Multi-center Structural & Functional Quantitative CT Pulmonary Phenotyping

多中心结构

• 批准号: 8514716
• 负责人: ERIC Alfred HOFFMAN
• 金额: $ 116.48万
• 依托单位: UNIVERSITY OF IOWA
• 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 2016-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8514716
• 关键词: Accounting; Adherence; Air; Algorithms; Anatomy; Asthma; Back; Biological Markers; Biomedical Engineering; Blood Vessels; Blood Volume; Blood flow; Calibration; Chronic Obstructive Airway Disease; Cluster Analysis; Computer software; Contrast Media; Coupled; Data Collection; Development; Disease; Dose; Environmental air flow; Equipment; Etiology; Evaluation; Functional Imaging; Gases; Genotype; Heterogeneity; Image; Image Analysis; Imaging Techniques; Inflammation; Inflammatory; Injection of therapeutic agent; Intervention; Journals; Link; Liquid substance; Lung; Lung diseases; Manufacturer Name; Measurement; Measures; Medicine; Methodology; Methods; Metric; Modeling; Multicenter Trials; New England; Noise; Outcome; Pathologic Processes; Pathology; Perfusion; Peripheral; Phenotype; Population; Process; Protocols documentation; Pulmonary Emphysema; Radiation; Relative (related person); Reporting; Research; Respiratory physiology; Scanning; Science; Smoking; Staging; Structure; Structure-Activity Relationship; Subgroup; Techniques; Technology; Testing; Time; Trees; Venous; X-Ray Computed Tomography; Xenon; airway remodeling; base; computerized tools; detector; disease phenotype; disorder subtype; endothelial dysfunction; feeding; imaging Segmentation; indexing; insight; interest; lung imaging; lung volume; new technology; novel; novel strategies; physiologic stressor; public health relevance; reconstruction; response; tool

DESCRIPTION (provided by applicant): Biomarkers of regional lung function, coupled with validated low dose methods of assessing anatomic features of the lung are critical to promote discovery and testing of new interventions in COPD and asthma. This proposed bioengineering research partnership seeks to take advantage of the emerging acquisition technique of multi-spectral computed tomography (currently dual energy CT: DECT), careful evaluation of dose lowering methods, and novel approaches to statistical cluster anlaysis to expand the biomarkers used in multi-center studies to identify sub-populations of lung disease. Current CT methods have focused largely on parenchymal destruction, air trapping and airway remodeling. With our recent findings reported in the Proceedings of the National Acedemy of Sciences and the New England Journal of Medicine, there is growing evidence that the etiology of emphysema may be correlated with abnormal vascular responses to inflammation in COPD. To further validate these findings, we focus on multi-spectral CT to simplify the current dynamic CT approach in its assessment of ventilation and perfusion. With DECT we can simplify to a single breath of xenon gas or a slow peripheral injection of iodinated contrast agent to assess regional ventilation or perfused blood volume (PBV). Our approach consists of 5 tightly integrated aims seeking to: 1) establish the minimum dose required to achieve the measurements of importance in defining COPD and asthma sub-populations; 2) use our well characterized CT assessment of pulmonary perfusion and ventilation using dynamic axial imaging to validate metrics from DECT, providing indices of ventilation and perfusion via single breath hold / single lung volume techniques; 3) expand image segmentation of the lung to the pulmonary arterial and venous trees to further link structure to function as well as to reliabily provide a framework for dividing the lung into sublobar segments as the standard region of interest; 4) test the application of a novel statistica approach to cluster analysis such that the measures from quantitative CT fully account for specific phenotypes for disease subgroups and link to a computational fluid dynamics model such that a putative phenotype can be better understood; and finally 5) provide a framework whereby newly developed protocols are harmonized across manufacturers and scanner models, allowing for cross institutional data collection and a means whereby technology is allowed to progress within the context of longitudial studies.

描述(由申请人提供)：局部肺功能的生物标记物，加上经过验证的低剂量肺解剖特征评估方法，对于促进COPD和哮喘新干预措施的发现和测试至关重要。这一拟议的生物工程研究伙伴关系寻求利用新兴的多光谱计算机断层扫描(目前为双能量CT：DECT)采集技术、剂量降低方法的仔细评估以及统计聚类分析的新方法，以扩大用于多中心研究的生物标记物，以识别肺部疾病的亚群。目前的CT方法主要集中在实质破坏、空气滞留和气道重塑。随着我们最近的发现发表在《美国国家科学院院刊》和《新英格兰医学杂志》上，越来越多的证据表明，肺气肿的病因可能与COPD患者对炎症的异常血管反应有关。为了进一步验证这些发现，我们将重点放在多层螺旋CT上，以简化目前的动态CT方法来评估其通气性和灌注性。使用DECT，我们可以简化为一次氙气呼吸或缓慢外周注射碘化造影剂来评估区域通气量或灌注量(PBV)。我们的方法由5个紧密结合的目标组成，寻求：1)建立在确定COPD和哮喘亚群时实现重要测量所需的最小剂量；2)使用我们具有良好特性的CT使用动态轴向成像对肺灌注和通风进行评估来验证DECT的测量结果，通过单次屏气/单肺容量技术提供通风和灌注指数；3)将肺的图像分割扩展到肺动静脉树，以进一步将结构与功能联系起来，并可靠地提供将肺划分为亚叶节段作为标准感兴趣区的框架；4)测试新的统计方法在聚类分析中的应用，使定量CT的测量充分考虑疾病亚组的具体表型，并与计算流体动力学模型相联系，从而可以更好地理解推定的表型；最后，5)提供一个框架，使新开发的方案在制造商和扫描仪模型之间得到协调，从而能够进行跨机构的数据收集，并提供一种手段，使技术能够在纵向研究的范围内取得进展。