Quantitative Molecular Imaging of Heart Failure by 123I-MIBG SPECT

123I-MIBG SPECT 心力衰竭的定量分子成像

基本信息

  • 批准号:
    7926866
  • 负责人:
  • 金额:
    $ 19.48万
  • 依托单位:
  • 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:
    2010-04-20 至 2012-03-31
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): Imaging of biologically targeted markers is gaining increased attention for its potential to provide early disease detection, improved individualized risk stratification and monitoring of medical therapies. The molecular tracer 123I-metaiodobenzylguanidine (123I-MIBG) is an analog of norepinephrine which provides a noninvasive approach for imaging the sympathetic innervations of the heart. The overall goal of this project is to develop clinical software tools for quantification of 123I-MIBG molecular imaging of heart failure to facilitate clinical translation of this important imaging technology to routine clinical practice. The specific aims of this project are to: 1) develop software methods for improved quantification of clinical 123I-MIBG SPECT imaging of heart failure patients, 2) develop a novel software method for accurate automated quantification of HMR and WR from planar views projected from the reconstructed 123I-MIBG SPECT images of Aim 1, and 3) clinical validation of the software tools developed in Aims 1 and 2 using retrospective analysis of image data and clinical outcomes from Phase III clinical trials of cardiac 123I-MIBG imaging. The results of recently completed Phase III trials have demonstrated that 123I-MIBG cardiac imaging can identify a subpopulation of heart failure patients with low 2-year risk of fatal cardiac events and the potential to define patients with increased likelihood of heart failure progression, ventricular arrhythmias, or cardiac death. These promising results are based on simple global quantitative measures of cardiac 123I-MIBG uptake, such as the heart-to-mediastinum ratio (HMR) and washout rate (WR), using planar radionuclide imaging. However, recent data has shown that the lack of standardized acquisition and processing protocols for planar imaging has limited the applicability of 123I-MIBG for widespread use. Moreover, single photon emission computed tomography (SPECT) imaging has the potential for more accurate quantification of 123I-MIBG uptake and retention. Unfortunately SPECT quantification has been hampered by the physical properties of imaging 123I labeled tracers, and the characteristically rapid sympathetic neuronal washout and low cardiac retention of 123I-MIBG in heart failure patients. The proposed project will address these limitations by developing a comprehensive approach for improved quantification of 123I-MIBG SPECT, including the application of recent advances in SPECT iterative reconstruction with corrections for photon attenuation, scatter and septal penetration and detector response modeling and novel methods for automated segmentation of the left ventricle (LV) in emission images. We anticipate that the successful outcome of the proposed project will provide automated quantification methods, software tools and validation data that will be extremely useful in future efforts to define guidelines and standards for the acquisition and processing of 123I-MIBG molecular imaging of heart failure. PUBLIC HEALTH RELEVANCE: The use of molecular imaging for management of heart failure patients is a recent advance that enables more individualized patient care, improved assessment of risk for adverse events, and can potentially reduce the healthcare costs associated with heart failure. This proposal will develop imaging software necessary for advancing molecular imaging technology to the clinic practice and facilitate wider clinical adoption of this promising advance in the care of heart failure patients.
描述(由申请人提供):生物靶向标记物成像因其提供早期疾病检测、改进个体化风险分层和医学治疗监测的潜力而受到越来越多的关注。分子示踪剂123I-metaiodobenzylguanidine (123I-MIBG)是一种去甲肾上腺素的类似物,为心脏交感神经成像提供了一种无创方法。该项目的总体目标是开发用于量化123I-MIBG心衰分子成像的临床软件工具,以促进这项重要成像技术在临床中的常规临床应用。该项目的具体目标是:1)开发软件方法,改进心衰患者临床123I-MIBG SPECT成像的量化;2)开发一种新的软件方法,从目标1重建的123I-MIBG SPECT图像投影的平面视图中准确自动量化HMR和WR; 3)通过对心脏123I-MIBG成像III期临床试验的图像数据和临床结果的回顾性分析,对目标1和2中开发的软件工具进行临床验证。最近完成的III期试验结果表明,123I-MIBG心脏成像可以识别2年致命性心脏事件风险较低的心力衰竭患者亚群,并有可能确定心力衰竭进展、室性心律失常或心源性死亡可能性增加的患者。这些有希望的结果是基于心脏123I-MIBG摄取的简单全球定量测量,如心脏与纵隔比(HMR)和冲洗率(WR),使用平面放射性核素成像。然而,最近的数据表明,缺乏标准化的平面成像采集和处理协议限制了123I-MIBG的广泛使用。此外,单光子发射计算机断层扫描(SPECT)成像具有更准确量化123I-MIBG摄取和保留的潜力。不幸的是,显像123I标记示踪剂的物理特性,以及心力衰竭患者典型的123I- mibg快速交感神经元冲洗和低心脏保留,阻碍了SPECT量化。拟议的项目将通过开发一种全面的方法来改进123I-MIBG SPECT的量化,包括应用SPECT迭代重建的最新进展,对光子衰减、散射、间隔穿透和检测器响应建模进行校正,以及在发射图像中自动分割左心室(LV)的新方法,来解决这些限制。我们预计,拟议项目的成功结果将提供自动化量化方法,软件工具和验证数据,这将在未来的努力中非常有用,以确定心力衰竭123I-MIBG分子成像的获取和处理的指南和标准。

项目成果

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