Quantitiative MRI of prostate cancer as a biomarker and guide for treatment

前列腺癌的定量 MRI 作为生物标志物和治疗指南

• 批准号: 8300247
• 负责人: Fiona Fennessy
• 金额: $ 33.84万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-22 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8300247
• 关键词: Acetates; Aftercare; Age; Algorithms; American; Androgens; Benign; Biological Markers; Biopsy; Cancer Etiology; Cancer Patient; Characteristics; Clinical; Clinical Data; Data; Detection; Diffusion Magnetic Resonance Imaging; Diffusion weighted imaging; Disease; Dose; Drug Kinetics; Equipment; Evaluation; External Beam Radiation Therapy; Focused Ultrasound Therapy; Functional disorder; Gland; Gleason Grade for Prostate Cancer; Histopathology; Image; Imaging Device; Lesion; Leuprolide Acetate; Magnetic Resonance; Magnetic Resonance Imaging; Malignant Neoplasms; Malignant neoplasm of prostate; Maps; Measurement; Methodology; Metric; Microcirculation; Multivariate Analysis; Neoadjuvant Therapy; Operative Surgical Procedures; Pathology; Patients; Permeability; Physicians; Property; Prostate; Prostatectomy; Prostatic Neoplasms; Protocols documentation; Radical Prostatectomy; Recurrence; Residual Tumors; Risk; Safety; Serum; Specificity; Specimen; Techniques; Testing; Tissues; Vascular Permeabilities; Weight; abiraterone; deprivation; follow-up; high risk; imaging modality; improved; indexing; magnetic resonance spectroscopic imaging; men; molecular marker; mortality; pharmacodynamic model; response; statistics; tool; treatment planning; tumor

DESCRIPTION (provided by applicant): Prostate cancer is the most common malignancy and third leading cause of cancer-related mortality in American men. Due to the ageing "baby boomers", the number of men with localized prostate cancer will increase, as will the need for an accurate non-invasive imaging tool. Magnetic Resonance (MR) imaging has the ability to deliver precise anatomical mapping of tumor. Newer MR techniques allow for pharmacokinetic (PK) evaluation of prostate tissue. This functional aspect of MR imaging could contribute greatly to the accuracy of tumor detection and localization, and potentially serve as a guide for focal ablative therapy, or non-invasively assess functional aspects of prostate tissue microcirculation in response to neoadjuvant treatment. The objective of this study is therefore to determine if optimized MR analysis tools and algorithms can be used as a biomarker guide for targeted therapy and as a surrogate for disease recurrence in prostate cancer. We plan to achieve our objective through 4 specific aims: 1. To develop and implement imaging methodology and analysis tools for automated, robust quantitative assessment of prostate tumor volumetry and assessment of the functional properties (vascularity and permeability) using quantitative multi-parametric MR imaging (mpMRI). 2. To clinically validate the prostate mpMRI quantitative analysis tools described in Aim 1. We will perform a multivariate analysis of the results of the analyses tools, and patient-specific parameter maps for tumor localization (a summary statistic display) will be obtained and correlated with pathology at prostatectomy. 3. To determine the clinical use of the analysis tools as a biomarker guide for targeted therapy and as a surrogate for disease recurrence in low-risk prostate cancer patients. We will obtain mpMRI maps, detailing the index lesion and its margins, and register them with focal ablative therapy treatment planning images. Follow up mpMRI maps will be registered the pre-treatment maps to detect changes, and will be correlated with PSA to determine the "expected" treatment margin and untreated prostate mpMRI characteristics. 4. To determine the clinical use of the analysis tools in evaluating tumor response to treatment with neoadjuvant androgen deprivation therapy (ADT) in patients with high-risk prostate cancer. We will assess the changes in mpMRI maps after 12 weeks of ADT to determine if prostate tumor vascular permeability changes may be a suitable predictor of pathological response, by correlation with prostatectomy specimens.

描述（由申请人提供）：前列腺癌是美国男性中最常见的恶性肿瘤，也是癌症相关死亡率的第三大原因。由于“婴儿潮一代”的老龄化，患有局限性前列腺癌的男性人数将增加，对准确的非侵入性成像工具的需求也将增加。磁共振（MR）成像能够提供精确的肿瘤解剖标测。较新的MR技术允许对前列腺组织进行药代动力学（PK）评价。磁共振成像的这一功能方面可以极大地有助于肿瘤检测和定位的准确性，并可能作为局部消融治疗的指导，或非侵入性评估前列腺组织微循环对新辅助治疗的反应的功能方面。因此，本研究的目的是确定优化的MR分析工具和算法是否可用作靶向治疗的生物标志物指南和前列腺癌疾病复发的替代物。我们计划通过四个具体目标来实现我们的目标： 1.开发和实施成像方法和分析工具，用于使用定量多参数MR成像（mpMRI）对前列腺肿瘤体积进行自动化、稳健的定量评估，并评估功能特性（血管分布和渗透性）。 2.临床验证目标1中描述的前列腺mpMRI定量分析工具。我们将对分析工具的结果进行多变量分析，并将获得肿瘤定位的患者特异性参数图（汇总统计显示），并将其与肿瘤切除术的病理学相关联。 3.确定分析工具作为靶向治疗的生物标志物指南和作为低风险前列腺癌患者疾病复发的替代物的临床用途。我们将获得mpMRI图，详细描述索引病变及其边缘，并将其与局灶性消融治疗计划图像配准。随访mpMRI图将与治疗前图配准以检测变化，并将与PSA相关以确定“预期”治疗边界和未治疗前列腺mpMRI特征。 4.确定分析工具在评价肿瘤对以下治疗的反应中的临床用途： 新辅助雄激素剥夺疗法（ADT）治疗高危前列腺癌患者。我们将评估ADT治疗12周后mpMRI图的变化，通过与前列腺切除术标本的相关性，确定前列腺肿瘤血管通透性变化是否可能是病理学反应的适当预测因子。