Use of Radiological Clips for Improving Quantitative Ultrasound Imaging

使用放射夹改善定量超声成像

• 批准号: 10029562
• 负责人: Michael L. Oelze
• 金额: $ 44.49万
• 依托单位: UNIVERSITY OF ILLINOIS AT URBANA-CHAMPAIGN
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10029562
• 关键词: Accounting; Adoption; Anatomy; Animal Cancer Model; Animal Model; Animals; Breast; Breast Cancer Model; Breast Cancer Patient; Breast Cancer therapy; Calibration; Cancer Detection; Cell Death; Classification; Clinic; Clinical; Clinical Research; Clip; Cosmetics; Data; Diagnosis; Diagnostic; Female; Gold; Human; Imaging Techniques; In Situ; In complete remission; Longitudinal Studies; Magnetic Resonance Imaging; Malignant Neoplasms; Mammography; Medical; Monitor; Neoadjuvant Therapy; North America; Operative Surgical Procedures; Outcome; Pathologic; Patients; Physical assessment; Procedures; Process; Property; Radiation therapy; Radiology Specialty; Recurrence; Research; Residual Cancers; Roentgen Rays; Shapes; Signal Transduction; Surgeon; Techniques; Technology; Testing; Time; Tissues; Titanium; Translating; Ultrasonics; Ultrasonography; Woman; advanced breast cancer; attenuation; base; chemotherapy; clinical imaging; electric impedance; hormone therapy; human study; improved; in vivo; malignant breast neoplasm; novel; predicting response; quantitative ultrasound; response; standard care; tool; transmission process; treatment responders; treatment response; tumor

Project Summary Radiological markers or clips are an essential diagnostic and surgical tool. Radiological clips made of titanium or gold are widely used, compatible with MRI and have proven safe for use in human patients. These clips come in many shapes and sizes and are visible with both X-ray and ultrasound. The clips provide large ultrasonic scattering signals because they are made of gold or titanium, which have large impedance mismatch with tissue. For example, patients with locally advanced breast cancer (LABC) undergoing neoadjuvant chemotherapy have clips placed in the tumors so that surgeons can locate and excise, with accuracy, residual cancer tissue. Over the last fifteen years, we have been developing quantitative ultrasound (QUS) imaging techniques for a number of applications including monitoring of therapy response. We have demonstrated that QUS techniques can detect the response of tumors to therapy because QUS is sensitive to the presence of cell death. Recently, we were able to implement this approach in a small clinical study, where we demonstrated the ability of QUS to definitively detect and predict the response of LABC patients to chemotherapy between one and four weeks from therapy onset. We verified that QUS could identify LABC therapy responders and nonresponders. However, we hypothesize that accuracies of QUS estimates in humans can be dramatically improved by incorporating a novel calibration procedure that utilizes appropriate radiological clips as an in situ calibration target. Clinically, these clips are already being placed in tumors for various diagnostic tasks. By inserting an appropriate type of clip, the clip can be used as an in situ calibration providing a reference signal for QUS estimates. The in situ reference will automatically correct for attenuation and transmission losses from overlying tissue layers. Current reference phantom techniques are incomplete in providing corrections for attenuation and transmission losses. Therefore, the use of appropriate radiological clips as calibration targets will provides superior bias and variance of QUS estimates resulting in improved accuracy for identifying LABC response. The scientific premise of the proposed research is that radiological markers used for X-ray and conventional ultrasound can also be used as an in situ calibration target for improving QUS estimates in vivo. Novel calibration procedures will be tested and refined in phantom studies, in animals models of cancer and finally validated in human breast cancer patients undergoing neoadjuvant chemotherapy using QUS to identify early responders to therapy. To verify this scientific premise we propose three specific aims. 1) Develop and refine an in situ calibration approach in phantom studies that accounts for layering effects on QUS estimates thereby improving QUS estimate accuracy. 2) Validate the in situ calibration approach in animal models of cancer and quantify calibration properties in a longitudinal study. 3) Collect longitudinal QUS patient data at early time points during the course of neoadjuvant chemotherapy using a novel in situ calibration procedure and quantify the improvements of QUS classifier accuracy with the in situ calibration approach.

项目概要 放射标记或夹子是重要的诊断和手术工具。钛制成的放射夹 或金被广泛使用，与 MRI 兼容，并已被证明可安全用于人类患者。这些剪辑来了 有多种形状和尺寸，并且通过 X 射线和超声波都可以看到。夹子提供大超声波 散射信号，因为它们是由金或钛制成的，与组织有很大的阻抗不匹配。 例如，接受新辅助化疗的局部晚期乳腺癌（LABC）患者 将夹子放置在肿瘤中，以便外科医生能够准确定位并切除残留的癌组织。 在过去的十五年里，我们一直在开发定量超声 (QUS) 成像技术 许多应用，包括监测治疗反应。我们已经证明了 QUS 技术 可以检测肿瘤对治疗的反应，因为 QUS 对细胞死亡的存在很敏感。最近， 我们能够在一项小型临床研究中实施这种方法，我们证明了 QUS 的能力 明确检测并预测 LABC 患者对化疗一到四周内的反应 治疗开始。我们验证了 QUS 可以识别 LABC 治疗有反应者和无反应者。 然而，我们假设人类 QUS 估计的准确性可以通过以下方式显着提高： 纳入一种新颖的校准程序，利用适当的放射夹作为原位校准 目标。在临床上，这些夹子已经被放置在肿瘤中以执行各种诊断任务。通过插入一个 适当类型的夹子，该夹子可用作现场校准，为 QUS 提供参考信号 估计。现场参考将自动校正叠加造成的衰减和传输损耗 组织层。当前的参考模型技术在提供衰减校正方面并不完整，并且 传输损耗。因此，使用适当的放射夹作为校准目标将提供 QUS 估计值的优越偏差和方差提高了识别 LABC 响应的准确性。 拟议研究的科学前提是用于 X 射线和常规的放射性标记 超声还可用作原位校准目标，以改善体内 QUS 估计。新颖的校准 程序将在模型研究、癌症动物模型中进行测试和完善，并最终在 接受新辅助化疗的人类乳腺癌患者使用 QUS 来识别早期反应者 治疗。为了验证这一科学前提，我们提出了三个具体目标。 1) 开发和完善现场 模型研究中的校准方法考虑了 QUS 估计的分层效应，从而改进 QUS 估计精度。 2) 在癌症动物模型中验证原位校准方法并进行量化 纵向研究中的校准特性。 3) 在早期时间点收集纵向 QUS 患者数据 使用新型原位校准程序来评估新辅助化疗的过程并量化 通过原位校准方法提高了 QUS 分类器的精度。