Development of a combined ARFI/SWEI ultrasound elasticity imaging system for targeted prostate biopsy guidance

开发用于靶向前列腺活检引导的组合 ARFI/SWEI 超声弹性成像系统

• 批准号: 10580038
• 负责人: Derek Yu Xuan Chan
• 金额: $ 1.6万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-01 至 2023-05-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10580038
• 关键词: 3-Dimensional; 3D ultrasound; Acoustics; Algorithms; Anatomy; Appearance; Benign; Biopsy; Cancer Detection; Cancer Etiology; Cessation of life; Clinic; Clinic Visits; Clinical; Contrast Media; Core Biopsy; Custom; Data; Development; Diagnosis; Diagnostic Sensitivity; Disease; Early Diagnosis; Elasticity; Elements; Geometry; Gland; Goals; Guidelines; Health Care Costs; Heating; Human; Image; Imaging Techniques; In Vitro; Location; Magnetic Resonance Imaging; Malignant Neoplasms; Malignant neoplasm of prostate; Maps; Measures; Methods; Microbubbles; Modality; Modeling; Morphologic artifacts; Nature; PSA level; Patients; Penetration; Performance; Predisposition; Procedures; Prostate; Radiation; Radical Prostatectomy; Recommendation; Rectum; Research; Resolution; Risk; Sampling; Screening for Prostate Cancer; Serum; Signal Transduction; Speed; Staging; System; Techniques; Three-Dimensional Imaging; Time; Tissues; Transducers; Transrectal Ultrasound; Ultrasonics; Ultrasonography; United States; Work; accurate diagnosis; advanced system; attenuation; clinic ready; clinically significant; contrast enhanced; cost; design; diagnostic accuracy; diagnostic tool; digital; effective therapy; elastography; human subject; image guided; image reconstruction; imaging modality; imaging system; improved; in vivo; in vivo imaging system; insight; men; portability; prostate biopsy; rectal; research clinical testing; signal processing; simulation; standard of care; tool; ultrasound; validation studies; vector

ABSTRACT Prostate cancer is the most common cancer among men in the United States, and early detection is crucial for effective treatment or management. Following an initial screening for prostate cancer based on elevated prostate-specific antigen (PSA) levels or suspicious digital rectal exam, the current clinical standard of care for diagnosis is a transrectal ultrasound (TRUS)-guided biopsy, in which 10 to 12 systematically sampled cores are taken and examined. Because the TRUS procedure is guided by conventional B-mode ultrasound imaging, in which prostate cancer does not typically have a unique appearance, the biopsy cores are sampled from a predetermined grid of locations throughout the gland, and are not specifically targeted to cancer-suspicious regions. As a result, there is often a need for repeat biopsies when the first biopsy fails to detect cancer. Recent studies have demonstrated the ability of alternative imaging modalities, such as multiparametric MRI (mpMRI) or contrast-enhanced ultrasound (CEUS), to provide imaging guidance for a targeted prostate biopsy. These techniques have drawbacks, however, including challenges with registering the mpMRI volume with the real- time B-mode ultrasound image during the biopsy, or the need to inject microbubble contrast agents into the patient’s vasculature for CEUS imaging. The goal of this proposal is to develop a low-cost, clinic-ready 3D ultrasound elasticity imaging system to guide a targeted biopsy that is specific for clinically significant disease in the prostate. Previous work has demonstrated that prostate cancer is stiffer than the surrounding healthy tissue and can thus be imaged using ultrasonic acoustic radiation force-based techniques. The proposed system will simultaneously acquire two elasticity imaging modes: acoustic radiation force impulse (ARFI) imaging and shear wave elasticity imaging (SWEI), in order to create high-resolution, quantitative stiffness maps of the prostate. I hypothesize that using combined 3D ARFI/SWEI prostate volumes to guide a targeted biopsy for prostate cancer will result in improved diagnostic sensitivity and staging accuracy compared to current transrectal ultrasound standard-of-care biopsy. In this proposed work, I will develop advanced ARFI/SWEI reconstruction methods in order to examine the tradeoff between the number and intensity of acoustic radiation force excitations, transducer heating, and reconstructed image quality. In particular, I will use specialized finite-element simulation tools to compare different ultrasonic imaging sequences and implement these sequences on a state-of-the-art commercial ultrasound scanner. In order to evaluate these sequences in an in vitro setting, I will acquire combined ARFI/SWEI data in custom tissue-mimicking prostate anatomy phantoms. From here, I will assess the performance of the 3D ARFI/SWEI imaging system in a clinical setting, by using the system to obtain targeted biopsy cores in patients with suspected prostate cancer and comparing the diagnostic accuracy of the ultrasound targeting system with standard-of-care procedures.

摘要 前列腺癌是美国男性中最常见的癌症，早期发现对预防和治疗前列腺癌至关重要。 有效的治疗或管理。在基于升高的前列腺癌的初始筛查之后， 前列腺特异性抗原（PSA）水平或可疑的直肠指检，目前的临床护理标准， 诊断是经直肠超声（TRUS）引导的活检，其中10至12个系统采样的核心， 接受检查因为TRUS过程由常规B模式超声成像引导，所以在 前列腺癌通常不具有独特的外观，活检芯从 在整个腺体的位置的预定网格，并不是专门针对癌症可疑 地区因此，当第一次活检未能发现癌症时，通常需要重复活检。最近 研究已经证明了替代成像模式的能力，例如多参数MRI（mpMRI） 或对比增强超声（CEUS），为靶向前列腺活检提供成像引导。这些 然而，这些技术具有缺点，包括将mpMRI体积与真实的图像配准的挑战。 活检过程中B型超声图像的时间，或需要将微泡造影剂注射到 用于CEUS成像的患者血管。该提案的目标是开发一种低成本、临床就绪的3D 超声弹性成像系统，用于引导针对临床显著性的靶向活检， 前列腺疾病以前的研究表明，前列腺癌比周围的组织更硬， 健康组织，并因此可以使用基于超声声辐射力的技术来成像。拟议 系统将同时采集两种弹性成像模式：声辐射力脉冲（ARFI）成像 和剪切波弹性成像（SWEI），以创建高分辨率，定量刚度图的 前列腺我假设，使用组合的3D ARFI/SWEI前列腺体积来引导靶向活检， 与目前的经直肠前列腺癌相比， 超声波标准护理活检在这项工作中，我将开发先进的ARFI/SWEI重建 方法为了检查声辐射力激励的数量和强度之间的折衷， 换能器发热和重建图像质量。特别是，我将使用专门的有限元模拟 工具来比较不同的超声成像序列，并在最先进的 商用超声波扫描仪为了在体外环境中评估这些序列，我将获得 在定制的组织模拟前列腺解剖体模中结合ARFI/SWEI数据。从这里，我将评估 3D ARFI/SWEI成像系统在临床环境中的性能，通过使用该系统获得靶向 可疑前列腺癌患者的活检芯，并比较超声诊断的准确性 标准护理程序的目标定位系统。