Independent Scientist: ARFI and RWI Ultrasound for Improved Atherosclerosis Imagi

独立科学家：ARFI 和 RWI 超声可改善动脉粥样硬化 Imagi

• 批准号: 8144353
• 负责人: Caterina M Gallippi
• 金额: $ 10.18万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-15 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8144353
• 关键词: Acoustics; Address; Adult; Arterial Fatty Streak; Arteries; Atherosclerosis; Award; Blood flow; Budgets; Calcium; Carotid Arteries; Carotid Endarterectomy; Cause of Death; Clinical; Clinical Trials Design; Collagen; Data; Data Analyses; Deposition; Detection; Diagnosis; Diagnostic Imaging; Discrimination; Disease; Dissection; Elastin; Electrical Engineering; Ethics; Family suidae; Feasibility Studies; Fibrin; Funding; Gold; Heart Diseases; Human; Image; Imaging Techniques; Imaging technology; Immunohistochemistry; Incidence; Intervention; Laboratories; Left; Lipids; Malignant Neoplasms; Mechanics; Methods; National Heart, Lung, and Blood Institute; Obstruction; Patients; Peripheral; Physics; Predictive Value; Property; Public Health; Radiation; Research; Research Proposals; Risk; Risk Assessment; Rupture; Schedule; Scientist; Sensitivity and Specificity; Stroke; Structure; Technology; Testing; Tissues; Training; Translating; Translations; Ultrasonography; United States; Validation; Work; arterial remodeling; base; disability; electric impedance; iliac artery; imaging modality; improved; in vivo; novel; prevent; public health relevance; volunteer

DESCRIPTION (provided by applicant): While stroke remains the third leading cause of death behind heart disease and cancer and the primary cause of serious, long-term disability in the United States, decreasing incidence has been attributed to interventions including revascularization and statin therapy. However, administration of proper treatment is limited by inadequacies in modern diagnostic imaging technologies. These technologies are effective for detecting occlusive plaques associated with pronounced lumenal narrowing (occlusion) and/or blood flow obstruction, but their focus on lumenal features inhibits detection of nonocclusive plaques contained in arterial walls. Furthermore, their ability to predict plaque risk for causing cerebrovascular accident (CVA) is not established. There is a clear unmet need for a validated atherosclerosis imaging modality that can improve plaque detection and predict rupture risk. To address this need, our laboratory is developing novel acoustic radiation force-based images methods, which interrogate tissue composition and structure - features that indicate rupture risk. Our on-going R01 research involves developing one acoustic radiation force-based imaging methods, Acoustic Radiation Force Impulse (ARFI) ultrasound, for atherosclerosis diagnosis. We now propose to explore a new acoustic radiation force-based method, Relfected Wave Imaging (RWI), to improve ARFI's delineation of plaque composition and structure. We hypothesize that in vivo, transcutaneous ARFI and RWI ultrasound are capable of detecting occlusive and nonocclusive plaques in peripheral arteries and of assessing plaque composition and structure. The on-going R01 research pursues three specific aims: 1) Define the sensitivity and specificity of ARFI ultrasound for detecting plaques in familial hypercholesterolemic (FH) pigs, 2) Establish that ARFI imaging delineates plaque composition and structure in FH pigs, and 3) Establish that ARFI imaging delineates plaques and their composition and structure in humans. We now propose a new aim to develop RWI technology: 4) Exploit the reflections of acoustic radiation force-induced longitudinal and transverse waves to improve discrimination of plaque composition and structure in Reflected Wave Imaging (RWI). RWI alone and RWI as an adjunct to ARFI will be compared to ARFI alone for improvements in imaging sensitivity and specificity. The PI is trained in electrical engineering and ultrasound physics, but she proposes additional training in the physics of mechanical wave propagation in tissue to pursue aim #4 to her fullest capacity. In addition, the PI proposes training in clinical trials design, execution, and management as well as ethical conduct of research. PUBLIC HEALTH RELEVANCE: Stroke is the third leading cause of death and the primary cause of serious, long-term disability in the United States. Although timely and appropriate treatment is critical to saving lives, shortcomings in conventional diagnostic imaging technologies prevent advanced warning of the disease and delay therapy. The objectives of this research proposal are to demonstrate novel ultrasound imaging technologies - Acoustic Radiation Force Impulse (ARFI) and Reflected Wave Imaging (RWI) ultrasound - for improved diagnosis of atherosclerotic plaques and stroke risk.

描述（由申请人提供）：虽然中风仍然是心脏病和癌症仅次于的第三大死亡原因，这是美国严重，长期残疾的主要原因，但发病率的降低归因于包括血运重建和他汀类药物治疗在内的干预措施。但是，适当治疗的给药受到现代诊断成像技术不足的限制。这些技术可有效检测与明显的腔窄（遮挡）和/或血流阻塞相关的闭合斑块，但是它们对腔内特征的关注抑制了检测到动脉壁中包含的非透明斑块的检测。此外，未建立他们预测引起脑血管事故（CVA）的牙菌斑风险的能力。明显未满足的需要经过验证的动脉粥样硬化成像方式，可以改善牙菌斑检测并预测破裂风险。为了满足这一需求，我们的实验室正在开发新型的基于声学辐射力的图像方法，这些方法询问组织组成和结构 - 表明破裂风险的特征。我们正在进行的R01研究涉及开发一种基于声学辐射力的成像方法，即声辐射力脉冲（ARFI）超声，以进行动脉粥样硬化诊断。现在，我们建议探索一种新的基于声学辐射力的方法，用于改善ARFI的斑块组成和结构的描述。我们假设体内，经体ARFI和RWI超声能够检测外周动脉中的咬合和非划合斑块，并评估斑块组成和结构。 The on-going R01 research pursues three specific aims: 1) Define the sensitivity and specificity of ARFI ultrasound for detecting plaques in familial hypercholesterolemic (FH) pigs, 2) Establish that ARFI imaging delineates plaque composition and structure in FH pigs, and 3) Establish that ARFI imaging delineates plaques and their composition and structure in humans.现在，我们提出了开发RWI技术的新目标：4）利用声辐射力诱导的纵向和横向波的反射，以改善反射波成像（RWI）中斑块组成和结构的歧视。仅将RWI和RWI作为ARFI的辅助功能与ARFI进行比较，以提高成像敏感性和特异性。 PI接受了电气工程和超声物理学的培训，但她提出了在组织中机械波传播物理学的额外培训，以使Aim＃4达到她的最大容量。此外，PI建议在临床试验设计，执行和管理以及研究的道德行为方面进行培训。 公共卫生相关性：中风是美国的第三大主要原因，也是美国长期残疾的主要原因。尽管及时且适当的治疗对于挽救生命至关重要，但常规诊断成像技术中的缺点阻止了对疾病的先进警告和延迟治疗。该研究建议的目标是证明新颖的超声成像技术 - 声学辐射力脉冲（ARFI）和反射波成像（RWI）超声 - 以改善动脉粥样硬化斑块和中风风险的诊断。