Novel Dynamic Liver Imaging Method with Flexible Temporal and Spatial Resolution

描述（由申请人提供）：肝癌对公众健康造成越来越大的负担。目前，3D多期增强MR检查用于分离动脉和静脉血供到任何病变，以确定是否恶性。它在很大程度上依赖于患者维持屏气的能力，但在相当一部分患者中，这种能力受到损害，导致图像质量急剧下降。它还依赖于操作者精确的给药时间，这样，第一个所谓的肝动脉期是在动脉增强的正确峰值处获得的。注射时间错误导致增强模式的次优视图，对准确诊断肝脏疾病的能力产生负面影响。本研究的长期目标是提高肝脏MR成像检测肝细胞癌和其他恶性肿瘤的鲁棒性和准确性。作为该目标的一部分，本研究的目的是开发一种强大的图像采集和可视化技术。本研究的假设是，该技术消除了这些需求，并以最佳方式向读者呈现所有可用的动态信息。所提出的研究的基本原理是，一种鲁棒和准确的动态成像方法能够快速提取所有必要的造影剂摄取和冲洗信息，以准确诊断肝脏病变。为了验证这一假设，我们追求以下两个具体目标：1)开发具有高时空分辨率的三维时间分辨率对比度增强自由呼吸成像序列，并结合交互式四维可视化和后处理引擎；2)在患者研究中评估开发的自由呼吸肝脏MRI序列的诊断性能。本研究的预期结果是一种交互式动态肝脏磁共振成像方法，将显著改善肝脏病变的检测和表征方式。这种技术可能会产生积极的影响，因为它有望提高肝脏MRI的敏感性和特异性，减少对肝脏活检的需求，以及对患者合作和操作人员技能的依赖。

DESCRIPTION (provided by applicant): Liver cancer presents an increasing burden on public health. Currently, a 3D multi-phase contrast-enhanced MR exam is used to separate the arterial from the venous blood supply to any lesion to determine whether it is malignant or not. It relies heavily on the ability of the patient to sustain a breath-hold, but in a considerable subset of patients, this ability is compromised, leading to a sharp decrease in image quality. It also relies on accurate bolus timing by the operator, such that the first so-called hepatic arterial phase is acquired at the right peak arterial enhancement. Bolus timing errors lead to a suboptimal view of the enhancement pattern, negatively affecting the ability to accurately diagnose liver disease. The long-term goal of this research is to improve the robustness and accuracy of MR imaging of the liver for the detection of hepatocellular carcinoma and other malignancies. The objective of this research, as part of that goal, is to develop a robust image acquisition and visualization technology. The hypothesis in this research is that this technology eliminates these requirements and optimally presents all available dynamic information to the reader. The rationale for the proposed research is that a robust and accurate dynamic imaging method enables the fast extraction of all necessary contrast uptake and washout information for the accurate diagnosis of liver lesions. To test the hypothesis, the following two specific aims are pursued: 1) develop a three-dimensional time-resolved contrast-enhanced free-breathing imaging sequence with high temporal and spatial resolution together with an interactive four-dimensional visualization and post-processing engine, and 2) evaluate the diagnostic performance of the developed free-breathing liver MRI sequence in a patient study. The expected outcome of this research is an interactive dynamic MR imaging method of the liver that will significantly improve the way liver lesions are detected and characterized. Such a technique is likely to have a positive impact, since it expected to increase the sensitivity and specificity of liver MRI and to reduce the need for liver biopsy and the reliance on patient cooperation and operator skill. . PUBLIC HEALTH RELEVANCE: The proposed research is relevant to public health because, if completed successfully, it is expected to increase the sensitivity and specificity of liver MRI. It will reduce the need for liver biopsy and the reliance on patient cooperation and operator skill. It is likely to lead to significant improvements in the staging of hepatocellular carcinomas and in the assignment of ranking scores for liver transplantation.