Novel MRI Imaging Tools and Software for Assessing Pediatric Crohn's Disease

用于评估儿童克罗恩病的新型 MRI 成像工具和软件

• 批准号: 9212806
• 负责人: SIMON K WARFIELD
• 金额: $ 37.16万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-01-08 至 2018-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9212806
• 关键词: Abdomen; Adolescent; Adult; Affect; Algorithms; Bayesian Modeling; Biological Markers; Biomedical Computing; Blood Tests; Body Image; Caring; Cell Proliferation; Cellularity; Child; Childhood; Chronic; Clinical; Clinical Management; Clinical Research; Colonoscopy; Computational Science; Computer software; Computers; Crohn' s disease; Custom; Data; Development; Diagnosis; Diagnostic; Diagnostic radiologic examination; Diagnostic tests; Diffusion; Diffusion Magnetic Resonance Imaging; Disease; Disease Management; Evaluation; Excision; Fibrosis; Goals; Histology; Image; Imaging Device; Imaging Techniques; Immune system; Individual; Inflammation; Inflammatory; Inflammatory Bowel Diseases; Inflammatory disease of the intestine; Intestines; Ionizing radiation; Magnetic Resonance; Magnetic Resonance Imaging; Maximum Likelihood Estimate; Measurement; Medical; Medical Imaging; Medicine; Methods; Microcirculation; Modeling; Monitor; Motion; North America; Operative Surgical Procedures; Pathology; Patient-Focused Outcomes; Patients; Pediatric Radiologist; Performance; Perfusion; Pharmaceutical Preparations; Physiological Processes; Physiology; Population; Postoperative Period; Process; Radiation; Recurrence; Reference Standards; Research; Resected; Scientist; Signal Transduction; Specimen; Standardization; Structure; Surgeon; Surrogate Markers; Target Populations; Techniques; Technology; Testing; Time; Tissues; Toxic effect; Translating; Ulcerative Colitis; United States; United States National Institutes of Health; Work; X-Ray Computed Tomography; base; clinical imaging; combinatorial; density; diffusion weighted; disease diagnosis; experience; imaging approach; imaging modality; imaging software; improved; indexing; innovation; novel; open source; parametric imaging; practical application; prevent; public health relevance; rapid technique; reconstruction; response; therapy outcome; translational impact; treatment planning; tumor

DESCRIPTION (provided by applicant): An estimated 1.4 million people in the United States suffer from inflammatory bowel disease (IBD), half of whom are believed to have Crohn's disease (CD), one of two primary forms of IBD along with ulcerative colitis. At least 10% are <18. Our response to Innovations in Biomedical and Computational Science and Technology under PAR-07-344, "Novel MRI Imaging Tools and Software for Assessing Pediatric Crohn's Disease" (pCD), is aimed at developing and refining a new type of parametric imaging- accelerated spatially constrained incoherent motion MRI (aSCIM-MRI)-as a highly accurate quantitative biomarker for cell proliferation, density and size, and tissue perfusion-all indices tat characterize the extent of disease activity (i.e., inflammation) in the tissue micro-structure of te bowel. If successful, this non-invasive, radiation-free technique will constitute a dramatic improvement over current reference standards (i.e., magnetic resonance enterography (MRE), clinical exam, blood tests, and histology), separately, and in combination. Specifically, a-SCIM-MRI is expected to substantially improve our ability to assess inflammatory activity in pCD; monitor response-to-therapy; evaluate the need for surgical intervention; develop treatment plans that are tailored to individual disease profiles; and predict the likelihood of recurrence. T these ambitious ends, we will undertake the following Specific Aims: 1) to determine whether a spatially constrained signal decay model (SCIM-MRI) improves the reliability of fast and slow diffusion quantification from diffusion-weighted MRI (DW-MRI); 2) to accelerate SCIM-MRI acquisition time with a Bayesian model-based reconstruction (aSCIM-MRI); and 3) to assess the efficacy of fast and slow diffusion components at distinguishing active inflammation from fibrosis in pCD as determined by histopathological findings. With the support of the NIH, these anticipated research accomplishments will result in vastly improved management of a most debilitating bowel disease, the diagnosis of which is often elusive, and on diagnosis, challenging to treat; in part because optimal therapies are somewhat limited for children; and in part because the target population is developmentally fragile to begin with, and thus more susceptible to toxicity from strong biologic drugs and to the complications (both short- and long-term) associated with surgery. Given the fact that up to 75% of children with CD must undergo a bowel resection as some point in their lives, and given the fact that these surgeries are rarely curative; the demand to improve assessment capabilities has never been greater. This highly innovative imaging approach, aSCIM-MRI, is therefore expected not only to create a new reference standard by which pCD is evaluated, monitored, and treated; it is also expected to have rapid translational impact once it is introduced into routine clinical imaging. A second, important overall goal of this project is to develop and broadly disseminate open source software will enable the standardized evaluation of other diseases that are presently evaluated with DW-MRI and would benefit from the advanced diagnostic and assessment capabilities of aSCIM-MRI.

描述（由申请人提供）：估计美国有 140 万人患有炎症性肠病 (IBD)，其中一半被认为患有克罗恩病 (CD)，这是与溃疡性结肠炎一起的两种主要形式的 IBD 之一。至少 10% 的年龄<18 岁。我们对 PAR-07-344“用于评估儿童克罗恩病的新型 MRI 成像工具和软件”(pCD) 下的生物医学和计算科学技术创新的回应，旨在开发和完善一种新型参数成像——加速空间约束运动 MRI (aSCIM-MRI)——作为细胞增殖、密度和细胞增殖的高精度定量生物标志物。 大小和组织灌注——所有指标都表征肠道组织微观结构中疾病活动（即炎症）的程度。如果成功，这种非侵入性、无辐射的技术将比当前的单独和组合的参考标准（即磁共振肠造影（MRE）、临床检查、血液测试和组织学）产生巨大的改进。具体来说，a-SCIM-MRI 预计将大大提高我们评估 pCD 炎症活动的能力；监测治疗反应；评估手术干预的必要性；制定适合个人疾病概况的治疗计划；并预测复发的可能性。为了实现这些雄心勃勃的目标，我们将实现以下具体目标： 1）确定空间约束信号衰减模型（SCIM-MRI）是否提高了扩散加权 MRI（DW-MRI）的快速和慢速扩散量化的可靠性； 2) 通过基于贝叶斯模型的重建（aSCIM-MRI）来加速 SCIM-MRI 采集时间； 3) 评估快速和慢速扩散成分在区分 PCD 中的活动性炎症和纤维化方面的功效（根据组织病理学结果确定）。在美国国立卫生研究院的支持下，这些预期的研究成果将大大改善对一种最令人衰弱的肠道疾病的治疗，这种疾病的诊断往往难以捉摸，而且诊断后又难以治疗；部分原因是最佳治疗方法对于儿童来说有些有限；部分原因是目标人群一开始就发育脆弱，因此更容易受到强效生物药物的毒性以及与手术相关的并发症（短期和长期）的影响。鉴于高达 75% 的克罗恩病儿童在一生中的某个阶段必须接受肠切除术，而且这些手术很少能治愈；提高评估能力的需求从未如此强烈。因此，这种高度创新的成像方法，aSCIM-MRI，不仅有望创建一个新的参考标准来评估、监测和治疗 pCD，而且还将成为 PCD 评估、监测和治疗的新参考标准。一旦引入常规临床成像，预计也会产生快速转化影响。该项目的第二个重要总体目标是开发并广泛传播开源软件，该软件将能够对目前使用 DW-MRI 评估的其他疾病进行标准化评估，并将受益于 aSCIM-MRI 的先进诊断和评估能力。