Molecular Biomedical Imaging Laboratory

分子生物医学成像实验室（MBIL）于2009财年在NIBIB成立，2010年5月在10号楼完成了1500平方英尺的办公空间。 正在进行的项目包括： 第一章 心力衰竭的无创成像（10-CC-0153）。 心力衰竭是老年人常见的心血管疾病。 其发病率随着年龄的增长而增加，影响高达10%的> 65岁的人。 在美国，心力衰竭是医疗保险受益人出院时最常见的诊断之一。 最近的一项估计表明，美国心力衰竭相关护理的总成本可能高达279亿美元。 对本世纪中期的预测表明，随着人口老龄化，心力衰竭的患病率和费用将继续上升。 本提案的主要目的是研究非侵入性成像方法，用于量化心脏磁共振成像（CMR）和多排计算机断层扫描（MDCT）心力衰竭患者的弥漫性心肌纤维化。 心肌纤维化在心力衰竭的发生和发展中起重要作用。 胶原在细胞外基质中的过度沉积可导致心肌硬度增加，随后导致心脏肥大和左心室功能障碍。 到目前为止，还没有非侵入性的方法来量化弥漫性纤维化，我们正在努力解决这个问题。 这是一项为期两年的自然历史研究。 本研究计划招募160名心力衰竭患者和32名正常志愿者。 （二） HCMNet研究的心脏MRI核心实验室（OHSR-CC-5125） 肥厚型心肌病（HCM）是最常见的心血管遗传性疾病，具有表型和基因型异质性。 HCMNet研究是一项由NHLBI资助的多中心观察性研究，重点是全面表征临床前HCM、显性HCM（G +/LVH +=阳性对照人群）和正常对照（G-/LVH-），以确定早期疾病发展的可靠表型和潜在替代终点，以监测治疗反应。 该研究的目的是建立将基本发现有效转化为预期未来人类临床试验的先决条件，以预防或改变HCM的发展。 MBIL是HCMNet研究的核心心脏MRI实验室。 在准备阶段，MBIL设计了先进的心脏方案，包括电影图像、标记、延迟增强和T1标测，验证了研究序列，协调了研究序列分布，建立了CMR数据库，培训了MRI技术人员。 目前，MBIL正在分析本研究的CMR数据。 第三章 影像学与基于风险因素的斑块消退治疗的随机试验（10-CC-0208） 本研究的总体目的是比较图像引导降脂方法与由临床风险因素和血脂水平指导的标准治疗的有效性。 年龄超过55岁的男性和女性谁是他汀类药物治疗的候选人将被随机分配到普通的降胆固醇护理，或护理的颈动脉MRI图像的指导下。 随机分配到第二组（成像引导组）的受试者将根据MRI观察到的动脉粥样硬化程度分配LDL胆固醇目标。 研究终点将是观察到的斑块消退的总程度，达到这种消退所需的他汀类药物剂量，以及心血管事件的发生率。 MBIL为本研究采购了高分辨率颈动脉表面线圈。 四、 多种族动脉粥样硬化研究（MESA） 动脉粥样硬化的多种族研究（MESA）是一项由NHLBI资助的亚临床心血管疾病特征研究（在产生临床体征和症状之前非侵入性地检测到的疾病）和预测临床上明显的心血管疾病进展的风险因素，以及预测亚临床疾病本身进展的风险因素，在6，500名年龄在45 - 84岁的男性和女性的多样化的基于人群的样本中。 大约40%的队列将是白色，30%的非洲裔美国人，20%的西班牙裔和10%的亚洲人，主要是中国血统。 自MESA 5以来，MBIL和约翰霍普金斯医院作为本研究的联合核心CMR实验室。 在MESA中，延迟增强成像首次被引入到MESA研究中，这是延迟增强成像首次用于大规模人群研究。 MBIL积极参与MESA5的方案设计、人员培训、数据库设计和实施以及图像分析。

The Molecular Biomedical Imaging Laboratory (MBIL) was established in FY 09 at NIBIB and 1500 square foot office space was completed in May 2010 at Building 10. The ongoing projects include: 1) Noninvasive Imaging of Heart Failure (10-CC-0153). Heart failure is a common cardiovascular disorder in the elderly. Its incidence increases with age, affecting up to 10% of people > 65 years of age. In the US, heart failure is one of the most common diagnoses at discharge among medicare beneficiaries. A recent estimate suggested that the total cost of heart failure related care in the US could be as high as $27.9 billion. Projection into the middle part of this century suggests that, as the population ages, the prevalence and cost of heart failure will continue to rise. The primary aim of this proposal is to investigate noninvasive imaging methods for quantifying diffuse myocardial fibrosis with cardiac magnetic resonance imaging (CMR) and multi-detector computed tomography (MDCT) in heart failure patients. Myocardial fibrosis plays an essential role in the development and progression of heart failure. Excess deposition of collagen in extracellular matrix can lead to increased myocardial stiffness and subsequently to cardiac hypertrophy and left ventricular dysfunction. So far there is no non-invasive method to quantify diffuse fibrosis and we are trying to solve this problem. This is a two year natural history study. We are planning to enroll 160 heart failure patients and 32 normal volunteers for this study. 2) Cardiac MRI core lab of HCMNet Study (OHSR-CC-5125) Hypertrophic cardiomyopathy (HCM) is the most common cardiovascular genetic disorder, marked by phenotypic and genotypic heterogeneity. The HCMNet Study is a NHLBI funded multicenter observational study focused on the comprehensively characterization of preclinical HCM, overt HCM (G+/LVH+= positive control population), and normal controls (G-/LVH-) in order to identify reliable phenotypes of early disease development and potential surrogate endpoints to monitor treatment response. The aim of the study is to establish the prerequisites for effective translation of basic discoveries to anticipated future human clinical trials to prevent or modify the development of HCM. The MBIL is the core cardiac MRI lab of HCMNet study. In the preparation phase, MBIL designed advanced cardiac protocol including cine image, tagging, delayed enhancement and T1 mapping, validated research sequences, coordinated research sequence distribution, established CMR database and trained MRI technicians. Currently, the MBIL is analyzing CMR data for this study. 3) Randomized Trial of Imaging Versus Risk Factor Based Therapy for Plaque Regression (10-CC-0208) The overall aim of this study is to compare the effectiveness of an image guided approach to lipid lowering to standard therapy guided by clinical risk factors and blood lipid levels. Men and women over age 55 who are candidates for statin therapy will be randomized to usual cholesterol lowering care, or to care guided by MRI images of the carotid arteries. Participants randomized to the second, imaging guided, group will be assigned to LDL cholesterol targets according to the degree of atherosclerosis seen by MRI. The study endpoints will be the total degree of plaque regression seen, the dosage of statin drugs required to achieve that reduction, and the rate of cardiovascular events. The MBIL has procured a high resolution carotid surface coil for this study. 4) Multi-Ethnic Study of Atherosclerosis (MESA) The Multi-Ethnic Study of Atherosclerosis (MESA) is a NHLBI funded study of the characteristics of subclinical cardiovascular disease (disease detected non-invasively before it has produced clinical signs and symptoms) and risk factors that predict progression to clinically overt cardiovascular disease, and that predict progression of subclinical disease itself, in a diverse, population-based sample of 6,500 men and women aged 45-84. Approximately 40 percent of the cohort will be white, 30 percent African-American, 20 percent Hispanic, and 10 percent Asian, predominantly of Chinese descent. MBIL and Johns Hopkins Hospital is working as the joined core CMR lab of this study since MESA5. In MESA, delayed enhancement imaging was first introduced to MESA study and this is the first study delayed enhancement imaging was used in a large scaler population study. MBIL actively involved in the protocol design, staff training, database design and implementation, and image analysis of MESA5.