Quantitative Photoacoustic Detection of Lymph-node Metastases

描述（由申请人提供）：滨江研究和夏威夷大学及其附属的Kuakini医学中心提议评估将定量光声（QPA）方法应用于淋巴结转移检测的可行性，并结合其资助的用于区分癌症患者的含癌和无癌淋巴结的新型定量超声（QUS）方法的研究。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。我们的目标是显着减少现有方法的失败，以检测转移的25%至30%的解剖节点和50%的节点与微转移。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，以识别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，通过开发一种高度敏感和特异性的，纯超声成像方法，具有良好的空间分辨率淋巴结转移性疾病。我们的超声波结果显示了在广泛的癌症类型的淋巴结清扫中检测癌症的显着能力，并且它们承诺了引导病理学家到淋巴结清扫的含癌区域的可靠手段。我们的超声波方法能够精确定位转移性癌症，当淋巴结实际上含有微转移性疾病时，可以大大减少或消除不可接受的假阴性测定的发生。这些发现鼓励我们将新型QPA方法与我们的QUS方法相结合的研究可能能够同时实现接近100%的灵敏度和特异性值。因此，我们计划结合QUS信号数据的采集来采集QPA信号数据，并在多特征方法中使用这些数据的分析结果来将淋巴结组织分类为癌性或非癌性。如果拟议的研究确定了单独使用QPA或与QUS结合使用的可行性，那么我们将建议进行验证研究，如果成功，可以为将来开发用于病理学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，以识别需要活检或解剖的淋巴结。总之，该项目可以有益于淋巴结评估，用于所有类型癌症的分期，预后和治疗计划，例如，乳腺、结肠直肠、胃、胰腺、肺、甲状腺、前列腺等，以及前哨淋巴结解剖过程， 例如，在一个实施例中，治疗乳腺癌我们正在开发的方法显然可以对术前或术中检查的淋巴结的原位评价、包括哨兵淋巴结在内的区域淋巴结的术中评价以及解剖淋巴结的术后评价产生显著的有益影响。这些方法也可用于评估非癌性疾病，如心脏病、肌肉骨骼疾病等。

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.