Investigation of nerve fibre imaging in radiosurgery

放射外科神经纤维成像研究

• 批准号: 488406-2015
• 负责人: Sarfehnia, Arman
• 金额: $ 1.82万
• 依托单位: University of Toronto
• 依托单位国家: 加拿大
• 项目类别: Engage Grants Program
• 财政年份: 2015
• 资助国家: 加拿大
• 起止时间: 2015-01-01 至 2016-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=586235
• 关键词: Investigation; nerve; fibre; imaging; radiosurgery

20-40% of all cancer patients develop brain metastases (BM). The incidence is likely to increase as cancer patients are living longer. Effective treatment provides patients with a high quality of life, but must be efficient and accurate due to increasing patient numbers and the risks associated with treatment failure. An increasingly used precise treatment is "stereotactic brain radiosurgery" (SRS), which avoids sensitive brain regions and can be used repeatedly if new metastases are later diagnosed, which happens in more than 50% of cases. As in neurosurgery (NS), SRS relies on magnetic resonance imaging (MRI) for planning treatment. In NS, MRI provides the neurosurgeon with the optimal approach through the brain, avoiding important brain structures. In SRS, MRI provides the optimal path of the radiation beams. There is increasing interest in obtaining brain nerve fiber maps using an MRI technique called "diffusion tensor imaging" (DTI) for NS planning. DTI could also be used in SRS planning to minimize injury to important neural pathways and nerves, especially when patients have had previous SRS. Furthermore, DTI may improve detection of radiation damage to nerve fibers, and better delineate tumour boundary than with current imaging. However, DTI is very sensitive to spatial distortions, which currently limits its utility. Synaptive Medical is a medical device/software company based in Toronto that has developed solutions for correcting and incorporating fiber tract visualization into NS planning (BrightMatterTM Plan), as well assessing incoming DTI scans for meeting minimum diagnostic requirements (BrightMatterTM Bridge). The main proposal objective is to investigate how Synaptive's solutions may improve SRS planning accuracy. Project milestones include evaluation of: currently used DTI protocols, functionality needed for SRS planning, ability to see BM boundary, and ability to visualize nerve fiber damage from SRS.

20-40%的癌症患者发生脑转移（BM）。随着癌症患者寿命的延长，发病率可能会增加。有效的治疗为患者提供了高质量的生活，但由于患者数量的增加和与治疗失败相关的风险，必须有效和准确。越来越多使用的精确治疗是“立体定向脑放射外科手术”（SRS），它避开敏感的脑区域，如果后来诊断出新的转移，可以重复使用，这发生在50%以上的病例中。 与神经外科（NS）一样，SRS依赖于磁共振成像（MRI）来规划治疗。在NS中，MRI为神经外科医生提供了通过大脑的最佳方法，避免了重要的大脑结构。在SRS中，MRI提供辐射束的最佳路径。越来越多的人对使用称为“扩散张量成像”（DTI）的MRI技术获得用于NS计划的脑神经纤维图感兴趣。DTI也可用于SRS计划，以尽量减少对重要神经通路和神经的损伤，特别是当患者既往有SRS时。此外，DTI可以改善对神经纤维辐射损伤的检测，并且比当前成像更好地描绘肿瘤边界。然而，DTI是非常敏感的空间失真，这目前限制了其效用。 Synaptive Medical是一家位于多伦多的医疗设备/软件公司，开发了用于校正和将纤维束可视化纳入NS计划（NCTMatterTM计划）的解决方案，以及评估传入的DTI扫描以满足最低诊断要求（NCTMatterTM Bridge）。该提案的主要目标是研究Synaptive的解决方案如何提高SRS规划的准确性。项目里程碑包括评价：当前使用的DTI协议、SRS计划所需的功能、查看BM边界的能力以及可视化SRS神经纤维损伤的能力。