Towards intra-operative guidance in brain tumor surgery using real-time resting-state functional MRI

使用实时静息态功能 MRI 进行脑肿瘤手术的术中指导

• 批准号: 10761498
• 负责人: Clark Chin-Chung Chen
• 金额: $ 37.82万
• 依托单位: NEURINSIGHT, LLC
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-19 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10761498
• 关键词: Anesthesia procedures; Biometry; Brain; Brain Mapping; Brain Neoplasms; Clinical; Clinical Trials; Collaborations; Complement; Computer Workstations; Consumption; Custom; Data; Databases; Equilibrium; Evaluation; Excision; FDA approved; Functional Magnetic Resonance Imaging; Geometry; Grant; Head Movements; Language; Lesion; Magnetic Resonance; Magnetic Resonance Imaging; Maps; Methodology; Minnesota; Monitor; Morphologic artifacts; Motion; Motor; Nervous System Physiology; Neuroanatomy; Neurologic; Neurosurgeon; New Mexico; Operative Surgical Procedures; Patient Participation; Patients; Performance; Phase; Physiological; Qualifying; Quality Control; Research; Research Personnel; Rest; Scanning; Sensitivity and Specificity; Sensory; Signal Transduction; Slide; Small Business Technology Transfer Research; Software Tools; Speed; Statistical Data Interpretation; System; Technology; Testing; Time; Tissues; Validation; analysis pipeline; awake; cerebrovascular; connectome; cortex mapping; cost effective; data quality; deep learning; design; experience; frontal lobe; functional MRI scan; functional disability; high end computer; minimally invasive; neurovascular; patient population; preservation; programs; success; technology validation; tool; tumor

Summary Resting-state functional MRI (rsfMRI) is a rapidly developing task-free approach for presurgical mapping. It can complement task-based functional MRI (tfMRI) in patients who have difficulties performing tasks and efficiently map resting state networks (RSNs) in regions that are not typically mapped with tfMRI due to time constraints, such as frontal cortex. It has the potential to provide iterative intra-operative guidance during progressive resection, enables connectome mapping in anesthetized patients, and holds promise for intra-operative guidance of minimally invasive surgery where intra-operative electrocortical mapping may not be possible. To achieve clinical acceptance, rsfMRI analysis needs to be highly tolerant to head movement, physiological signal pulsation, lesion-related changes of functional neuro-anatomy and cerebrovascular uncoupling; and provide data quality control metrics during the ongoing scan. Intra-operative guidance additionally requires automated online mapping of RSNs and tolerance to intra-operative brain shifts. There are currently no FDA-approved rsfMRI tools available for presurgical mapping. Here, we propose a fully automated, highly sensitive and cost-effective real-time rsfMRI analysis technology on a high-performance workstation for presurgical and intraoperative mapping. The project builds on TurboFIRE, a powerful real-time tfMRI and rsfMRI analysis software tool for high-speed fMRI, the success of a prior Phase I STTR study in 12 brain tumor patients that showed clinically acceptable concordance of real-time high-speed multi-echo rsfMRI with tfMRI, and intra-operative electrocortical stimulation (ECS); and our experience with intra-operative rsfMRI in anesthetized brain tumor patients. This technology provides online rsfMRI mapping, eliminating time-consuming postprocessing, and seamless integration into presurgical planning and intra-operative MRI. This methodology will have significant clinical and commercial potential for a wide range of neurological and psychiatric applications beyond pre-surgical mapping in patients with brain tumors. It opens up functional brain mapping to patient populations that have been difficult to study in the past.

摘要 静息状态功能磁共振成像(RsfMRI)是一种快速发展的无任务术前标测方法。它 可以补充执行任务有困难的患者的基于任务的功能磁共振成像(TfMRI) 在受时间限制通常未使用tfMRI映射的区域中高效映射休眠状态网络(RSN) 限制因素，如额叶皮质。它有可能在手术中提供反复的指导 渐进式切除，能够在麻醉患者中进行连接组图，并有望 术中皮层标测可能不适用的微创手术的术中指导 有可能。为了获得临床接受，rsfMRI分析需要高度耐受头部运动， 生理信号脉动、功能神经解剖学和脑血管病变相关改变 解耦；并在正在进行的扫描期间提供数据质量控制指标。术中指导 此外，还需要自动在线绘制RSN和耐受术中脑转移。 目前还没有FDA批准的rsfMRI工具可用于术前标测。在这里，我们提出一种 全自动、高灵敏度、高性价比的高性能实时rsfMRI分析技术 用于术前和术中标测的工作站。该项目建立在TurboFire上，一个强大的实时 用于高速fMRI的tfMRI和rsfMRI分析软件工具，在12个月中成功进行了先前的I期STTR研究 实时高速多回波rsfMRI显示临床可接受的一致性的脑肿瘤患者 使用tfMRI和术中电皮质刺激(ECS)；以及我们在术中使用rsfMRI的经验 在麻醉的脑肿瘤患者中。该技术提供在线rsfMRI映射，消除了 耗时的后处理，以及与术前计划和术中MRI的无缝集成。 这一方法学将具有巨大的临床和商业潜力，可用于广泛的 脑肿瘤患者手术前标测以外的神经学和精神病学应用。它 为过去难以研究的患者群体打开功能脑图谱。