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

项目总结 植入胎盘谱系(PAS)障碍是指胎盘不能部分分离的情况 或完全从子宫壁取出，导致严重的产中产妇发病率和分娩时的死亡率。 根据胎盘侵入周围组织的程度，子宫切除术可能是挽救生命的方法。 分娩前对PAS严重程度的评估对于多学科手术计划和患者至关重要 心理咨询。然而，临床上对异常的定量、客观测量的需求仍未得到满足。 胎盘位置可作为侵袭和子宫切除风险的预测指标。建议的总体目标是 该项目是使用定量多参数前瞻性评估妊娠期高危妇女的PAS 磁共振(MR)成像和自动纹理放射组学，并将所见与外科手术相关联 结果。 来自化学、生物和物理先生的高度跨学科背景， 应聘者的长期职业目标是成为一名拥有深入知识和技能的独立调查员 进行转译胎盘成像研究。候选人的短期目标是完成一项试验 在跨学科咨询委员会的指导下评估高危女性PAS的研究 使用多参数磁共振成像和纹理放射组学进行妊娠。 为了达到这些目标，提出了以下研究目标：1)评估胎盘侵袭性 使用多参数磁共振成像和基于深度学习的新型量化工具在PAS高分辨率成像中的妊娠 高危妊娠，以及2)提取高危PAS胎盘的整个妊娠期的放射学模式，并确定 它与临床手术结果的关系。这些研究目标将作为职业生涯的平台 发展计划和培训目标包括：1)获得翻译前瞻性研究方面的知识 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)在培训期间发展指导和领导技能。 研究和培训目标将共同为以下方面提供培训、经验和初步数据 一个R01应用程序。未来的R01将为高危患者开发临床和手术结果预测模型 PAS怀孕，有可能改善孕产妇和胎儿的结局。培训将使应聘者达到 成为翻译胎盘成像研究领域的领导者。

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.