Neuroimaging Aids for Treatment of CNS Vision Pathology

描述（由申请人提供）：该项目的目标是开发功能性磁共振成像（fMRI）工具，用于评估和治疗患有脑肿瘤或涉及视觉系统，特别是视觉皮层的其他局灶性病理的人类患者。这些患者可能面临艰难的决定，以平衡积极，侵入性治疗与副作用，包括部分或完全丧失视力的病理。核心技术包括在癌症部位附近创建视觉皮层功能脑图的方法，并将其与一种称为功能场图（FFMap）的独特显示技术联系起来。后者使医生能够很容易地根据视力保留/损伤来解释fMRI活动模式，从而评估侵入性治疗的潜在副作用。使用一种新型的视野缺陷模拟器，患者可以体验到一种特定治疗方案可能导致的潜在视力丧失的模拟。这些工具将有助于诊断、治疗计划和几乎任何局部病理的随访评估，尤其是癌症。根据这项拨款（以及随后的第二阶段提案），目前存在于Pi实验室的原型系统将被优化用于临床应用和商业化。初步验证测试将延长，以验证商业化的可行性。概念验证将通过在附属医院的放射科安装一个测试系统来演示，并使用它来获取、分析和显示患有脑性视力缺陷的患者志愿者的数据。包括放射科医生、神经外科医生和放射肿瘤学家在内的经验丰富的医生团队将评估该方法的效用。成功的项目完成将产生一个安装和功能的原型系统，并对临床效用进行初步评估。

DESCRIPTION (provided by applicant): The goal of this project is to develop functional magnetic resonance imaging (fMRI) tools for assessing and treating human patients with a brain neoplasm or other focal pathology involving the visual system, especially visual cortex. Such patients can face difficult decisions balancing aggressive, invasive treatment of the pathology with side- effects involving partial or complete loss of vision. The core technology includes methods for creating a brain map of visual cortex function near a cancer site and linking this to a unique display technology, termed a Functional Field Map (FFMap). The latter allows the physician to easily interpret the fMRI activity patterns in terms of vision preservation/impairment and thereby assess the potential side effects of invasive treatment. Using a novel Visual Field Defect simulator, the patient can experience a simulation of potential vision loss that a particular treatment scenario might cause. These tools will aid diagnosis, treatment planning, and follow-up assessment for virtually any localized pathology, but especially cancer. Under this grant (and a subsequent Phase II proposal), the prototype system that currently exists in the Pi's lab will be optimized for clinical use and commercialization. Initial validation tests will be extended to verify the feasibility of commercialization. Proof of concept will be demonstrated by installing a test system in the Radiology Dept. of an affiliated hospital and using it to acquire, analyze and display data from patient volunteers having brain-based vision deficits. A team of experienced physicians including radiologists, neurosurgeons and radiation oncologists will assess the utility of the approach. Successful project completion will produce an installed and functioning prototype system with initial assessment of clinical utility.