Quantitative Photoacoustic Detection of Lymph-node Metastases

淋巴结转移的定量光声检测

• 批准号: 8507233
• 负责人: Ernest Joseph Feleppa
• 金额: $ 20.15万
• 依托单位: RIVERSIDE RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-01 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8507233
• 关键词: Academic Medical Centers; Area; Asses; Biopsy; Breast; Cancer Patient; Cancerous; Classification; Colorectal; Data; Data Analyses; Detection; Development; Diagnostic Neoplasm Staging; Disease; Dissection; Disseminated Malignant Neoplasm; Distant; Evaluation; Failure; Fostering; Foundations; Frequencies; Funding; Future; Goals; Gold; Grant; Hawaii; Heart Diseases; Histologic; Histology; Histopathology; Image; In Situ; Laboratories; Lasers; Light; Lung; Lymph Node Tissue; Lymph node excision; Malignant Lymph Node Neoplasm; Malignant Neoplasms; Malignant neoplasm of abdomen; Medical center; Methods; Micrometastasis; Microtomy; Musculoskeletal Diseases; Neoplasm Metastasis; Nodal; Noise; Operating Rooms; Operative Surgical Procedures; Optics; Pancreas; Paris, France; Pathologist; Pathology; Performance; Postoperative Period; Procedures; Property; Prostate; ROC Curve; Research; Resolution; Scanning; Sensitivity and Specificity; Sentinel Lymph Node; Signal Transduction; Specific qualifier value; Staging; Stomach; System; Techniques; Thyroid Gland; Tissues; Ultrasonics; Ultrasonography; United States National Institutes of Health; Universities; absorption; base; cancer therapy; cancer type; clinically significant; imaging modality; improved; instrument; instrumentation; lymph nodes; malignant breast neoplasm; novel; outcome forecast; prototype; quantitative ultrasound; theories; treatment planning; validation studies

DESCRIPTION (provided by applicant): Riverside Research and the University of Hawaii and its affiliated Kuakini Medical Center propose to assess the feasibility of applying quantitative photoacoustic (QPA) methods to detection of metastases in lymph nodes in conjunction with its funded studies of novel quantitative ultrasound (QUS) methods for discriminating between cancer-containing and cancer-free lymph nodes of cancer patients. Detection of metastatic cancer in lymph nodes is crucial for accurate staging, prognosis, and treatment planning. Our goal is to reduce markedly the failure of existing methods to detect metastases in 25% to 30% of dissected nodes and 50% in nodes with micrometastases. To achieve our goal, we propose to develop QPA methods used alone or in combination with high-frequency QUS to identify regions of nodes that warrant careful histologic examination. We already have made exciting progress toward this goal by developing a highly sensitive and specific, purely ultrasonic method of imaging metastatic disease in lymph nodes with fine spatial resolution. Our ultrasonic results show a remarkable ability to detect cancer in dissected lymph nodes for a broad range of cancer types, and they promise a reliable means of guiding pathologists to cancer-containing regions of dissected lymph nodes. The ability of our ultrasonic methods to pinpoint metastatic cancer potentially can reduce or eliminate the occurrence of unacceptable false-negative determinations drastically when nodes actually contain micrometastatic disease. These findings provide encouragement that our proposed studies combining novel QPA methods with our QUS methods may be able to achieve simultaneous sensitivity and specificity values approaching 100%. Therefore, we plan to acquire QPA-signal data in conjunction with acquisition of QUS- signal data, and to use the results of analyses of these data in a multifeature approach to classification of lymph-node tissue as cancerous or non-cancerous. If the proposed studies establish the feasibility of using QPA alone or in combination with QUS, then we will propose to undertake validation studies that, if successful, can provide a foundation for future development of a prototype node-evaluation instrument for use in the pathology laboratory. In the more-distant future, we also will investigate application of these QPA and QUS techniques at lower ultrasound frequencies for use in the examination or operating room to identify nodes that warrant biopsy or dissection. In conclusion, this project can benefit lymph-node evaluations for staging, prognosis, and treatment planning of all types of cancers, e.g., breast, colorectal, gastric, pancreatic, lung, thyroid, prostate, etc., as well as sentinel-node dissection procedures, e.g., for breast cancer. The methods we are developing clearly can have a significant beneficial impact on in situ evaluations of lymph nodes examined prior to or during surgery, intra-operative evaluations of regional nodes including sentinel-nodes, and post- operative evaluations of dissected nodes. These methods also may be of use in evaluations of non-cancerous diseases such as cardiac disease, musculoskeletal disease, etc.

描述（由申请人提供）：Riverside Research和夏威夷大学及其附属的Kuakini医学中心提议评估应用定量光声（QPA）方法检测淋巴结转移的可行性，并结合其资助的新型定量超声（QUS）方法来区分癌症患者的含癌和无癌淋巴结。淋巴结转移癌的检测对于准确的分期、预后和治疗计划至关重要。我们的目标是显著降低现有方法检测转移的失败率，在25%至30%的解剖淋巴结和50%的微转移淋巴结中检测转移。为了实现我们的目标，我们建议开发QPA方法单独使用或与高频QUS结合使用，以确定需要仔细组织学检查的淋巴结区域。我们已经朝着这个目标取得了令人兴奋的进展，开发了一种高灵敏度和特异性的纯超声方法，以精细的空间分辨率成像淋巴结转移性疾病。我们的超声结果显示，在广泛的癌症类型中，在清扫淋巴结中检测癌症的能力显着，并且它们承诺指导病理学家到清扫淋巴结的含癌区域的可靠手段。当淋巴结实际上包含微转移性疾病时，我们的超声方法确定转移性癌症的能力可能会大大减少或消除不可接受的假阴性测定的发生。这些发现鼓励我们提出的研究将新的QPA方法与我们的QUS方法结合起来，可能能够同时达到接近100%的灵敏度和特异性值。因此，我们计划在获取qpa信号数据的同时获取QUS信号数据，并利用这些数据的分析结果在多特征方法中对淋巴结组织进行癌性或非癌性分类。如果提议的研究确定单独使用QPA或与QUS结合使用的可行性，那么我们将提议进行验证研究，如果成功，可以为将来开发用于病理实验室的原型节点评估仪器提供基础。在更遥远的将来，我们还将研究这些QPA和QUS技术在较低超声频率下的应用，用于检查或手术室，以确定需要活检或解剖的淋巴结。综上所述，本项目可为乳腺癌、大肠癌、胃癌、胰腺癌、肺癌、甲状腺癌、前列腺癌等各类癌症的分期、预后和治疗方案评估及前哨淋巴结清扫手术提供参考。