Development of new methods for multi-parametric magnetic resonance imaging of the spinal cord

脊髓损伤是一种严重的发病原因，可导致不可逆的感觉和运动（瘫痪）缺陷。今天，有86，000名加拿大人患有脊髓损伤。虽然没有治愈方法，但存在几种治疗方法，如再生医学和个性化理疗。然而，它们的疗效在很大程度上取决于对脊髓的损伤，例如病变的大小以及已经退化的轴突通路的数量和类型。因此，能够以高灵敏度和准确性评估脊髓损伤对于改善诊断和在测试新治疗方法时监测结构变化至关重要。磁共振成像（MRI）的最新进展表明，通过使用新的定量生物标志物来评估轴突结构损伤的可能性。尽管这些技术在过去几年中已经成功地在大脑中得到验证，但由于灵敏度差（低信号）和图像上存在伪影，它们仍然不能正确地应用于脊髓。为了克服这些挑战，我建议开发和验证新的MRI硬件和软件，专门用于在体内表征脊髓结构。具体目标包括：（1）开发创新线圈，以提高信号接收的灵敏度并最大限度地减少伪影;（2）创建新的算法和软件，以自动处理脊髓图像，这将提供一个独特的平台，旨在在全球范围内推广;（3）在临床环境中翻译所提出的方法，并在患者中验证它们。我们预计，这些发展将改善脊髓创伤患者的诊断和预后，更普遍的是，从任何脊髓病变，如多发性硬化症和肿瘤。在加拿大和全球范围内，未来对临床应用的需求不断增长，因此非常需要先进的线圈技术、优化的MRI序列和强大的自动化分析管道。

Spinal cord injury is a severe cause of morbidity that can lead to irreversible sensory and motor (paralysis) deficits. Today, 86,000 Canadians are living with spinal cord injury. Although there is no cure, several therapeutic approaches exist such as regenerative medicine and personalized physiotherapy. However, their efficacy strongly depends on the damage to the spinal cord, such as the size of the lesion and the number and type of axonal pathways that have degenerated. Thus, it is crucial to be able to assess spinal cord damage with great sensitivity and accuracy for improving diagnosis and for monitoring structural changes while testing new treatments. Recent advances in magnetic resonance imaging (MRI) have shown the possibility to assess structural damage to axons via the use of new quantitative biomarkers. Although these techniques have successfully been validated in the brain for the past years, they still cannot be applied properly in the spinal cord due to the poor sensitivity (low signal) and the presence of artifacts on the images. To overcome these challenges, I propose to develop and validate new MRI hardware and software dedicated to the in vivo characterization of spinal cord structure. Specific objectives consist in (1) developing innovative coils to improve the sensitivity of signal reception and minimize artifacts, (2) creating new algorithms and software to automatically process spinal cord images, which will provide a unique platform that aims to be distributed worldwide and (3) translating the proposed methods in a clinical context and validate them in patients. We anticipate that these developments will improve the diagnosis and prognosis of people suffering from spinal cord trauma and, more generally, from any spinal cord pathology such as multiple sclerosis and tumors. Advanced coil technology, optimized MRI sequences and powerful automated analysis pipelines are very much needed in a future where the demand for clinical applications is in constant growth, in Canada and worldwide.