Analysis Techniques for Diffusion Tensor Imaging in Spinal Cord Disease

脊髓疾病弥散张量成像分析技术

基本信息

批准号：
7801284
负责人：
James Reuss
金额：
$ 36.13万
依托单位：
PRISM CLINICAL IMAGING INC.
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-07-15 至 2012-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7801284
关键词：
Academy Accounting Administrator Adult Advertising Affect Aftercare Age American American College of Radiology Anatomy Angiography Award Awareness Brain Diseases Brain imaging Brain scan Businesses Caring Cerebrospinal Fluid Cervical Cervical spinal cord structure Cervical spine Clinical Clinical Research Clinical Treatment Code Color Communication Communities Competence Computer software Cost Analysis Current Procedural Terminology Codes Data Data Collection Degenerative Disorder Dementia Detection Development Devices Diagnosis Diagnostic Diagnostic Imaging Diffusion Diffusion Magnetic Resonance Imaging Disease Disease Progression Doctor of Philosophy Elderly Electrophysiology (science)Equipment Europe Evaluation Fees Foundations Functional disorder Goals Gold Grant Growth Health Insurance Healthcare Hospitals Image Imagery Imaging Device Imaging Techniques Imaging technology Industry Institution Intellectual Property Intelligence International Internet Laws Lead Leadership Legal patent Licensing Longevity Magnetic Resonance Magnetic Resonance Imaging Manufacturer Name Maps Marketing Measurement Measures Medical Medical Device Medical Imaging Medicare Medicine Methodology Methods Modality Movement Names Neuraxis Neurodegenerative Disorders Neurologic Neurologist Neurology Neurosurgeon North America Notification Online Systems Operative Surgical Procedures Outcome Pamphlets Paper Patients Penetration Periodicals Phase Physicians Plant Roots Poaceae Population Predictive Value Press Releases Prevalence Price Principal Investigator Printing Procedures Process Professional Meetings and Conferences Protocols documentation Public Health Qualifying Radiculopathy Radiology Specialty Research Sales Sampling Secondary to Societies Software Tools Somatosensory Evoked Potentials Spinal Spinal Cord Spinal Cord Diseases Spinal Degenerative Disorder Spinal cord injury Spondylosis Stem cells Surface Surgeon Symptoms System Techniques Technology Time Trademark Translating Translations Treatment outcome United States United States Food and Drug Administration Validation Vendor Vertebral column Visit Weight Wisconsin Work aging population base bone clinical practice cohort college cost design disability experience flexibility follow-up image visualization implantation improved innovation interest medical schools multimodality neuroimaging neuropsychiatry neurosurgery operation outreach programs public health relevance radiologist spinal cord mapping spinal tract symposium tool treatment planning tumor web site white matter white matter change

项目摘要

DESCRIPTION (provided by applicant): Myelopathy secondary to cervical spondylosis is a common cause of disability, and the most common primary diagnosis for patients over 64 years who undergo cervical spine surgery. Some studies suggest that surgical intervention after neurological decline is associated with worse outcome, prompting surgeons to operate earlier on the basis of imaging even in the absence of clinical symptoms, even though the predictive value of currently available imaging technology is poor. Because of the lack of accuracy in both clinical and radiographic prediction for disease progression, many patients who undergo surgery do not show significant improvement. Magnetic resonance imaging (MRI) is the gold standard to visualize the cervical spine, but clinical studies have not shown consistent correlation between T1- and T2-weighted MRI findings with patient outcome after either surgical or medical treatment. Diffusion tensor imaging (DTI) has a significant advantage over routine MRI in showing changes in white matter structural integrity in the spinal cord. Technical challenges remain in clinical translation of spinal DTI, including correction of distortion related to bone proximity, and cerebrospinal fluid (CSF) movement. There is an unmet need for multi-parameter, multi-modality spinal imaging visualization tools suited to the clinical workflow. We will design and implement a spinal imaging tool based upon our FDA-cleared Prism View(R) software package, currently indicated for use in pre- treatment planning for brain disorders. We will demonstrate feasibility in Phase I by developing means for visualizing pre- and post-treatment spinal imaging including anatomical, color-coded DTI mapping, quantitative diffusion parameter measurement, and functional mapping of diffusion spinal tractography. In Phase II, we will pursue clinical validation of spinal diffusion imaging by including spinal somatosensory evoked potential (SpSEP) studies, expand imaging to include registration of spinal CT, and investigate the utility of spinal tractography in surgical interventions such as stem cell implantation. Our initial focus is on applications to myelopathy, but it is expected that the technology will also find application in radiculopathy and spinal cord injury assessment, treatment planning, and follow-up. PUBLIC HEALTH RELEVANCE: We will develop and evaluate imaging tools to aid in the diagnosis, treatment planning, and follow-up of cervical myelopathy, a common cause of disability subject to surgical intervention. This will include application of diffusion tensor imaging (DTI) to assess white matter integrity and provide functional mapping of the spinal cord with potential applications to tract-wise treatment methods.

描述（由申请人提供）：宫颈脊椎病继发的骨髓病是残疾的常见原因，也是64岁接受颈椎手术的患者最常见的主要诊断。一些研究表明，神经系统下降后的手术干预与较差的结果有关，即使在没有临床症状的情况下，即使在没有临床症状的情况下，外科医生也会在成像中进行工作，即使当前可用成像技术的预测价值很差。由于疾病进展的临床和放射学预测缺乏准确性，许多接受手术的患者没有显示出显着改善。磁共振成像（MRI）是可视化颈椎的黄金标准，但是临床研究并未显示出T1-和T2加权MRI发现与手术或医疗后患者结局之间的一致相关性。扩散张量成像（DTI）比常规MRI具有显着优势，在显示脊髓中白质结构完整性的变化方面。脊柱DTI的临床翻译中仍然存在技术挑战，包括纠正与骨接近性有关的失真和脑脊液（CSF）运动。对适合临床工作流程的多模式的多模式脊柱成像可视化工具的需求未满足。我们将根据我们的FDA清除棱镜观点（R）软件包设计和实施脊柱成像工具，该软件包目前用于用于用于脑部疾病的预治疗计划。我们将通过开发用于可视化前后治疗前和治疗后的脊柱成像的方法来证明可行性，包括解剖学，颜色编码的DTI映射，定量扩散参数测量以及扩散脊柱散段的功能映射。在第二阶段，我们将通过包括脊柱体感诱发潜力（SPSEP）研究，扩展成像以包括脊柱CT的注册，并研究脊柱拖拉术在手术干预措施（例如干细胞植入）中的效用。我们最初的重点是对脊髓病的应用，但是预计该技术还将在根瘤病和脊髓损伤评估，治疗计划和随访中找到应用。公共卫生相关性：我们将开发和评估成像工具，以帮助诊断，治疗计划和宫颈骨髓病的随访，这是造成手术干预的残疾的常见原因。这将包括应用扩散张量成像（DTI）评估白质完整性，并提供脊髓的功能映射，并潜在地应用于管道处理方法。