Internet-Based Distributed Quantitative 4D Analysis of Aortic MR/MDCT Images

描述（由申请人提供）：仅在美国，主动脉瘤和夹层是每年超过13，000人的常见可预防死亡原因。更多的患者生活在动脉粥样硬化或先天性原因造成的灾难性主动脉事件的持续威胁下。因此，早期和全面的诊断主动脉的形态学或动力学变化是非常重要的。该STTR提案将MR和MDCT的3D和4D主动脉图像数据的定量评估技术（最近由NIH资助的爱荷华州大学研究的结果）扩展并转移至临床适用性。无论是使用MR评估结缔组织疾病，还是基于MDCT的动脉粥样硬化评估，目前都没有此类分析可用于商业用途。拟议的项目将允许从MR/MDCT图像对主动脉瓣和横膈膜之间的整个主动脉长度进行互联网启用的高度自动化定量4D分析。第一阶段将完成以下具体目标：7目标1：证明爱荷华州大学主动脉MR和MDCT分割及3D和4D定量分析基础研究方法的技术转让可行性。构建功能组件并指定它们的接口，从而为第二阶段的模块化建立先决条件。 7目标2：通过对现有技术的扩展，提出了一种基于MDCT的动脉粥样硬化胸主动脉管腔和壁的4D分割方法，并验证了其可行性。 7目标3：开发基于MR和MDCT的主动脉评估的新指标，以及量化先天性疾病进展和手术或治疗有效性的新指标。在第二阶段：7目标4：将用于从MR和MDCT分割胸主动脉以及3D和4D定量分析的I期方法转换为模块化分布式多平台处理环境。 目标5：开发模块化主动脉图像分析系统的分布式原型，添加通信、支付机制和安全模块作为商业化的基础。 目标6：通过（a）使用130个MR/MDCT数据集进行完整的4D验证，（B）在各种部署场景中对整个系统的性能和人体工程学进行广泛测试，以及（c）设计患者报告并评估其临床决策的适用性，验证并显示原型的临床实用性。因此，将开发一个基于互联网的分布式主动脉定量图像分析系统的全功能原型，并准备在随后的第三阶段商业化。 公共卫生相关性：仅在美国，主动脉瘤和夹层是每年超过13，000人的常见可预防死亡原因。更多的患者生活在灾难性主动脉事件的持续威胁下。因此，结缔组织疾病和动脉粥样硬化的早期诊断、疾病状态的客观监测以及有助于疾病进展的准确预测是非常重要的。拟议项目将允许对主动脉瓣和横膈膜之间的整个主动脉进行分布式互联网支持的高度自动化定量4D（3D+时间）分析，从而有助于对患有影响其血管的先天性或动脉粥样硬化疾病的患者进行客观诊断和疾病监测。

DESCRIPTION (provided by applicant): Aortic aneurysms and dissections are a cause of frequently preventable death for over 13,000 people annually in the US alone. Many more patients live under a constant threat of a catastrophic aortic event from atherosclerotic or congenital causes. Therefore, early and comprehensive diagnosis of morphological or dynamic changes in the aorta is of great importance. This STTR proposal extends and transfers the technology for quantitative assessment of 3D and 4D aortic image data from MR and MDCT, the results of recent NIH-funded research at the University of Iowa, to clinical applicability. No such analyses are currently commercially available neither for either assessment of connective tissue disorders using MR nor for MDCT-based assessment of atherosclerosis. The proposed project will allow Internet-enabled highly-automated quantitative 4D analysis of the entire aorta from MR/MDCT images for the entire aortic length between the aortic valve and the diaphragm. The following specific aims will be completed in Phase I: 7 Aim 1: Demonstrate the technology transfer feasibility of University of Iowa's basic-research methods for aortic MR and MDCT segmentation and quantitative analysis in 3D and 4D. Build functional components and specify their interfaces, thus establishing the prerequisites for modularization in Phase II. 7 Aim 2: Develop a 4D segmentation method for lumen and wall of the atherosclerotic thoracic aorta from MDCT by significantly extending our enabling technology, and demonstrate its feasibility. 7 Aim 3: Develop novel indices for MR- and MDCT-based aorta assessment, and new metrics to quantify congenital disease progression and the effectiveness of surgery or therapy. and in Phase II: 7 Aim 4: Translate the Phase I methods for segmentation of the thoracic aorta from MR and MDCT and quantitative analysis in 3D and 4D to a modular distributed multi-platform processing environment. 7 Aim 5: Develop a distributed prototype of a modular aortic image analysis system, adding communication, payment mechanisms, and security modules as the basis for commercialization. 7 Aim 6: Validate and show the clinical utility of the prototype by (a) full 4D validation using 130 MR/MDCT datasets, (b) extensive testing of performance and ergonomics of the overall system in various deployment scenarios, and (c) design of a patient report and evaluation of its suitability for clinical decision making. As a result, a fully-functional prototype of a distributed Internet-based aortic quantitative image analysis system will be developed and ready for commercialization in the subsequent Phase III. PUBLIC HEALTH RELEVANCE: Aortic aneurysms and dissections are a cause of frequently preventable death for over 13,000 people annually in the US alone. Many more patients live under a constant threat of a catastrophic aortic event. Early diagnosis of connective tissue disorders and atherosclerosis, objective monitoring of disease status, and contributing to accurate prediction of disease progression are thus of great importance. The proposed project will allow distributed Internet- enabled highly-automated quantitative 4D (3D+time) analysis of the entire aorta between the aortic valve and the diaphragm and will thus contribute to objective diagnosis and disease monitoring in patients with congenital or atheriosclerotic conditions affecting their aortas.