基于超声-磁共振融合的影像组学技术对IDH1/2突变型胶质瘤术中分子边界可视化的初步研究

胶质瘤是最常见的恶性脑肿瘤，最大范围安全切除是延长患者生存时间的首选疗法。由于胶质瘤呈浸润性生长，常规术中导航（MRI）仅能指导影像学全切而非分子全切。术中快速诊断IDH1/2突变能够帮助外科医生判定胶质瘤分子边界，但现有诊断技术尚不能实现分子边界的可视化，无法用于术中导航。课题组前期采用基于深度学习的影像组学技术对胶质瘤IDH1/2突变进行无损预测，准确率达到93%，进一步对MRI数据进行模块化处理，实现了IDH1/2突变的可视化和定量化。本课题将在此基础上深入研究术中超声与术前磁共振的融合导航及基于多模态影像组学的分子可视化技术，通过解决跨模态配准和转化重建的技术难点，纠正术中 “脑漂移”造成的MRI导航误差，验证基于IDH1/2分子边界可视化的准确性，最终获得精准、实时的胶质瘤分子边界可视化导航，帮助外科医生实现胶质瘤分子水平全切除，最大限度延长患者总体生存时间。

Glioma is the most common malignant brain tumor in central nervous system. Maximal safe resection is the preferent treatment to prolong patient survival time. Due to its infiltrative growth pattern, regular image-based neuro-navigation (MRI) is out of feasibility to guide molecular total resection. Rapid intra-operative IDH1/2 mutational status detection can be applied to delineate glioma molecular boundary. However, there is no relevant technology or method can be successfully established to visualize the entire tumor molecular boundary. In our previous study, we used a deep-learning based radiomics method to non-invasively predict IDH1/2 mutational status with accuracy of 93% by conventional MR images, furthermore, realizing IDH1/2 mutational visualization and semi-quantification of entire tumor. Hereafter, we plan to focus on in-depth research of developing modified radiomics-based molecular visualization method to delineate glioma molecular boundary by using combined ultrasound-MRI navigation. A novel modal conversion strategy is designated to resolve the challenge of trans-modality registration in neuro-navigation. Thus, combined ultrasound-MRI radiomics method can facilitate the accuracy of intra-operative molecular boundary delineation. Meanwhile, the application of ultrasound can correct the navigation error of “Brain Shift”. This novel method has great potential to help neurosurgeon visualize glioma molecular boundary in a real-time and precise manner so as to achieve molecular total resection. Patients will be benefit with prolonged survival time and more opportunities to treated with comprehensive medical healthcare.