Web-based Automated Imaging Differentiation of Parkinsonism

基于网络的帕金森病自动成像鉴别

• 批准号: 10685065
• 负责人: Angelos Barmpoutis
• 金额: $ 7.62万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10685065
• 关键词: Algorithms; American; Area Under Curve; Autopsy; Biological Markers; Blinded; Brain; Clinic; Clinical; Clinical Trials; Communities; Data; Data Analyses; Data Collection; Dementia; Diagnosis; Diagnostic; Differential Diagnosis; Diffusion; Diffusion Magnetic Resonance Imaging; Disease; Enrollment; Goals; Growth; Health; Image; Machine Learning; Magnetic Resonance Imaging; Modeling; Motor; Movement Disorders; Multiple System Atrophy; Nerve Degeneration; Neurologic; Neurologist; Online Systems; Outcome; Parkinson Disease; Parkinsonian Disorders; Participant; Pathologic; Pathology; Patient Care; Patients; Persons; Pharmaceutical Preparations; Phase II Clinical Trials; Phase III Clinical Trials; Probability; Procedures; Process; Prognosis; Progressive Supranuclear Palsy; Prospective cohort; Protocols documentation; Radiology Specialty; Reading; Research Personnel; Risk; Secure; Signal Transduction; Site; Software Tools; System; Techniques; Testing; TimeLine; Tissues; Training; Translating; Validation; Variant; Vendor; Water; accurate diagnosis; algorithm development; atypical parkinsonism; clinical diagnosis; cohort; data exchange; diagnostic accuracy; diagnostic algorithm; diagnostic biomarker; diagnostic criteria; disease diagnosis; dopamine transporter; experience; imaging biomarker; improved; indexing; individualized medicine; innovation; performance tests; programs; quality assurance; support vector machine; tool; treatment planning; web site

SUMMARY Across the globe, there has been a considerable growth in the number of people diagnosed with Parkinsonism. Estimates indicate that from 1990 to 2015 the number of Parkinsonism diagnoses doubled, with more than 6 million people currently carrying the diagnosis, and by year 2040, 12 and 14.2 million people will be diagnosed with Parkinsonism. Parkinson’s disease (PD), multiple system atrophy Parkinsonian variant (MSAp), and progressive supranuclear palsy (PSP) are neurodegenerative forms of Parkinsonism, which can be difficult to diagnose as they share similar motor and non-motor features, and they each have an increased chance of developing dementia. In the first five years of a PD diagnosis, about 58% of PD are misdiagnosed, and of these misdiagnoses about half have either MSA or PSP. Since PD, MSAp, and PSP require unique treatment plans and different medications, and clinical trials testing new medications require the correct diagnosis, there is an urgent need for both clinic ready and clinical-trial ready markers for differential diagnosis of PD, MSAp, and PSP. Over the past decade, we have developed diffusion imaging as an innovative biomarker for differentiating PD, MSAp, and PSP. In this proposal, we will leverage our extensive experience to create a web-based software tool that can process diffusion imaging data from anywhere in the world. We will disseminate and test the tool in the largest prospective cohort of participants with Parkinsonism (PD, MSAp, PSP), working closely with the Parkinson Study Group. The reason to test this in the Parkinson Study Group network, is because they are the community that evaluates Phase II and Phase III clinical trials in Parkinsonism. This web-based software tool will be capable of reading raw diffusion imaging data, performing quality assurance procedures, analyzing the data using a validated pipeline, and providing imaging metrics and diagnostic probability. We will test the performance of the wAID-P by enrolling 315 total subjects (105 PD, 105 MSAp, 105 PSP) across 21 sites in the Parkinson Study Group. Each site will perform imaging, clinical scales, diagnosis, and will upload the data to the web-based software tool. The clinical diagnosis will be blinded to the diagnostic algorithm and the imaging diagnosis will be compared to the movement disorders trained neurologist diagnosis. We will also enroll a portion of the cohort into a brain bank to ascertain pathological confirmation and to test the algorithm against cases with post-mortem diagnoses. The final outcome will be to disseminate a validated diagnostic algorithm to the Parkinson neurological and radiological community and to make it available to all on a website.

概括 在全球范围内，被诊断患有帕金森病的人数大幅增加。 据估计，从 1990 年到 2015 年，帕金森病的诊断数量增加了一倍，超过 6 例。 目前有 100 万人患有这种疾病，到 2040 年，将有 12 至 1420 万人被诊断出 患有帕金森症。帕金森病 (PD)、多系统萎缩帕金森变异型 (MSAp) 和 进行性核上性麻痹 (PSP) 是帕金森症的神经退行性形式，可能很难治愈 诊断，因为它们具有相似的运动和非运动特征，并且它们各自的机会增加 发展为痴呆症。在 PD 诊断的前五年，大约 58% 的 PD 被误诊，其中 大约一半的人误诊患有 MSA 或 PSP。由于 PD、MSAp 和 PSP 需要独特的治疗计划 和不同的药物，以及测试新药物的临床试验需要正确的诊断，有一个 迫切需要用于 PD、MSAp 和 PSP 鉴别诊断的临床和临床试验标记物。 在过去的十年中，我们开发了扩散成像作为区分 PD、 MSAP 和 PSP。在这个提案中，我们将利用我们丰富的经验来创建一个基于网络的软件工具 可以处理来自世界任何地方的扩散成像数据。我们将在以下位置传播和测试该工具： 最大的帕金森病参与者前瞻性队列（PD、MSAp、PSP），与 帕金森研究小组。之所以在帕金森研究组网络中对此进行测试，是因为它们是 评估帕金森病 II 期和 III 期临床试验的社区。这个基于网络的软件工具 将能够读取原始扩散成像数据、执行质量保证程序、分析 使用经过验证的管道获取数据，并提供成像指标和诊断概率。我们将测试 通过在 21 个地点共招募 315 名受试者（105 名 PD、105 名 MSAP、105 名 PSP）来评估 wAID-P 的表现 帕金森研究小组。每个站点将进行成像、临床量表、诊断，并将数据上传到 基于网络的软件工具。临床诊断将对诊断算法和影像学视而不见 诊断将与受过训练的神经科医生的运动障碍诊断进行比较。我们也将报名一部分 将队列放入脑库以确定病理学确认并针对以下病例测试算法 尸检诊断。最终结果将是将经过验证的诊断算法传播给 帕金森神经学和放射学社区，并在网站上向所有人提供。