Advancing MRI technology for early diagnosis of liver metastases

摘要 肝脏通常参与结直肠癌(CRC)的转移性疾病，并且了解 这些肿瘤的存在和位置影响治疗决定。在结直肠癌患者中， 肝转移瘤的手术或消融治疗可提高总体存活率。早期诊断 结直肠转移(即，虽然病变较小)有望通过以下方式改善治疗结果 增加可接受手术切除的受试者数量或通过确定受试者 早期，当非手术选择是一种替代治疗时。磁共振成像 (MRI)被认为是最有效的诊断和定性诊断方法 肝脏肿瘤。T2加权(T2w)和T1加权(T1w)图像。 一种格拉络合剂的应用和多时相动态增强 (DCE)-是用于检测和表征肝脏的基础采集 肿瘤。然而，在小病变的检测和特征方面仍然存在挑战 包括空间分辨率不足、部分体积效应、生理运动和 DCE成像中对比度到达时间的变化。在这种学术和产业合作关系中， 亚利桑那大学和西门子医疗解决方案公司的科学和工程团队 共同开发用于T2w/T2成像和DCE成像的强大的放射状MRI技术 改善对小肿瘤的检测和特征，目标是将 将这些技术应用到常规临床实践中。建议的工作是基于径向涡轮自旋- 回声技术由亚利桑那大学的研究小组开创，用于腹部成像和 用于DCE成像的连续采集的径向堆积星技术的具体目标 合作伙伴关系是：目标1：开发径向T2w采集和重建技术， 对肝脏进行有效的全覆盖以检测小肿瘤并对肿瘤进行准确的T2量化 人物刻画。目标2：实现一种自动导航的3D径向星堆技术 连续采集DCE数据，并对动态相位进行追溯重建。目标 3：对AIMS 1和AIMS 2的技术进行临床评估，对照传统的T2w 和DCE技术。目标4：通过以下方式简化将新的放射状方法应用于临床 开发一种计算效率高的重建管道。我们研究的终点包括 磁共振成像技术的进步，显著克服了目前肝脏磁共振成像的局限性 早期转移的诊断。我们希望我们的提案能带来技术改进。 这将提高转移性恶性肿瘤患者的护理精确度和预后 尤其是那些患有结直肠癌的人。

Abstract Liver is commonly involved in metastatic disease in colorectal cancer (CRC) and knowledge about the presence and location of these tumors affects treatment decisions. In patients with CRC, surgical or ablative treatment of liver metastases improves overall survival. Early diagnosis of colorectal metastases (i.e. while lesions are small) is expected to improve treatment outcomes by increasing the number of subjects that can undergo surgical resection or by identifying subjects early on, when non-surgical options are an alternative treatment. Magnetic Resonance Imaging (MRI) is regarded as the most effective imaging modality for the detection and characterization of liver neoplasms; T2-weighted (T2w) and T1-weighted (T1w) images - combined with administration of a gadolinium chelate agent and multi-phase dynamic contrast enhancement (DCE) - are the foundational acquisitions used for the detection and characterization of liver tumors. However, challenges remain for the detection and characterization of small lesions due to factors including inadequate spatial resolution, partial volume effects, physiological motion, and variations in timing of contrast arrival in DCE imaging. In this academic-industrial partnership the scientific and engineering teams at the University of Arizona and Siemens Medical Solutions are coming together to develop robust radial MRI techniques for T2w/T2 mapping and DCE imaging of the liver to improve detection and characterization of small tumors with the goal of bringing these techniques to routine clinical practice. The proposed work is based on a radial turbo spin- echo technique pioneered by the team at the University of Arizona for abdominal imaging and a radial stack-of-stars technique with continuous acquisition for DCE imaging. The specific aims of the partnership are: Aim 1: To develop radial T2w acquisition and reconstruction techniques with efficient full coverage of the liver for small tumor detection and accurate T2 quantification for tumor characterization. Aim 2: To implement a self-navigated 3D radial stack-of-stars technique for continuous acquisition of DCE data and retrospective reconstruction of the dynamic phases. Aim 3: To conduct a clinical evaluation of the techniques from Aims 1 and 2 against conventional T2w and DCE techniques. Aim 4: To streamline translation of the new radial methods to the clinic by developing a computationally efficient reconstruction pipeline. The endpoints of our study include technical advances in MRI acquisitions that markedly overcome limitations of current liver MRI for the diagnosis of early metastases. We expect our proposal to yield technology improvements that will increase precision of care and outcomes in patients with metastatic malignancies, in particular those with colorectal cancer.