Viscoelastic Parameters estimation and imaging for Thyroid Nodule differentiation

描述（由申请人提供）：目前，迫切需要对甲状腺结节进行活检前评估。常规超声对于甲状腺结节的检测是相当敏感的;然而，传统超声的低特异性导致大量不必要的（即，良性的）活检，这对患者造成显著的经济和身体负担。为了克服目前具有挑战性的困境，因此，重要的是开发新的低成本和非侵入性的技术，以评估甲状腺结节的高灵敏度和特异性。我们研究的目的是推进，优化和评估一种新的非侵入性方法的有效性，称为多光谱成像和弹性评估（MIEA），它由三种基于超声的技术组成：振动声成像（VA），梳推超声剪切波弹性成像（CUSE）和剪切波色散超声振动测量（SDUV）用于甲状腺结节的表征。术语多光谱是指在多个频带评估甲状腺组织以获得最大信息的概念。MIEA方法将提供诊断US成像无法提供的额外信息。VA是一种成像方法，可提供有关结节形状和结节中微钙化存在的信息，CUSE是一种用于弹性2D标测的方法，SDUV是一种用于弹性和粘度点测量的方法。弹性和钙化在恶性结节的诊断中都很重要，并将评估粘性在此鉴别中的作用。该项目的长期目标是开发一种评估甲状腺结节的新工具。我们的假设是，MIEA方法提高了甲状腺癌检测的灵敏度和特异性。因此，通过改善甲状腺结节活检的选择，该方法减少了不必要的FNAB的数量以及患者的相关成本和负担。MIEA可以在传统的超声扫描仪上实现，并且可以使用相同的超声探头在B型超声成像的引导下进行测量。所提出的MIEA方法是快速、低成本、便携式和非侵入性的，因此它可以用于大的患者群体。这项建议着重于两个具体目标。目标一：准备用于患者研究的系统-推进、优化和自动化用于人类甲状腺研究的MIEA方法;目标#2：人类研究-通过将结果与作为金标准的手术病理学相关联，评估MIEA方法在甲状腺结节鉴别中的诊断价值。方法：VA、SDUV和CUSE将在可编程超声系统上实现，并将使用甲状腺模拟体模对其性能进行测试和优化。将使用独立测量对结果进行验证。在第二个目标中，我们将对一组计划因疑似甲状腺结节接受临床指征甲状腺活检的患者进行人体研究。将对这些患者进行VA成像、CUSE二维弹性标测和SDUV粘弹性测量，结果将与病理学家报告的手术活检结果相关。结果将 可用于评价MIEA鉴别甲状腺结节的敏感性和特异性。

DESCRIPTION (provided by applicant): Currently, there is an urgent need for pre-biopsy assessment of thyroid nodules. Conventional ultrasound is quite sensitive for detection of thyroid nodules; however, low specificity of traditional ultrasound leads to a great number of unnecessary (i.e. benign) biopsies that causes a significant financial and physical burden to the patients. To overcome the present challenging dilemma, it is thus important to develop new low- cost and noninvasive techniques to evaluate thyroid nodules with high sensitivity and specificity. The purpose of our research is to advance, optimize and evaluate the efficacy of a new noninvasive method called Multispectral Imaging and Elasticity Assessment (MIEA), which is comprised of three ultrasound-based techniques: vibro-acoustography (VA), comb-push ultrasound shear wave elastography (CUSE), and shear wave dispersion ultrasound vibrometry (SDUV) for characterization of thyroid nodules. The term multispectral refers to the concept of evaluating thyroid tissue at multiple frequency bands to obtain maximum information. The MIEA method will provide additional information not available from diagnostic US imaging. VA is an imaging method that provides information about the nodule shape and the presence of microcalcifications in the nodules, CUSE is a method for 2D mapping of elasticity, and SDUV is a method for point measurement of elasticity and viscosity. Both elasticity and calcifications are important in diagnosis of malignant nodules and will evaluate the effects of viscosity in this differentiation. The long-term goal of this project is to develop a new tool for assessment of thyroid nodules. Our hypothesis is that the MIEA method improves the sensitivity and specificity of thyroid cancer detection. Hence by improving the selection of thyroid nodules for biopsy, this method reduces the number of unnecessary FNAB and the associated cost and burden to the patients. MIEA can be implemented on conventional ultrasound scanners, and measurements can be made under the guidance of B-mode ultrasound imaging using the same ultrasonic probe. The proposed MIEA method is fast, low cost, portable, and noninvasive, thus it can be available to a large patient population. This proposal focuses on two specific Aims. Aim # 1: Prepare system for patient studies - Advance, optimize, and automate the MIEA method for human thyroid study; Aim # 2: Human study - Assess diagnostic value of the MIEA method in differentiation of thyroid nodules by correlating the results to surgical pathology as the gold standard. Approach: VA, SDUV, and CUSE will be implemented on a programmable ultrasound system and their performance will be tested and optimized using thyroid-mimicking phantoms. The results will be validated using independent measurements. In the second Aim, we will conduct a human study on a group of patients who are scheduled to have clinically-indicated thyroid biopsy for suspected thyroid nodules. VA imaging, 2D elasticity mapping by CUSE, and viscoelasticity measurement by SDUV will be performed on these patients and the results will be correlated with the findings of surgical biopsy as reported by the pathologist. The results will be used to evaluate the sensitivity and specificity of MIEA for differentiation of thyroid nodules.