Automatic Three Dimensional (3D) Registration for Enhanced Cancer Management

项目描述(由申请者提供)：该项目资助申请的总体目标是通过支持对乳腺癌化疗反应的准确、早期检测和测量(项目1、3)，以及通过开发、应用和测试健壮和复杂的注册和相关信号处理工具，支持对大脑功能的术前运动和颞叶语言皮质评估(项目2)，从而改变当前的临床模式。项目1调查了通过使用容量、扩散和动态对比增强核磁共振成像对乳腺癌患者进行新辅助化疗或激素治疗的早期评估和反应测量的有效性。假设间隔乳腺检查的非线性配准提高了功能弥散成像(FDM)的敏感性和特异性以及动态对比增强(DCE)的准确性。开发低噪声、无偏见的工具来评估病变对治疗的反应是当前的一个重要课题。项目2通过检查我们独特的运动校正方法与不同的fMRI采集协议(例如集群采集)相结合的好处，扩展了之前完成的基于配准的fMRI运动的工作，以改善与患者的沟通和反应监测。项目3解决了动态核磁共振成像中与成像相关的基本模糊问题：对于任何给定的技术，我们都可以获得高空间或时间分辨率的成像数据，但不能同时获得两者。支持在MRI动态成像过程中控制和优化这些权衡的通用技术是非常重要的。 相关性：假设这些工具将极大地改善乳腺癌患者的管理，根据早期、更准确的信息进行个体化治疗，所选择的治疗方案有效/无效，应该分别继续/改变。对于乳腺癌治疗患者来说，没有理由冒贫血、白细胞和血小板耗尽的风险，也没有理由浪费时间继续虚弱的化疗方案，但在抑制肿瘤方面没有任何好处。对于脑癌患者，假设是，对语言和运动皮质的术前评估将极大地影响术前计划，甚至可能达到基于切除肿瘤所导致的缺陷而判定肿瘤不可手术的程度。通过适当的术前功能磁共振评估(特别包括语言和运动皮质)，可以避免与电刺激研究延长开放颅骨持续时间相关的额外风险，同时保留手术主要用于切除。对于这两组患者来说，情感和金钱成本以及健康风险都可以显着降低。

DESCRIPTION (provided by applicant): The overarching goal of this program project grant application is to change current clinical paradigms through the support of accurate, early detection and measurement of breast cancer response to chemotherapy (Projects 1, 3), and presurgical motor and temporal language cortex evaluation of brain function (Project 2) through the development, application and testing of robust and sophisticated registration and related signal processing tools. Project 1 investigates the efficacy of early-assessment and measurement of response to neoadjuvant chemo or hormonal therapy for patients with breast cancer obtained through the use of volumetric, diffusion and dynamic contrast enhancement MRI. The hypothesis is that nonlinear registration of interval breast exams increases the sensitivity and specificity of functional diffusion mapping (fDM) as well as the accuracy of dynamic contrast enhancement (DCE). Developing low noise, unbiased tools for assessing lesion response to therapy is currently an important topic. Project 2 extends previously completed work on registration-based fMRI motion by examining the benefits of combining our unique motion correction method with different fMRI acquisition protocols, e.g. clustered acquisition, to improve communication with the patient and response monitoring. Project 3 addresses the fundamental ambiguity problem in dynamic MRI associated with imaging in general: for any given technique either we can obtain high spatial or temporal resolution imaging data, but not both. Generalized techniques that support controlling and optimizing these tradeoffs during dynamic imaging in MRI are very important. RELEVANCE: The hypothesis is that these tools will dramatically improve the management of breast cancer patients by individuating therapy based on early, more accurate information that the chosen therapy regimen is/isn't working and should be continued/changed, respectively. For breast cancer therapy patients there is no reason to risk anemia, depleted white cells and platelets, and lost time to continue a debilitating chemotherapy regimen with no benefits in tumor suppression. For brain cancer patients the hypothesis is that presurgical evaluation of language and motor cortex will dramatically effect presurgical planning possibly even to the extent of deciding that a tumor is inoperable based on deficits that would be induced by its removal. Additional risks associated with extended open cranium-durations from electro-stimulation studies can be avoided by an appropriate presurgical fMRI evaluation which specifically includes the language and motor cortex, while reserving surgery primarily for resection. For both sets of patients emotional and monetary costs as well as health risks could be significantly reduced.