Measurement of surface lung tissue using ultrasound

 描述(申请人提供)：间质性肺病(ILD)是各种肺部疾病的总称，这些疾病与肺实质纤维化导致的肺僵硬的急剧变化有关。ILD可导致其他并发症，包括肺动脉高压和呼吸衰竭。近年来，ILD死亡率显著上升，预计这一上升趋势将继续下去。高分辨率计算机断层扫描(HRCT)是评估肺纤维化的临床标准，但其价格昂贵，且与高剂量辐射相关，限制了其在后续治疗中的使用。我们开发了一种非侵入性和非电离的技术，肺表面波弹性测定法(LSWE)，它可以快速和准确地测量浅层肺组织的粘弹性。我们的长期目标是确定LSWE在常规临床护理中的作用，因为它对肺粘弹性特性的定量测量可以用于肺部疾病的敏感评估。这项应用的具体目标是通过测量肺粘弹性来评估LSWE在纵向临床研究中的价值，并展示LSWE在肺的定量评估中的临床应用价值。 纤维化症。其基本原理是，需要一种更安全、更便宜的HRCT替代方案，因为ILD患者(特别是早期疾病)需要频繁的随访以评估疾病进展和治疗反应；LSWE有潜力通过可靠和敏感地评估肺纤维化而不使用侵入性或电离技术来满足这一需求。这项拟议的工作意义重大，因为LSWE将改善ILD的临床评估。它还创新地使用了一种新的表面波超声技术来测量肺粘弹性，并评估了其在ILD纵向研究中的临床应用价值。为了实现我们的目标，我们提出了两个具体目标。在目标1中，我们将提高LSWE测量的重复性和再现性，并评估LSWE在评估肺纤维化方面的临床应用价值。我们将确定LSWE测量是否比目前评估肺纤维化的临床方法更敏感。目的2将LSWE技术应用于评估ILD患者的纵向临床研究。我们将研究1)LSWE是否能为肺纤维化患者提供有关肺硬度变化的敏感数据；2)LSWE是否能比目前的临床方法更准确地评估对治疗的反应；以及3)检测肺粘弹性的细微变化是否比目前评估肺纤维化的严重程度和过程的临床方法更敏感。我们有信心这个项目将会成功，因为我们的可行技术和广泛的临床研究经验。该项目成功完成后，我们将拥有一种新的、无创、非电离、快速和便携的临床技术来定量评估肺纤维化。

 DESCRIPTION (provided by applicant): Interstitial lung disease (ILD) is an umbrella term for various lung disorders that are associated with dramatic changes in lung stiffness due to fibrosis of the lung parenchyma. ILD can lead to other complications, including pulmonary hypertension and respiratory failure. The ILD mortality rate has markedly increased in recent years, and this upward trend is expected to continue. High-resolution computed tomography (HRCT) is the clinical standard for assessing lung fibrosis, but it is expensive and associated with high doses of radiation that limit its use during follow-up. We have developed a noninvasive and nonionizing technique, lung surface wave elastometry (LSWE), that measures the viscoelasticity of superficial lung tissue with speed and accuracy. Our long-term goal is to establish a role for LSWE in routine clinical care because its quantitative measurement of lung viscoelastic properties can be used for sensitive evaluation of lung disease. The specific goals of this application are to evaluate LSWE in longitudinal clinical studies by measuring lung viscoelasticity and to demonstrate the clinical utility of LSWE for quantitative assessment of lung fibrosis. The rationale is that a safer and cheaper alternative to HRCT is needed because patients with ILD (especially early stage disease) need frequent follow-up to assess disease progression and response to treatment; LSWE has the potential to meet this need by reliably and sensitively assessing lung fibrosis without using invasive or ionizing techniques. The proposed work is significant because LSWE will improve clinical assessment of ILD. It also is innovative in its use of a novel surface wave ultrasonography technique to measure lung viscoelasticity and in the evaluation of its clinical utility in longitudinal studies of ILD. To acieve our goals, we propose 2 specific aims. In Aim 1, we will improve repeatability and reproducibility of LSWE measurements and assess the clinical utility of LSWE for evaluating lung fibrosis. We will determine whether the LSWE measurements are more sensitive than current clinical methods of assessing lung fibrosis. Aim 2 incorporates the LSWE technique into longitudinal clinical studies evaluating patients with ILD. We will study 1) whether LSWE provides sensitive data about lung stiffness changes for patients with lung fibrosis; 2) whether LSWE can assess response to therapies more accurately than current clinical methods; and 3) whether detection of subtle changes in lung viscoelasticity is more sensitive than current clinical methods of assessing the severity and course of lung fibrosis. We are confident that this project will be successful because of our feasible techniques and extensive clinical research experience. Upon successful completion of this project, we will have a novel, noninvasive, nonionizing, fast, and portable clinical technique for quantitatively assessing lung fibrosis.