A Comprehensive Clinical fMRI Software Solution to Enable Mapping of Critical Functional Networks and Cerebrovascular Reactivity in the Brain

全面的临床 fMRI 软件解决方案，可绘制大脑中的关键功能网络和脑血管反应性

• 批准号: 10595033
• 负责人: CATHERINE L ELSINGER
• 金额: $ 37.37万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-21 至 2027-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10595033
• 关键词: Area; Blood Vessels; Brain; Brain Mapping; Brain Neoplasms; Brain imaging; Clinical; Clinical Investigator; Communities; Computer software; Data; Data Set; Disease; Ensure; Environment; Epilepsy; Excision; Failure; Functional Magnetic Resonance Imaging; Hand; Hypercapnia; Image; Impairment; Institution; Language; Lesion; Linear Models; Magnetic Resonance Imaging; Malignant neoplasm of brain; Maps; Measurement; Measures; Methods; Morbidity - disease rate; Motor; Navigation System; Neoplasms; Neurosciences; Neurosciences Research; Operative Surgical Procedures; Pathology; Patients; Procedures; Process; Research; Rest; Seasons; Signal Transduction; Software Tools; Software Validation; Surgeon; Technology; Testing; Tissues; Tongue; Visual; Visualization; Work; blood oxygen level dependent; blood oxygenation level dependent imaging; brain surgery; brain tumor resection; cerebrovascular; clinical care; compliance behavior; flexibility; foot; graphical user interface; imaging detection; improved; independent component analysis; innovation; malformation; nervous system disorder; neurosurgery; neurovascular; neurovascular coupling; novel; patient population; preservation; prevent; software development; standard of care; tool; visual map

Project Summary Functional localization of eloquent brain areas for patients undergoing surgery for brain tumors, epilepsy, or other neurological diseases is crucial to prevent post-surgical deficits and reduce morbidity. Task-based (tb) functional MRI (fMRI), which detects blood oxygenation level–dependent (BOLD) signal changes while a patient performs task paradigms, is a standard-of-care clinical procedure for presurgical mapping of eloquent cortices. Two major limitations of clinical tb-fMRI are a patient's inability to perform the task and lesion-induced impairment of neurovascular coupling (which drives the BOLD signal). Resting-state (rs) fMRI, which measures synchronized BOLD signal oscillations during rest, can be used to map brain networks with minimal requirements for patient compliance and has been demonstrated to accurately localize motor and language areas for presurgical planning. Cerebrovascular reactivity (CVR) mapping, accessed by dynamic BOLD imaging during a hypercapnia task such as breath-holding, can be used to identify areas with potential false-negative fMRI results due to neurovascular uncoupling (NVU) and has been suggested as an emerging standard to be used with clinical fMRI. Currently, there are no commercially available FDA-cleared software tools for localizing the resting-state networks (RSNs) or CVR. Clinical investigators have relied on research software packages that are either not clinically integrated or not yet optimized and validated in large patient populations. Thus, a vetted software solution is urgently needed to enable these state-of-the-art fMRI methods to benefit patients beyond the limitations of tb-fMRI. We hypothesize that enhancing, optimizing, and validating our preliminary software and integrating it with an established commercial fMRI platform will create robust solutions for clinical mapping of RSN and CVR. Through three specific aims, the software solutions will be optimized and tested with rs-fMRI and CVR datasets from approximately 350 patients with brain tumors or epilepsy at three institutions. Aim 1 is to create the software for mapping RSNs and determine optimized workflows for localizing eloquent areas including primary visual, motor (hands, tongue, and feet), and language (primary and secondary) areas. Both seed-based correlation and independent component analysis will be incorporated. Aim 2 is to create the software for mapping CVR and determine the optimized workflow for identifying and visualizing brain areas with potential false-negative fMRI results. The software will include a multiple-latency general linear model and a unique graphical user interface to visualize the NVU. Aim 3 is to test and validate the software with presurgical fMRI datasets. The results will be compared against those obtained from (1) processed using widely used research software packages, (2) tb- fMRI, and (3) intraoperative direct cortical stimulation. This research is anticipated to create robust and clinically available software that will greatly increase the patient population who can benefit from presurgical fMRI and will improve confidence in functional localization for surgical planning. This will directly benefit patients by preserving their post-surgical functions while allowing surgeons to safely maximize the resection of brain lesions.

项目概要 接受脑肿瘤、癫痫或其他疾病手术的患者的雄辩大脑区域的功能定位 神经系统疾病对于预防术后缺陷和降低发病率至关重要。基于任务的 (tb) 功能 MRI (fMRI)，可检测患者执行操作时的血氧水平依赖性 (BOLD) 信号变化 任务范式是一种用于术前雄辩皮质绘图的护理标准临床程序。两大 临床 TB-fMRI 的局限性是患者无法执行任务以及病变引起的功能障碍 神经血管耦合（驱动 BOLD 信号）。静息态 (rs) fMRI，同步测量 休息时大胆的信号振荡，可用于绘制大脑网络图，对患者的要求最低 合规性，并已被证明可以准确定位运动和语言区域以进行术前规划。 脑血管反应性 (CVR) 绘图，在高碳酸血症任务期间通过动态 BOLD 成像进行访问，例如 作为屏气，可用于识别由于神经血管原因而可能出现假阴性 fMRI 结果的区域 解偶联（NVU）并已被建议作为临床功能磁共振成像的新兴标准。现在， 没有 FDA 批准的商用软件工具用于本地化静息态网络 (RSN) 或 CVR。临床研究人员依赖于未在临床上集成的研究软件包 或者尚未在大量患者群体中进行优化和验证。因此，迫切需要一个经过审查的软件解决方案 需要使这些最先进的功能磁共振成像方法超越 tb-fMRI 的局限性使患者受益。我们 假设增强、优化和验证我们的初步软件并将其与 成熟的商业功能磁共振成像平台将为 RSN 和 CVR 的临床绘图创建强大的解决方案。通过 三个具体目标，软件解决方案将使用 rs-fMRI 和 CVR 数据集进行优化和测试 三个机构中约有 350 名脑肿瘤或癫痫患者。目标 1 是创建软件 映射 RSN 并确定优化的工作流程，以定位雄辩区域，包括初级视觉、运动 （手、舌头和脚）和语言（主要和次要）区域。基于种子的相关性和 将纳入独立成分分析。目标 2 是创建用于映射 CVR 和 确定识别和可视化具有潜在假阴性功能磁共振成像的大脑区域的优化工作流程 结果。该软件将包括多延迟通用线性模型和独特的图形用户界面 可视化 NVU。目标 3 是使用术前功能磁共振成像数据集测试和验证该软件。结果将 与从（1）使用广泛使用的研究软件包处理得到的结果进行比较，（2）tb- fMRI，以及（3）术中直接皮质刺激。这项研究预计将创造出稳健且具有临床意义的 可用的软件将大大增加可以从术前功能磁共振成像中受益的患者人数，并将 提高对手术规划功能定位的信心。这将直接使患者受益 它们的术后功能，同时允许外科医生安全地最大限度地切除脑部病变。