Automated Assessment of Leptomeningeal Collaterals on CT Angiograms

CT 血管造影上软脑膜循环的自动评估

• 批准号: 8905209
• 负责人: STEPHEN R AYLWARD
• 金额: $ 15万
• 依托单位: KITWARE, INC.
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-06-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8905209
• 关键词: Academia; Achievement; Address; Algorithms; Angiography; Award; Blood Pressure; Blood Vessels; Blood flow; Brain; Businesses; Clinical; Clinical Data; Computer software; Consult; Contracts; Development; Doctor of Medicine; Doctor of Philosophy; Effectiveness; Evaluation; Funding; Goals; Gold; Human; Hypertension; Image; Image Analysis; Industry; Intervention; Intraobserver Variability; Koreans; Literature; Malignant Neoplasms; Manuals; Measurement; Medical Imaging; Methods; Morphology; Odds Ratio; Operative Surgical Procedures; Outcome; Patients; Phase; Play; Publishing; Radiation; Recurrence; Registries; Research; Retrospective Studies; Risk; Role; Scientist; Site; Slice; Small Business Innovation Research Grant; Solutions; Stream; Stroke; System; Techniques; Testing; Thrombolytic Therapy; Tissues; Treatment Efficacy; United States National Institutes of Health; Universities; Venous; Work; X-Ray Computed Tomography; acute stroke; base; commercialization; density; digital; image guided; innovation; open source; phase 2 study; post stroke; public health relevance; research clinical testing; tool; tumor

 DESCRIPTION (provided by applicant): The primary goal of this study is to develop an automated scoring system of leptomeningeal collaterals based on CT angiography (CTA) as a quantitative assessment of acute stroke. Leptomeningeal collaterals provide an alternate path of blood flow in the setting of a proximal occlusion. The presence and effectiveness of leptomeningeal collaterals (i.e., "collateral status") will vary significantly from patient to patint. Collateral status has been shown to be correlated with both patient outcome and risk of hemorrhagic transformation, suggesting that rapid and accurate assessment of the collaterals would provide a powerful tool for treatment evaluation. The current gold standard for collateral scoring is performed by subjective analysis of retrograde filling in invasive digital subtraction angiograms (DSA). Though CTA is more limited than DSA in the direct evaluation of collaterals, the presence of collaterals may also be evaluated in CTA by the degree of vessel filling beyond the site of occlusion. Several manual assessment techniques based on CTA have been proposed in the literature, but all are subjective and require significant human intervention. Thus, we propose to develop an automated CTA-based collateral status assessment. The aims of our work are as follows: 1) adapt our vessel segmentation algorithms to collateral vessel assessment, 2) perform retrospective evaluation of the CTA derived collateral measurements against DSA in patients, and 3) conduct preliminary retrospective clinical evaluation of the CTA derived collateral measurements against patient outcome. This work brings together a strong yet diverse team, addresses a significant clinical problem with an innovative solution, and uses a two-pronged approach to commercialization involving protected IP and an open-source platform that promotes consulting revenue.

 描述（由申请方提供）：本研究的主要目标是开发一种基于CT血管造影（CTA）的软脑膜侧支循环自动评分系统，作为急性卒中的定量评估。软脑膜侧支在近端闭塞的情况下提供了另一条血流路径。软脑膜侧支的存在和有效性（即，“侧支状态”）将因患者而异。侧支状态已被证明与患者结局和出血性转化风险相关，这表明快速准确的侧支评估将为治疗评估提供有力的工具。目前侧支评分的金标准是通过有创数字减影血管造影（DSA）中逆行充盈的主观分析进行的。虽然CTA在直接评价侧支循环方面比DSA更有局限性，但在CTA中也可以通过闭塞部位以外的血管充盈程度来评价侧支循环的存在。在文献中已经提出了几种基于CTA的手动评估技术，但都是主观的，需要大量的人为干预。因此，我们建议开发一个自动化的CTA为基础的抵押品状态评估。 我们的工作目标如下：1）调整我们的血管分割算法以进行侧支血管评估，2）根据患者的DSA对CTA衍生的侧支血管测量进行回顾性评价，3）根据患者结局对CTA衍生的侧支血管测量进行初步回顾性临床评价。 这项工作汇集了一个强大而多样化的团队，通过创新的解决方案解决了一个重大的临床问题，并采用了双管齐下的商业化方法，涉及受保护的知识产权和促进咨询收入的开源平台。