Time Resolved Breast Imaging Using a Combined MRI and Optical Tomography Approach

使用 MRI 和光学断层扫描相结合的方法进行时间分辨乳腺成像

• 批准号: 8476215
• 负责人: Stefan Alexandru Carp
• 金额: $ 23.48万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-10 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8476215
• 关键词: Adipose tissue; Algorithms; Biological Markers; Biomechanics; Blood Volume; Blood flow; Breast; Caliber; Cancer Patient; Characteristics; Choline; Classification Scheme; Clinical; Clinical Trials; Custom; Data; Diagnostic; Diffusion; Disease; Early treatment; Exhibits; Fatty acid glycerol esters; Functional Imaging; Goals; Hemoglobin; Image; Imaging Techniques; Joints; Lesion; Lipids; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Malignant - descriptor; Mammary Gland Parenchyma; Mammary Ultrasonography; Maps; Measurement; Measures; Medical; Metabolic; Metabolic Marker; Metabolism; Methods; Modality; Monitor; Near-Infrared Spectroscopy; Neoadjuvant Therapy; Normal tissue morphology; Operative Surgical Procedures; Optical Tomography; Optics; Outcome; Oxygen; Oxygen Consumption; Patients; Positron-Emission Tomography; Predictive Value; Procedures; Protocols documentation; ROC Curve; Residual state; Resolution; Scanning; Specificity; Staging; System; Techniques; Testing; Time; Tissues; Tumor Volume; Validation; Variant; Water; Weight; Work; blood oxygen level dependent; breast lesion; cancer diagnosis; chemotherapy; chromophore; healthy volunteer; hemodynamics; improved; instrumentation; malignant breast neoplasm; novel; optical fiber; optical imaging; reconstruction; response; success; therapy outcome; tomography; tumor

Primary systemic (neoadjuvant) therapy is routinely used for locally advanced breast cancer patients before surgery to down-stage the disease and increase the chances of a successful outcome. Many patients though do not respond to neoadjuvant therapy, and may be better off switching to a different treatment regime, or progressing to surgery immediately. However, therapy monitoring is difficult because current clinical examination and x-ray/ultrasound mammography follow-ups correlate poorly with final therapy pathological outcome. Both magnetic resonance imaging (MRI) and positron emission tomography (PET) have been evaluated as early predictors of response, with studies showing that 18F-FDG PET as well as diffusion weighted (DW) MRI and choline-compounds MR spectroscopy (tCho-MRS) measurements correspond well with therapy success within a few weeks from the beginning of treatment. Unfortunately, availability (PET), complexity (tCho-MRS), and specificity (MRI) limit the applicability of these methods. Consequently, there is a need to develop non-invasive specific early prediction approaches that more easily integrate into medical practice. A potential answer may be offered by near infrared spectroscopy and tomography (NIRS-DOT). NIRS-DOT is a novel functional imaging technique that can offer images of tissue chromophores such as oxy (HbO) and deoxy hemoglobin (HbR), water and lipids, and small studies have hinted at its potential to predict therapy outcome with high accuracy as early as one week after the start of treatment. Further, recent technological advancements have permitted DOT to reach high time resolution (> 1Hz), allowing new types of functional information to be probed by dynamic imaging. In particular, our group has obtained promising initial results monitoring the response of breast tissue to external compression. Tissue viscoelastic response to compression causes hemodynamic (blood volume) changes with bi-phasic temporal profiles likely to differentiate healthy tissues from breast lesions. Further, the interplay of hemodynamics and tissue oxygen metabolism leads to hemoglobin oxygenation transients that offer the opportunity to estimate tissue oxygen consumption (OC) and blood flow (BF) from time-resolved optical data. The overall goal of this proposal is to combine MRI and NIRS-DOT to characterize the predictive value of compression-enabled measurements of tissue hemodynamics, blood flow and oxygen consumption as new biomarkers sensitive to therapy progress and quantify their relationship to final pathological outcome. Structural information from the MRI scans will be used as prior information for the optical reconstructions and dynamic optical and HbR-related MR blood oxygen level dependent (BOLD) images will be simultaneously acquired enabling a fusion approach for reconstructing time-resolved hemodynamic maps and BF/OC distributions. Difference BOLD images will be cross-validated against corresponding HbR maps. The work will culminate with a clinical trial to assess the early therapy outcome predictive ability of the new biomarkers.

原发性（新辅助）疗法通常用于局部晚期乳腺癌患者 手术以减少疾病的阶段并增加成功结局的机会。虽然许多患者 不要对新辅助疗法做出反应，也可能会更好地转向不同的治疗方案，或者 立即进行手术。但是，治疗监测很困难，因为目前的临床 检查和X射线/超声乳腺X线摄影随访与最终疗法病理学不太相关 结果。磁共振成像（MRI）和正电子发射断层扫描（PET）都是 评估是反应的早期预测指标，研究表明18F-FDG PET以及扩散 加权（DW）MRI和胆碱化合物MR光谱学（TCHO-MRS）测量值良好 从治疗开始几周内就可以在治疗中取得成功。不幸的是，可用性（宠物）， 复杂性（TCHO-MR）和特异性（MRI）限制了这些方法的适用性。因此，有一个 需要开发非侵入性特定的早期预测方法，以更容易地整合到医学中 实践。近红外光谱和断层扫描（NIRS-DOT）可以提供潜在的答案。 NIRS点是一种新型的功能成像技术，可以提供组织发色团的图像，例如Oxy （HBO）和脱氧血红蛋白（HBR），水和脂质以及小型研究暗示了其预测的潜力 治疗开始后一周，治疗结果早在高精度上。此外，最近 技术进步使DOT达到了高时间分辨率（> 1Hz），允许新型类型 可以通过动态成像探测的功能信息。特别是，我们的小组已经获得了有希望的初始 结果监测乳腺组织对外部压缩的反应。组织粘弹性对 压缩会导致血液动力学（血容量）变化，而双重时间分布可能 将健康的组织与乳房病变区分开。此外，血流动力学和组织氧的相互作用 代谢导致血红蛋白氧合瞬变，这些瞬变提供了估计组织氧的机会 来自时间分辨的光学数据的消费（OC）和血流（BF）。 该提案的总体目标是将MRI和NIRS点相结合以表征预测值 新型组织血流动力学，血流和氧气消耗的测量 生物标记物对治疗的进展敏感并量化其与最终病理结果的关系。 来自MRI扫描的结构信息将用作光学重建的先验信息， 动态光学和HBR相关的MR血氧水平依赖（粗体）图像将同时是同时 获得了启用融合方法，用于重建时间分辨的血液动力学图和BF/OC 分布。差异粗体图像将针对相应的HBR图进行交叉验证。工作将 通过一项临床试验最终评估新生物标志物的早期治疗结果预测能力。