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.

总结 静息态功能磁共振成像（rsfMRI）是一种快速发展的无任务术前标测方法。它 可以补充基于任务的功能性MRI（tfMRI），用于难以执行任务的患者， 有效地映射静息状态网络（RSN），这些区域通常由于时间而不能用tfMRI映射 限制，如额叶皮层。它有可能在手术期间提供迭代的术中指导。 渐进性切除，使麻醉患者的连接体映射，并持有承诺， 术中皮层电标测可能不适用于微创手术的术中指导 可能为了获得临床认可，rsfMRI分析需要对头部运动具有高度耐受性， 生理信号脉动、功能性神经解剖和脑血管病变相关变化 解耦;以及在正在进行的扫描期间提供数据质量控制度量。术中指导 此外，还需要RSN的自动在线映射和对术中大脑变化的耐受性。 目前没有FDA批准的rsfMRI工具可用于术前标测。在这里，我们提出一个 全自动、高灵敏度和高性价比的实时rsfMRI分析技术， 术前和术中标测工作站。该项目基于TurboFIRE，一个强大的实时 tfMRI和rsfMRI分析软件工具的高速功能磁共振成像，成功的第一阶段STTR研究在12 显示实时高速多回波rsfMRI临床可接受一致性的脑肿瘤患者 tfMRI和术中皮层电刺激（ECS）;以及我们的术中rsfMRI经验 在麻醉的脑肿瘤患者中。这项技术提供了在线rsfMRI映射，消除了 耗时的后处理，并无缝集成到术前计划和术中MRI。 该方法将具有广泛的临床和商业潜力， 神经学和精神病学的应用超出了脑肿瘤患者的术前标测。它 为过去难以研究的患者群体开辟了功能性大脑图谱。