Twofold Reduction in Gadolinium Dose for Brain MRI Exams using a Novel Unbalanced T1 Relaxation-Enhanced Steady-State (uT1RESS) Technique

使用新型不平衡 T1 弛豫增强稳态 (uT1RESS) 技术将脑 MRI 检查的钆剂量减少两倍

• 批准号: 10671616
• 负责人: Robert R. Edelman
• 金额: $ 18.44万
• 依托单位: NORTHSHORE UNIVERSITY HEALTHSYSTEM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10671616
• 关键词: 3-Dimensional; Adult; Applications Grants; Biological Products; Blood; Blood Vessels; Brain; Brain Neoplasms; Clinical; Contrast Media; Cost Savings; Darkness; Deposition; Detection; Disease; Dose; Enhancing Lesion; Equation; European; Evaluation; Foundations; Gadolinium; Health Benefit; Healthcare Systems; Image; Imaging Techniques; Japan; Leptomeninges; Lesion; Magnetic Resonance Imaging; Malignant Neoplasms; Marketing; Medical; Medical Device; Methods; Modeling; Multi-Institutional Clinical Trial; Multiple Sclerosis; Neoplasm Metastasis; Nephrogenic Systemic Fibrosis; Noise; PET/CT scan; Pathology; Patients; Pharmacologic Substance; Physiologic pulse; Prognosis; Publishing; Radiosurgery; Recommendation; Relaxation; Reporting; Research; Risk; Savings; Scanning; Science; Sensitivity and Specificity; Site; Techniques; Technology; Testing; Time; United States; United States Food and Drug Administration; Water; blood-brain barrier crossing; brain magnetic resonance imaging; brain tumor imaging; contrast enhanced; cost; diagnostic accuracy; follow-up; healthy volunteer; improved; magnetic field; nervous system disorder; neuroimaging; novel; reconstruction; standard of care; treatment planning; tumor; tumor diagnosis

Contrast-enhanced magnetic resonance imaging (MRI) is the cornerstone for brain tumor diagnosis and treatment planning. While its sensitivity for metastases is superior to that of CT or PET-CT, small lesions (<5- mm) and leptomeningeal spread may still be missed, which can have a major impact on prognosis and planning for stereotactic radiosurgery, as well as on the use of targeted biologics that cross the blood-brain barrier. A method that could further improve the sensitivity and specificity of MRI for brain tumors would be of great clinical benefit. Towards this end, we have developed a new class of pulse sequences, called T1 Relaxation-Enhanced Steady-State (T1RESS), that greatly improves the visibility of tumors in contrast- enhanced MRI. Compared with existing neuroimaging techniques, T1RESS at least doubles the tumor-to- background contrast while significantly improving the tumor-to-background contrast-to-noise ratio. An “unbalanced” version (uT1RESS) renders blood vessel dark and is the focus of our proposal. In a preliminary study of 54 adult patients that was published in Science Advances, uT1RESS provided a remarkable twofold or greater improvement in tumor-to-brain contrast along with a marked improvement in lesion-to-brain contrast-to-noise in comparison to standard-of-care MPRAGE and other pulse sequences that are commonly used to image brain tumors. We found that even small metastatic tumor deposits and leptomeningeal lesions that were difficult to distinguish from small blood vessels with standard imaging techniques could be unambiguously identified. The primary hypothesis of this two-year grant proposal is that R21 grant proposal is that the twofold or greater improvement in sensitivity to gadolinium enhancement provided by uT1RESS will enable a corresponding twofold reduction in GBCA dose, with non-inferior diagnostic accuracy compared to full dose MRI using standard neuroimaging techniques. Studies of phantoms, healthy volunteers, and patients with brain tumors along with Bloch equation modeling will be used to guide sequence optimization. Our specific aims are as follows: 1. To maximize the sensitivity of uT1RESS to gadolinium enhancement while optimizing image quality and minimizing scan time. 2. To perform a single site research trial at 3 Tesla to determine whether half dose contrast-enhanced MRI using uT1RESS is non-inferior to full dose contrast-enhanced MRI using a standard neuroimaging technique in patients with brain tumors.

对比增强的磁共振成像（MRI）是用于脑肿瘤诊断的基石和 治疗计划。虽然其对转移的敏感性优于CT或PET-CT的敏感性，但小病变（<5-- MM）和瘦脑膨胀可能仍会被遗漏，这可能会对预后和预后产生重大影响 立体定向放射外科手术以及跨越血脑的靶向生物制剂的使用 障碍。一种可以进一步提高MRI对脑肿瘤的敏感性和特异性的方法将是 巨大的临床益处。为此，我们开发了一种新的脉冲序列，称为T1 放松增强的稳态（T1RESS），极大地提高了肿瘤的可见性 - 增强的MRI。与现有的神经影像技术相比，T1RESS至少翻了一番 背景对比度，同时显着改善了肿瘤与背景的对比度比率。一个 “不平衡”版本（UT1RESS）使血管变暗，这是我们提议的重点。 在一项针对科学进展中发表的54名成年患者的初步研究中，UT1RESS提供了 肿瘤到脑的对比度有显着改善，并显着改善 与护理标准的mprage和其他脉搏序列相比 通常用于图像脑肿瘤。我们发现，即使是小的转移性肿瘤沉积物和 难以与标准成像的小血管区分开的瘦脑膜病变 可以明确识别技术。 这项为期两年赠款提案的主要假设是R21赠款提案是双重或 UT1RESS提供的对gadolinium增强的敏感性将更大改善 与全剂量相比 使用标准神经影像技术的MRI。幻影，健康志愿者和患者的研究 脑肿瘤以及BLOCH方程模型将用于指导序列优化。我们的具体 目的如下： 1。最大化UT1RESS对gadolinium增强的敏感性，同时优化图像质量 并最大程度地减少扫描时间。 2。在3特斯拉进行一次现场研究试验，以确定一半剂量对比度增强的MRI是否 使用UT1RESS使用标准神经影像技术不属于全剂量对比增强MRI 患有脑肿瘤的患者。