Improved Whole-Brain Spectroscopic MRI for Radiation Treatment Planning

确定神经胶质瘤肿瘤边缘的放射治疗计划仍然是一项具有挑战性的任务， 这些肿瘤的浸润性质和目前标准成像方法的局限性。多项研究 包括我们自己的研究已经证明，磁共振光谱成像，或光谱MRI（sMRI），可以检测到， 具有高度敏感性的浸润性肿瘤区域，并且可能是治疗 导致早期复发。sMRI能够识别浸润细胞，这些细胞以增加的 胆碱/N-乙酰天冬氨酸比值，包括标准MRI无法检测到的区域和正常左侧 未经治疗。因此，sMRI显示出相当大的改善放射治疗效果的前景， 显著延缓复发。然而，在sMRI可以广泛应用之前，还需要技术改进。 采用临床使用。这项研究将通过利用四个不同领域的专业知识来实现这一目标。 研究中心设计和验证改善sMRI采集所需的技术改进， 分析和临床整合。这些改进将包括新的磁铁匀场技术， 将sMRI的空间覆盖范围增加到全脑体积;更新快速和运动稳健的sMRI方法 它结合了压缩传感，既提高了空间分辨率，又减少了采集时间; 新的处理，显示和分析方法，将以有效的方式呈现代谢物图谱， 临床医生友好的基于Web的界面，可与放射治疗计划软件集成 系统.技术发展的价值和功效将在一项临床研究中得到验证， 将sMRI纳入胶质母细胞瘤RT计划的参与研究中心，使用递增剂量， Cho/NAA显著升高的区域。本研究的完成将提供稳健的sMRI采集 方法和软件工具，将适用于临床使用。

Identifying the extent of glioma tumor margins for radiation treatment planning remains a challenging task due to the infiltrative nature of these tumors and limitations in current standard imaging methods. Multiple studies including our own have demonstrated that MR spectroscopic imaging, or spectroscopic MRI (sMRI), can detect areas of infiltrating tumor with a high degree of sensitivity, and could be an essential tool in treating areas that lead to early recurrence. sMRI enables the identification of infiltrating cells that are marked by increased Choline/N-Acetylaspartate ratios, including regions that are not detectable by standard MRI and normally left untreated. Therefore, sMRI shows considerable promise for improving the efficacy of radiation treatment and significantly delay recurrence. However, technological improvements are needed before sMRI can be broadly adopted for clinical use. This study will achieve this goal by leveraging diverse areas of expertise at four research sites to engineer and validate technological improvements needed to improve sMRI acquisition, analysis, and clinical integration. These improvements will include new magnet shimming technology to increase the spatial coverage of sMRI to whole-brain volumes; updated rapid and motion-robust sMRI method that incorporates compressed sensing to both increase spatial resolution and decrease acquisition times; and new processing, display, and analysis methods that will present metabolite maps in an efficient manner with a clinician-friendly web-based interface that enables integration with radiation treatment planning software systems. The value and efficacy of the technological developments will be validated in a clinical study at the participating sites that will incorporate sMRI into RT planning for glioblastoma, using an escalated dose for regions of significantly increased Cho/NAA. The completion of this study will provide robust sMRI acquisition methods and software tools that will be suitable for clinical use.