Advanced Ultrasonic Evaluation of Sentinel Lymph Nodes

前哨淋巴结的高级超声评估

基本信息

  • 批准号:
    8698713
  • 负责人:
  • 金额:
    $ 23.44万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2006
  • 资助国家:
    美国
  • 起止时间:
    2006-09-30 至 2016-07-31
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): Riverside Research Institute, the University of Hawaii and Kuakini Medical Center, and the National Center for Scientific Research (Paris, France) propose to continue to investigate, refine, and expand the use of novel quantitative ultrasound methods for discriminating between cancer-containing and cancer-free lymph nodes of cancer patients. Detection of metastatic cancer in lymph nodes is absolutely crucial for accurate staging, prognosis, and treatment planning. Our overall objective is to reduce markedly the unacceptable failure of existing histopathological methods to detect metastases in 25% to 30% of dissected nodes and 50% in nodes with micrometastases. To achieve this objective, we proposed to develop quantitative imaging methods using high-frequency ultrasound in the pathology laboratory to identify regions of dissected nodes that warrant careful histologic examination. We have made exciting progress toward this objective by developing a sensitive and specific ultrasonic method of imaging metastatic disease present in lymph nodes with fine spatial resolution. Our results have shown a remarkable ability to detect cancer in dissected lymph nodes for a broad range of cancer types, and they promise a revolutionary means of guiding pathologists to cancer-containing regions of dissected lymph nodes. The demonstrated ability of our proposed methods to pinpoint metastatic cancer potentially can reduce the occurrence of false-negative determinations drastically when nodes contain micrometastatic disease, which easily can be overlooked using current histopathology methods. Our current results substantially have validated our original hypothesis that the proposed methods can identify cancer- containing regions of dissected nodes with a simultaneous sensitivity and specificity of approximately 90%. These findings provide encouragement that our proposed studies fully achieve our general objective, and they suggest that a simultaneous sensitivity and specificity exceeding 95% in fact may be possible. Therefore, we propose to acquire additional data to expand our existing database and thoroughly validate our findings. We also propose to investigate the feasibility of applying the same techniques at lower frequencies for clinical use in the examination or operating room to identify nodes that warrant biopsy or dissection. In addition, we propose to improve models for ultrasound scattering in lymph nodes using very-high-frequency ultrasonic microscopy and to formulate engineering specifications for a low-cost ultrasound instrument capable of performing node evaluations routinely in the pathology laboratory. In conclusion, this project can benefit lymph-node evaluations for staging, prognosis, and treatment planning of all types of cancers, e.g., breast, colorectal, gastric, pancreatic, lung, thyroid, prostate, etc., as well as sentinel-node dissection procedures, e.g., for breast cancer. The methods we are developing clearly can have a significant beneficial impact on in situ evaluations of lymph nodes examined prior to or during surgery, intra-operative evaluations of regional nodes including sentinel-nodes, and post-operative evaluations of dissected nodes.
描述(由申请人提供):河滨研究所,夏威夷大学和Kuakini医学中心,以及国家科学研究中心(法国巴黎)提议继续研究,完善和扩大使用新的定量超声方法来区分癌症患者的含癌和无癌淋巴结。淋巴结转移癌的检测对于准确的分期、预后和治疗计划至关重要。我们的总体目标是显著减少现有组织病理学方法在25%至30%的解剖淋巴结和50%的微转移淋巴结中检测转移的不可接受的失败。为了实现这一目标,我们建议在病理实验室使用高频超声开发定量成像方法,以确定需要仔细组织学检查的淋巴结清扫区域。我们在这方面取得了令人兴奋的进展,开发了一种敏感和特异性的超声方法,以精细的空间分辨率成像淋巴结中的转移性疾病。我们的研究结果显示了在清扫淋巴结中检测各种癌症类型的卓越能力,它们承诺了一种革命性的方法,指导病理学家到清扫淋巴结的含癌区域。我们提出的方法能够精确定位转移性癌症,当淋巴结含有微转移性疾病时,可以大大减少假阴性检测的发生,而微转移性疾病很容易被当前的组织病理学方法所忽视。我们目前的结果基本上验证了我们最初的假设,即所提出的方法可以识别淋巴结清扫的含癌区域,同时灵敏度和特异性约为90%。这些发现为我们提出的研究完全实现我们的总体目标提供了鼓励,它们表明同时超过95%的灵敏度和特异性实际上是可能的。因此,我们建议获取额外的数据来扩展我们现有的数据库,并彻底验证我们的发现。我们还建议研究将相同的技术在较低频率下应用于临床检查或手术室,以确定需要活检或解剖的淋巴结的可行性。此外,我们建议使用甚高频超声显微镜改进淋巴结超声散射模型,并制定能够在病理实验室常规进行淋巴结评估的低成本超声仪器的工程规范。综上所述,本项目可为乳腺癌、大肠癌、胃癌、胰腺癌、肺癌、甲状腺癌、前列腺癌等各类癌症的分期、预后和治疗规划提供淋巴结评估,也可为乳腺癌等前哨淋巴结清扫手术提供帮助。我们正在开发的方法对术前或术中淋巴结原位评估、术中局部淋巴结(包括前哨淋巴结)评估和术后淋巴结清扫评估都有显著的有益影响。

项目成果

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Ernest Joseph Feleppa其他文献

Ernest Joseph Feleppa的其他文献

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{{ truncateString('Ernest Joseph Feleppa', 18)}}的其他基金

Detection of metastases in lymph nodes using quantitative ultrasound
使用定量超声检测淋巴结转移
  • 批准号:
    8987137
  • 财政年份:
    2015
  • 资助金额:
    $ 23.44万
  • 项目类别:
Quantitative Photoacoustic Detection of Lymph-node Metastases
淋巴结转移的定量光声检测
  • 批准号:
    8507233
  • 财政年份:
    2012
  • 资助金额:
    $ 23.44万
  • 项目类别:
Quantitative Photoacoustic Detection of Lymph-node Metastases
淋巴结转移的定量光声检测
  • 批准号:
    8402077
  • 财政年份:
    2012
  • 资助金额:
    $ 23.44万
  • 项目类别:
Prostate-cancer Imaging by Combined Ultrasound and Magnetic-resonance Parameters
结合超声和磁共振参数的前列腺癌成像
  • 批准号:
    8123232
  • 财政年份:
    2010
  • 资助金额:
    $ 23.44万
  • 项目类别:
Prostate-cancer Imaging by Combined Ultrasound and Magnetic-resonance Parameters
结合超声和磁共振参数的前列腺癌成像
  • 批准号:
    7989004
  • 财政年份:
    2010
  • 资助金额:
    $ 23.44万
  • 项目类别:
Prostate-cancer Imaging by Combined Ultrasound and Magnetic-resonance Parameters
结合超声和磁共振参数的前列腺癌成像
  • 批准号:
    8478061
  • 财政年份:
    2010
  • 资助金额:
    $ 23.44万
  • 项目类别:
Focal HIFU Ablation of Prostate Cancer Using Advanced Ultrasound Guidance
使用先进超声引导进行前列腺癌局灶 HIFU 消融
  • 批准号:
    8231444
  • 财政年份:
    2010
  • 资助金额:
    $ 23.44万
  • 项目类别:
Focal HIFU Ablation of Prostate Cancer Using Advanced Ultrasound Guidance
使用先进超声引导进行前列腺癌局灶 HIFU 消融
  • 批准号:
    8068888
  • 财政年份:
    2010
  • 资助金额:
    $ 23.44万
  • 项目类别:
Focal HIFU Ablation of Prostate Cancer Using Advanced Ultrasound Guidance
使用先进超声引导进行前列腺癌局灶 HIFU 消融
  • 批准号:
    7893335
  • 财政年份:
    2010
  • 资助金额:
    $ 23.44万
  • 项目类别:
Prostate-cancer Imaging by Combined Ultrasound and Magnetic-resonance Parameters
结合超声和磁共振参数的前列腺癌成像
  • 批准号:
    8677765
  • 财政年份:
    2010
  • 资助金额:
    $ 23.44万
  • 项目类别:

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