Three-Dimensional Multi-Parametric Ultrasound for Monitoring Therapy of Liver Metastasis

三维多参数超声监测肝转移治疗

• 批准号: 10456333
• 负责人: Ahmed El Kaffas
• 金额: $ 68.75万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10456333
• 关键词: 3-Dimensional; 3D ultrasound; Abdomen; Address; Anatomy; Biological Markers; Blood Vessels; Cancer Patient; Cessation of life; Clinical; Clinical Trials; Clinical assessments; Collaborations; Colorectal; Computer software; Contrast Media; Data; Development; Disease; Early treatment; Evaluation; Foundations; Functional Imaging; Future; Goals; Grant; Healthcare; Image; Imaging Techniques; Industry; Inflammatory Response; Interobserver Variability; Lesion; Liver; Liver neoplasms; Malignant Neoplasms; Measurement; Metastatic Neoplasm to the Liver; Methods; Modality; Monitor; Morbidity - disease rate; Motion; Multi-Institutional Clinical Trial; Organ; Outcome; Patient Care; Patient Monitoring; Patients; Perfusion; Phase; Prediction of Response to Therapy; Radiation; Radiology Specialty; Reporting; Reproducibility; Research Project Grants; Resources; Sampling Errors; Savings; Scanning; Site; Spectrum Analysis; Survival Rate; System; Techniques; Technology; Therapeutic; Three-Dimensional Imaging; Tissue imaging; Tissues; Transducers; Tumor Volume; Ultrasonography; Validation; Vendor; Work; anatomic imaging; base; cancer imaging; cancer therapy; cancer type; chemotherapy; clinical application; clinical care; clinical center; clinical research site; colorectal cancer metastasis; contrast enhanced; cost; data acquisition; design; effective therapy; experience; imaging approach; improved; improved outcome; industry partner; innovation; liver visualization; metastatic colorectal; novel; novel marker; patient response; portability; quantitative ultrasound; response; side effect; success; tool; treatment response; tumor; tumor heterogeneity; ultrasound

PROJECT SUMMARY/ABSTRACT The ability to non-invasively predict or monitor early patient response to cancer therapy will have significant implications for patient care with the potential to spare non-responding patients the high morbidity and cost associated with failed treatments. Due to its wide accessibility, lack of radiation, relatively low cost, and excellent visualization of the liver, ultrasound is a demonstrated and potentially ideal modality to repeatedly image and monitor patient responses over the course of therapy. In the first phase of this work, we demonstrated that current 2D dynamic contrast-enhanced ultrasound (DCE-US) is fundamentally limited in quantification due to tumor heterogeneities, resulting in consecutive sampling errors with substantial over- or underestimation of treatment response in patients. We then showed that these limitations could be overcome by a novel 3D DCE-US imaging approach using innovative matrix array transducer technology to provide motion-compensated, accurate quantitative and volumetric assessment of tissue perfusion of liver metastases. In this competitive renewal proposal, framed as an industry-academic partnership with Philips who is committed to our proposal, our aim to clinically advance 3D multi-parametric tissue and perfusion characterization with ultrasound (3D MPUS) to predict or monitor early response in patients with metastatic colorectal cancers to the liver (mCRC). For this, we have proposed a set of specific aims where we will: i) work with Philips to enhance 3D DCE-US data acquisition to overcome previously reported limitations, enable simultaneous acquisition of raw RF/Bmode data for tissue characterization, and develop an analysis software suite for MPUS quantification, ii) carry-out a multi-site clinical feasibility, acquisition repeatability and quantification reproducibility assessment of 3D MPUS in 300 patients, and iii) determine whether 3D MPUS quantification can predict or monitor early therapy response. For this, baseline and early changes of tumor perfusion and tissue parameters (obtained before and at 2-3 weeks after initiation of therapy) will be correlated to treatment response. Treatment response as defined on abdominal radiological scans acquired at 2 months following treatment initiation will be determined using standard RECIST 1.1 reporting. Our proposal builds on the recent FDA approval of ultrasound contrast agents for liver tumor imaging, increased clinical availability of commercial 3D US abdominal probes, and our initial clinical validation of 3D DCE-US and extensive experiences in QUS.

项目摘要/摘要 非侵入性预测或监测癌症治疗早期患者反应的能力将具有重要意义 对患者护理的影响，有可能使无反应的患者避免高发病率和高成本 与失败的治疗有关。由于其可获得性广，缺乏辐射，成本相对较低，以及 良好的肝脏可视化，超声是一种被证实的，也是潜在的理想的重复检查方式 成像和监测患者在治疗过程中的反应。在这项工作的第一阶段，我们 表明目前的2D动态对比增强超声(DCE-US)基本上局限于 由于肿瘤的异质性而导致的量化，导致连续的抽样误差，具有显著的过度OR 低估了患者的治疗反应。然后，我们展示了这些限制是可以克服的 通过使用创新的矩阵阵列换能器技术的新型3D DCE-US成像方法提供 运动补偿，准确定量和体积评估肝转移瘤的组织灌注量。 在这份竞争性续订提案中，与飞利浦建立了行业-学术合作伙伴关系，飞利浦是 致力于我们的建议，我们的目标是在临床上推进3D多参数组织和灌注 超声(3DMPUS)用于预测或监测转移性肿瘤患者的早期反应 结直肠癌至肝脏(MCRC)。为此，我们提出了一套具体的目标，我们将在以下方面：i)工作 与飞利浦一起增强3D DCE-US数据采集，以克服之前报告的限制，实现 同时采集用于组织定征的原始RF/B模式数据，并开发分析软件 用于MPU量化的套件，ii)进行多点临床可行性、采集重复性和 在300名患者中对3D MPU的量化可重复性评估，以及III)确定3D MPU是否 量化可以预测或监测早期治疗反应。为此，肿瘤的基线和早期变化 血流灌注和组织参数(在治疗开始前和治疗后2-3周获得)将是相关的。 对治疗的反应。根据2个月后采集的腹部放射扫描所确定的治疗反应 随后的治疗启动将使用标准的RECIST 1.1报告来确定。我们的建议是建立在 最近FDA批准了用于肝脏肿瘤成像的超声造影剂，提高了临床应用 商用3D US腹部探头，以及我们对3D DCE-US和广泛应用的初步临床验证 在QUS中的经验。