Bone Quality Assessment with a Novel Three-Bore Magnet Extremity MRI Scanner

使用新型三孔磁铁肢体 MRI 扫描仪进行骨质量评估

• 批准号: 10092957
• 负责人: JEROME L ACKERMAN
• 金额: $ 51.5万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-02-01 至 2025-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10092957
• 关键词: 3-Dimensional; Address; Age; American; Animals; Biological; Biological Markers; Bone Density; Bone Matrix; Calibration; Capital; Cessation of life; Chemicals; Clinic; Clinical Data; Clinical Research; Clinical Trials; Coupled; Data; Deformity; Development; Diagnosis; Diagnostic; Disease; Dual-Energy X-Ray Absorptiometry; Elderly; Funding; Future; Gender; Generations; Goals; Health; Health system; Human; Image; Imaging Techniques; Ionizing radiation; Joints; Knowledge; Laboratories; Leg; Limb structure; MRI Scans; Magnetic Resonance Imaging; Measurement; Measures; Metabolic Bone Diseases; Methodology; Methods; Minerals; Noise; Osteomalacia; Osteoporosis; Pain; Patients; Performance; Peripheral; Phosphorus; Physiologic pulse; Postmenopause; Protons; Public Health; RF coil; Radiation Dose Unit; Radiation exposure; Renal Osteodystrophy; Resolution; Safety; Scanning; Serum; Signal Transduction; Societies; Solid; Specimen; Suggestion; Technology; Testing; Time; United States; United States National Institutes of Health; Woman; Writing; accurate diagnosis; accurate diagnostics; animal tissue; arm; base; bone; bone fragility; bone imaging; bone quality; cohort; cost; density; design; design and construction; diagnostic panel; economic cost; experimental study; fracture risk; fragility fracture; healthy volunteer; image reconstruction; imaging modality; metabolic abnormality assessment; mineralization; network architecture; novel; quantitative imaging; reconstruction; screening; skeletal; soft tissue; solid state; stem; technology development

Osteoporosis and related metabolic bone diseases are nearly universal problems associated with advanced age, particularly for postmenopausal women, expecting to cost society over $22 billion annually by 2020, and leading to 65,000 deaths each year stemming from bone fragility fractures. Recent studies have demonstrated that MRI may be of particular utility for addressing several factors related to bone quality that can only be measured with difficulty in patients. High spatial resolution MRI can be used to accurately characterize trabecular microarchitecture, and follow it with treatment, without the attendant ionizing radiation dose of DXA or CT. Solid state MRI can uniquely measure the organic bone matrix content noninvasively as well as the mineral. Proton (1H) solid state MRI has been used to measure bone matrix, while phosphorus (31P) solid state MRI has potential to accurately assess 3D bone mineral density. Combining these two measurements in a single simultaneous measurement could facilitate a more informative diagnostic for metabolic bone disease, especially if coupled with high spatial resolution 3D trabecular imaging. MRI is an expensive measurement, and not justified for screening for or diagnosing metabolic bone disease. However, if the cost of MRI could be drastically reduced, such measurements could become financially competitive with DXA while providing significantly increased diagnostic information content, and at the same time completely eliminating ionizing radiation exposure. In this project, we will develop the methodology of MRI characterization of metabolic bone disease using a unique dedicated inexpensive, compact, cryogen-free extremity MRI scanner designed and constructed in a previous NIH-funded project. Notably, the magnet of this scanner has been designed for comfortable and efficacious extremity scanning, and in particular contains three bores: a central bore that is the “active” bore in which the limb being scanned is inserted, and two peripheral “nonactive” bores that comfortably accept the leg not being scanned. Both the capital and operating costs of this scanner, as well as the clinic “real estate” it occupies, are drastically lower than for the typical whole body scanner. As of this writing, a second generation compact tiltable magnet with multiple openings may arrive in the PI's lab by the beginning of this project. The specific aims are: 1) Further the technical development of high spatial resolution 3D MRI of trabecular network architecture, and solid state proton and phosphorus MRI for quantitative bone mineral and matrix measurement; 2) Assess the quantitative accuracy of solid state MRI for these measurements in phantoms, animal tissues, and live animals; 3) Evaluate the repeatability and accuracy of high spatial resolution and solid state MRI scanning in healthy volunteer subjects; and 4) Carry out studies of metabolic bone disease patients and age- and gender-matched normals to make a preliminary assessment of the accuracy of MRI-based bone characterization, and to acquire statistical information that will permit the design of future clinical trials.

骨质疏松症和相关的代谢性骨病几乎是与晚期相关的普遍问题 年龄，特别是绝经后妇女，预计到 2020 年每年给社会造成的损失将超过 220 亿美元，以及 每年导致 65,000 人死于脆性骨折。最近的研究表明 MRI 对于解决与骨质量相关的几个因素可能特别有用，而这些因素只能通过 对患者进行测量有困难。高空间分辨率 MRI 可用于准确表征 小梁微结构，并随后进行治疗，无需 DXA 电离辐射剂量 或CT。固态 MRI 可以独特地非侵入性地测量有机骨基质含量以及 矿物。质子 (1H) 固态 MRI 已用于测量骨基质，而磷 (31P) 固态 MRI 已用于测量骨基质 MRI 有潜力准确评估 3D 骨矿物质密度。将这两个测量值结合在一个 单一同时测量可以促进代谢性骨疾病的更多信息诊断， 尤其是与高空间分辨率 3D 小梁成像相结合时。 MRI 是一种昂贵的测量方法，不适用于筛查或诊断代谢性骨 疾病。然而，如果 MRI 的成本能够大幅降低，这种测量可能会变得更容易。 与 DXA 相比具有财务竞争力，同时提供显着增加的诊断信息内容，并且 同时完全消除电离辐射暴露。 在这个项目中，我们将使用以下方法开发代谢性骨病的 MRI 表征方法： 独特的专用廉价、紧凑、无冷冻剂四肢 MRI 扫描仪，设计和制造于 之前的 NIH 资助项目。值得注意的是，该扫描仪的磁铁经过精心设计，既舒适又方便 有效的四肢扫描，特别是包含三个孔：一个中心孔，是“活动”孔 被扫描的肢体被插入，两个外围“非活动”孔可以舒适地容纳腿部 不被扫描。该扫描仪的资本和运营成本，以及诊所的“房地产” 占用的空间大大低于典型的全身扫描仪。截至撰写本文时，第二代 具有多个开口的紧凑型可倾斜磁铁可能会在该项目开始时到达 PI 的实验室。 具体目标是：1）进一步发展小梁高空间分辨率3D MRI技术 网络架构以及用于定量骨矿物质和基质的固态质子和磷 MRI 测量; 2) 评估体模中这些测量的固态 MRI 的定量准确性， 动物组织和活动物； 3）评估高空间分辨率和固体的重复性和准确性 健康志愿者受试者的状态 MRI 扫描； 4）开展代谢性骨病患者的研究 以及年龄和性别匹配的正常人，对基于 MRI 的骨的准确性进行初步评估 表征，并获取统计信息，以便设计未来的临床试验。