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Establishing the validity of brain tumor perfusion imaging

建立脑肿瘤灌注成像的有效性

基本信息

批准号：
9754786
负责人：
Christopher Chad Quarles
金额：
$ 26.49万
依托单位：
ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-07-01 至 2021-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9754786
关键词：
Address Adoption Aftercare Biopsy Blood Vessels Blood Volume Blood flow Bolus Infusion Brain Neoplasms Cell Density Cell Shape Cell Size Clinic Clinical Clinical Trials Communities Community Clinical Oncology Program Complex Computer Simulation Consensus Contrast Media Data Dependence Dose Evaluation Extravasation Future Gadolinium Geometry Glioma Goals Healthcare Image Imaging Techniques Injections Institutes Kinetics Lead Local Therapy Magnetic Resonance Imaging Maps Measurement Measures Methodology Methods Multi-Institutional Clinical Trial Operative Surgical Procedures Oxidants Patients Perfusion Permeability Physicians Physiologic pulse Prediction of Response to Therapy Predisposition Prospective Studies Protocols documentation Publishing Radiation necrosis Recommendation Recurrence Reference Standards Relaxation Research Resources Scheme Series Signal Transduction Site Standardization Techniques Time Tissues Validation Vendor base cancer imaging cerebral blood volume clinical care clinically relevant cost effective density digital ferumoxytol image archival system imaging modality improved in vivo iron oxide maltreatment neuro-oncology novel open source perfusion imaging physical property prevent response targeted treatment tool treatment effect tumor

项目摘要

ABSTRACT The central goal of this proposal is to establish the accuracy of brain tumor perfusion imaging. Dynamic susceptibility contrast (DSC) MRI is one of the most widely used advanced imaging techniques in neuro- oncology. Multiple studies have shown how DSC-MRI measures of relative cerebral blood volume (rCBV) can differentiate glioma grades, tumor types and identify tumor components in non-enhancing glioma distinguish tumor recurrence from post-treatment effects, and predict tumoral response and patient survival after targeted therapy. Despite DSC-MRI's potential impact on clinical care, its broad scale integration has been slow, in large part from a lack of consensus about methodology and how to prevent potential rCBV inaccuracies. Although DSC relies on the assumption that gadolinium-based contrast agents (GBCA) remain within the vascular lumen, this condition is often violated in vivo. If not corrected for, contrast agent leakage effects lead to rCBV inaccuracy, misdiagnosis, and potentially mistreatment. While numerous leakage correction strategies exist, a fundamental limitation has prevented the standardization and wide-spread adoption of DSC-MRI methodology: To date, no study has validated the accuracy of leakage corrected rCBV measures in patients. The lack of validation impacts DSC-MRI standardization efforts, the establishment of rCBV thresholds for clinic use, multi-site comparisons and clinical trials. Given the importance of rCBV accuracy we propose to address this through two highly focused studies. First, we aim to validate rCBV accuracy by comparison to an intravascular reference standard in high-grade glioma patients. Multiple acquisition and analysis techniques will be investigated. Second, using a novel in silico digital phantom we aim to systematically define the range of DSC-MRI protocols that maintain consistent rCBV measurements. Impact on Healthcare: Our primary deliverable is to provide the neuro-oncology community with validated image acquisition and analysis methods for accurate rCBV mapping in brain tumor patients. Validated DSC-MRI techniques will improve its clinical reliability and justify its use across a range of clinical scenarios, including tumor localization, therapy response assessment, surgical and biopsy guidance, and multi-site clinical trials of conventional and targeted brain tumor therapies. !

摘要