical planning and patient counseling. However, there is an unmet clinical need for quantitative, objective measures of abnormal placentation that can serve as predictors of risk of invasion and hysterectomy. The overall goal of the proposed project is to prospectively assess PAS in high-risk women across gestation using quantitative multi-parametric magnetic resonance (MR) imaging and automated textural radiomics and to correlate findings with surgical outcomes. Coming from a highly interdisciplinary background of MR chemistry, biology, and physics, the candidate's long-term career goal is to become an independent investigator with in-depth knowledge and skills to conduct translational placental imaging research. The candidate's short-term goal is to complete a pilot study under the mentorship of an interdisciplinary advisory committee to evaluate PAS in women with high-risk pregnancies using multi-parametric MRI and textural radiomics. To meet these goals, the following research aims are proposed: 1) Evaluate placental invasion across gestation using multi-parametric MR imaging and deep learning based novel quantification tools in PAS high- risk pregnancies, and 2) Extract the radiomic pattern across gestation of high-risk PAS placenta and determine its association with clinical surgical outcome. These research aims will serve as the platform for the career development plan and training aims which include: 1) Gain knowledge in translational prospective research design, 2) Improve technical skills in advanced clinical MR acquisition development, 3) Acquire applied statistical and data analysis skills, and 4) Develop mentorship and leadership skills while under training. Together, the research and training aims will provide the training, experience and preliminary data for an R01 application. The future R01 will develop a clinical and surgical outcome prediction model for high-risk PAS pregnancies, potentially improving maternal and fetal outcomes. The training will position the candidate to become a leader in translational placental imaging research.