Merit of MRI Perfusion Targets for Radiotherapy Planning

描述（由申请人提供）：该I期STTR提案的目标是将MRI（磁共振成像）衍生的灌注测量无缝集成到脑肿瘤患者的放射治疗（RT）计划系统中。目前用于确定RT靶体积的MRI和CT（计算机断层扫描）信息是基于脑解剖信息，而不是肿瘤病理生理信息。尽管基于灌注的新型MRI方法在预测放射治疗的成功、帮助发现和优化新的治疗策略以及降低发病率方面表现出了巨大的希望，但情况仍然如此。这些先进的成像技术还没有被转化到临床，因为没有有效的方法来处理、显示和整合这些技术到一个可用的平台上，可用于辐射规划。因此，实现这些技术的全部临床和商业潜力的关键是开发一个集成的显示和分析平台，其输出对RT计划有用。新成立的公司SPUD Imaging Inc.正在开发这样一个平台。该平台的一个输出将是由多参数灌注数据集生成的轮廓，该数据集是通过一种新型的梯度回波(GE)/自旋回波（SE） MRI序列获得的。通过这种专利方法，我们能够测量脑血容量（CBV）和脑血流量（CBF），对整个血管群（GE）或微血管群（SE）敏感，测量平均血管直径（mVD），平均传递时间（MTTs）和传递时间分布（TTDs）。虽然我们现在为了研究目的而定期获得这些生理成像图，但目前还没有办法将这些生理数据与RT计划系统相结合。本STTR应用程序通过提出改进和优化代码来对独特的灌注数据进行后处理，开发一个原型查看器来显示生理和解剖参数之间的关键定量和空间关系（里程碑1），并以与辐射规划平台兼容的方式输出数据（里程碑2），从而解决了这个问题。在完成拟议的研究后，将存在一种原型技术，使临床可行性研究能够进行，以确定使用灌注靶标进行放射计划时结果的差异（II期）。

DESCRIPTION (provided by applicant): The goal of this Phase I STTR proposal is to seamlessly integrate MRI (magnetic resonance imaging)- derived perfusion measurements into the radiation treatment (RT) planning systems for brain tumor patients. Currently the MRI and CT (computed tomography) information that is used to define the RT target volumes is based on information about brain anatomy, and not tumor pathophysiology. This continues to be the case even though new perfusion-based MRI methods have demonstrated great promise in predicting the success of radiation treatments, aiding in the discovery and optimization of new treatment strategies and decreasing morbidity. These advanced imaging techniques have not been translated into the clinic since there is no efficient way to process, display and integrate these technologies into a useable platform available for radiation planning. Consequently, the key to realizing the full clinical and commercial potential of such techniques is the development of an integrated display and analysis platform with an output that is useful for RT planning. Such a platform is under development at the newly formed company, SPUD Imaging Inc. One output of this platform will be contours generated from a multi-parameter perfusion data set, which is obtained with a novel combined gradient-echo(GE)/spin-echo(SE) MRI sequence. With this patented approach, we are able to provide measurements of cerebral blood volume (CBV) and cerebral blood flow (CBF), sensitive to either the entire population of vessels (GE) or the microvascular vessel population (SE), measures of the mean vessel diameter (mVD), mean transit times (MTTs) and transit time distributions (TTDs). Though we are now obtaining these physiologic imaging maps routinely for research purposes, there is currently no way to interface such physiologic data with the RT planning systems. This STTR application addresses this issue by proposing to refine and optimize code to post-process the unique perfusion data, develop a prototype viewer to display the critical quantitative and spatial relationships between the physiologic and anatomic parameters (milestone 1), and output the data in a manner compatible with radiation planning platforms (milestone 2). Upon completion of the proposed studies there will exist a prototype technology that enables the performance of clinical feasibility studies, to determine differences in outcome when using perfusion targets for radiation planning (Phase II).