Advanced diffusion MRI for evaluating early response to radiation treatment in cervical cancer

先进的扩散 MRI 用于评估宫颈癌放射治疗的早期反应

• 批准号: 10596155
• 负责人: Rebecca Ann Rakow-Penner
• 金额: $ 63.35万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 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 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10596155
• 关键词: Access to Information; Affect; Aftercare; Age; Agreement; Algorithms; Benign; Biological Markers; Bladder; Brain; Cancer Etiology; Cancer Patient; Cervical; Cervical Cancer Screening; Cervix Uteri; Cessation of life; Chemotherapy and/or radiation; Classification; Clinical; Contrast Media; Data; Detection; Development; Diagnosis; Diffusion; Diffusion Magnetic Resonance Imaging; Disease; Disease Progression; Early treatment; Edema; Evaluation; Free Will; Functional disorder; Gold; Hemorrhage; Hysterectomy; Image; Imaging Techniques; Indolent; Infertility; Inflammation; Intestines; Lesion; Machine Learning; Magnetic Resonance Imaging; Malignant - descriptor; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Manuals; Measures; Methods; Mission; Modeling; Morbidity - disease rate; Morphologic artifacts; Organ; Outcome; Patient Care; Patients; Pelvic Pain; Performance; Pilot Projects; Positron-Emission Tomography; Property; Prostate; Public Health; Radiation; Radiation therapy; Reader; Research; Restriction Spectrum Imaging; Sampling; Sensitivity and Specificity; Signal Transduction; Source; Staging; Standardization; Structure; Techniques; Testing; Therapeutic; Time; Tissues; Translating; Treatment Efficacy; Tumor Burden; Tumor Tissue; United States National Institutes of Health; Visualization software; Water; Woman; Work; X-Ray Computed Tomography; biomedical imaging; biophysical model; biophysical properties; cancer imaging; chemoradiation; classification algorithm; clinically significant; cohort; contrast enhanced; imaging modality; improved; innovation; magnetic field; mortality; nerve injury; novel strategies; prevent; prospective; radiation response; radical hysterectomy; response; screening program; standard of care; theories; tool; treatment planning; treatment response; tumor; uptake; water diffusion

Project Summary Despite the advent of aggressive cervical cancer screening programs, cervical cancer remains one of the most common cancers affecting women under age 35, and the fourth most common cause of cancer death worldwide. The standard of care for early stage (≥IB) cervical cancer is hysterectomy or radiation. Unfortunately, the consequences of radical treatment include fertility loss, nerve injury causing bladder and bowel dysfunction, and pelvic pain. There is a critical need to reduce cervical cancer mortality, while minimizing the potential morbidities of treatment. To achieve this end requires refined approaches for diagnosis and evaluation of response to treatment using noninvasive biomarkers to differentiate indolent from clinically significant disease at the earliest possible time-point. PET/CT is currently the mainstay in evaluating response to treatment and is highly confounded by post-treatment changes such as edema. Magnetic resonance imaging (MRI) with advanced diffusion-weighted imaging may offer an alternative approach to evaluate treatment response, with additional advantages of being a radiation-free and contrast media-free exam. The overall objective in this application is to develop and evaluate a robust advanced diffusion-weighted imaging technique that provides a highly sensitive and specific reflection of cervical cancer tumor burden and treatment response at the earliest possible time point. Our hypothesis is that restriction spectrum imaging (RSI), an advanced diffusion imaging technique, is as sensitive and specific as standard of care post-treatment PET/CT for evaluation of treatment efficacy of cervical cancer and can be performed 3 months earlier than standard of care PET/CT. The aims of this proposal are 1) Determine the RSI model for cervical cancer evaluation, 2) Develop and validate a cervical cancer classification algorithm from multi-parametric MRI based on the Aim 1 biophysical model using established machine learning techniques, 3) Prospectively validate RSI-MRI compared to PET/CT in evaluating response to radiation treatment in cervical cancer patients (≥ stage IB) in a pilot study0. The main significance of this study is the development of a radiation-free and non-contrast imaging technique for evaluating response to treatment three months earlier than the current standard of care PET/CT. This will allow appropriate treatment earlier preventing unnecessary progression of disease. The innovation proposed involves developing a diffusion model specific for cervix imaging within the RSI framework based on the biophysical characteristics of healthy and malignant cervical tissue. We will then apply this quantitative technique prospectively on a preliminary cohort of patients before and after treatment and compare to the standard of care PET/CT imaging. At the completion of the study, a new tool for evaluating response to treatment in cervical cancer that is contrast and radiation free will be available. This is directly translatable to the clinical setting to benefit cervical cancer patients. Cervical cancer patients will be better served, particularly patients not responding to treatment, as they can be directed to appropriate treatment at an earlier time point.

项目摘要 尽管有侵略性的宫颈癌筛查计划，但宫颈癌仍然是最多的 影响35岁以下妇女的普通癌，也是全世界癌症死亡的第四个最常见原因。 早期（≥IB）宫颈癌的护理标准是子宫切除术或辐射。不幸的是， 自由基治疗的后果包括生育能力丧失，神经损伤导致膀胱和肠功能障碍，以及 骨盆疼痛。降低宫颈癌死亡率的迫切需要，同时最大程度地减少潜在的病因 治疗。为了实现这一目的，需要采用精致的方法来诊断和评估对 使用非侵入性生物标志物治疗，以最早的临床意义与临床意义分化 可能的时间点。 PET/CT目前是评估对治疗反应的中流 被治疗后的变化（例如水肿）感到困惑。具有先进的磁共振成像（MRI） 扩散加权成像可能提供了一种评估治疗反应的替代方法，并有其他 作为无辐射和对比度的无媒体考试的优点。该应用程序的总体目标是 开发和评估强大的高级扩散加权成像技术，可提供高度敏感的 以及最早可能的时间点的宫颈癌肿瘤和治疗反应的特定反射。 我们的假设是限制频谱成像（RSI）是一种先进的扩散成像技术，如 敏感和特异性作为护理标准的治疗后宠物/CT评估宫颈治疗效率 癌症，可以比护理宠物/CT的标准提前3个月进行。该提议的目的是1） 确定用于宫颈癌评估的RSI模型，2）开发和验证宫颈癌分类 基于AIM 1生物物理模型的多参数MRI算法使用已建立的机器学习 技术，3）与PET/CT相比，前瞻性验证RSI-MRI在评估辐射反应时 宫颈癌患者（≥IB）的治疗。这项研究的主要意义是 开发无辐射和非对比度成像技术，用于评估对治疗的反应三 比目前的护理宠物/CT标准早几个月。这将允许尽早进行适当的治疗 不必要的疾病进展。提出的创新涉及开发特定于 基于健康和恶性的生物物理特征，RSI框架内的子宫颈成像 宫颈组织。然后，我们将前瞻性地应用此定量技术 治疗前后，并将其与护理宠物/CT成像的标准进行比较。研究完成时， 一种用于评估宫颈癌治疗反应的新工具，而无辐射将是 可用的。这可以直接翻译成临床环境，以使宫颈癌患者受益。宫颈癌 患者将得到更好的服务，尤其是患者没有反应治疗的患者，因为可以直接进行治疗 在较早的时间点进行适当的治疗。