Analysis Techniques for Diffusion Tensor Imaging in Spinal Cord Disease

脊髓疾病弥散张量成像分析技术

• 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
• 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

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）：继发于颈椎病的脊髓病是导致残疾的常见原因，也是 64 岁以上接受颈椎手术的患者最常见的初步诊断。一些研究表明，神经功能衰退后的手术干预与较差的结果相关，这促使外科医生即使在没有临床症状的情况下也要根据影像学更早进行手术，尽管目前可用的影像技术的预测价值很差。由于临床和影像学预测疾病进展缺乏准确性，许多接受手术的患者并未表现出明显的改善。磁共振成像 (MRI) 是颈椎可视化的黄金标准，但临床研究尚未表明 T1 和 T2 加权 MRI 结果与手术或药物治疗后患者结果之间存在一致的相关性。弥散张量成像 (DTI) 在显示脊髓白质结构完整性的变化方面比常规 MRI 具有显着优势。脊柱 DTI 的临床转化仍然存在技术挑战，包括纠正与骨接近度和脑脊液 (CSF) 运动相关的变形。对于适合临床工作流程的多参数、多模态脊柱成像可视化工具的需求尚未得到满足。我们将根据 FDA 批准的 Prism View(R) 软件包设计和实施脊柱成像工具，该软件包目前用于脑部疾病的预治疗计划。我们将通过开发可视化治疗前和治疗后脊柱成像的方法来证明第一阶段的可行性，包括解剖、颜色编码的 DTI 映射、定量扩散参数测量和扩散脊髓束成像的功能映射。在第二阶段，我们将通过包括脊柱体感诱发电位（SpSEP）研究来追求脊柱扩散成像的临床验证，扩大成像范围以包括脊柱CT的配准，并研究脊柱束成像在干细胞植入等外科手术中的效用。我们最初的重点是应用于脊髓病，但预计该技术也将应用于神经根病和脊髓损伤评估、治疗计划和随访。 公共卫生相关性：我们将开发和评估成像工具，以帮助诊断、治疗计划和随访脊髓型颈椎病，这是因手术干预导致残疾的常见原因。这将包括应用弥散张量成像（DTI）来评估白质完整性，并提供脊髓的功能图谱，并可能应用于逐束治疗方法。