Quantitative Ultrasound for Assessment of Placental Structure During the Development of Preeclampsia

点击翻译按钮获取中文摘要

PROJECT SUMMARY A lack of effective treatments for preeclampsia persists due, in part, to our inability to detect altered placental tissue microstructure as an indicator of abnormal placental development. This application proposes a MPI collaborative study to be performed by Weill Cornell Medicine (WCM) in New York, NY and Tulane University (TU) in New Orleans, LA. The proposed project is responsive to the Human Placenta Project PAR-22-236 and seeks to develop a novel ultrasound approach for “safe, real-time, and non-invasive” assessment of “the development … of the human placenta across pregnancy”. Our long-term goal is to develop imaging tools to improve outcomes in women with preeclampsia. The overall objective of this proposal is to develop and validate quantitative ultrasound (QUS) to detect and correlate microstructural alterations in the placenta with preeclampsia. QUS uses radio-frequency (RF) US signals to characterize soft tissues quantitatively. We hypothesize that QUS-based parameters will be capable of quantifying the microstructural changes which characterize preeclampsia. Guided by a strong scientific premise, this hypothesis will be tested by pursing two specific aims: 1) To quantify altered human placental microstructure ex vivo; and 2) To assess placental microstructure longitudinally in vivo in an established rodent model of preeclampsia. Under the first aim, we will develop QUS methods to characterize the human placenta and test the hypothesis that specific QUS parameters will correlate with altered vascular development and injury in the ex vivo human preeclamptic placenta, with histopathology as the gold standard. The second aim will test the hypothesis that QUS parameters will correlate with microstructural and changes due to altered vasculature and fibrosis in the reduced uterine perfusion pressure rat model of preeclampsia. The expected outcome of this work will be the validation of QUS-derived parameters for the assessment of placental microstructure. With these imaging methods, we anticipate correlating specific QUS parameters related to placental microstructure with the diagnosis of preeclampsia. This outcome will strongly motivate the dedication of additional resources for clinical translation and in vivo longitudinal validation of QUS to earlier detect and predict severity of preeclampsia in women. Consistent with the goals of this funding opportunity and the goals of the HPP, this work will lead to the development of a new point-of-care ultrasound assessment of preeclampsia risk and severity, which can be accomplished using the ultrasound systems existing in the clinic.