R01CA258788

A comprehensive clinical fMRI software solution to enable mapping of critical functional networks and cerebrovascular reactivity in the brain - Project Summary.

Functional localization of eloquent brain areas for patients undergoing surgery for brain tumors, epilepsy, or other neurological diseases is crucial to prevent post-surgical deficits and reduce morbidity. Task-based (TB) functional MRI (fMRI), which detects blood oxygenation level-dependent (BOLD) signal changes while a patient performs task paradigms, is a standard-of-care clinical procedure for presurgical mapping of eloquent cortices.

Two major limitations of clinical TB-fMRI are a patient's inability to perform the task and lesion-induced impairment of neurovascular coupling (which drives the BOLD signal). Resting-state (RS) fMRI, which measures synchronized BOLD signal oscillations during rest, can be used to map brain networks with minimal requirements for patient compliance and has been demonstrated to accurately localize motor and language areas for presurgical planning.

Cerebrovascular reactivity (CVR) mapping, accessed by dynamic BOLD imaging during a hypercapnia task such as breath-holding, can be used to identify areas with potential false-negative fMRI results due to neurovascular uncoupling (NVU) and has been suggested as an emerging standard to be used with clinical fMRI.

Currently, there are no commercially available FDA-cleared software tools for localizing the resting-state networks (RSNs) or CVR. Clinical investigators have relied on research software packages that are either not clinically integrated or not yet optimized and validated in large patient populations. Thus, a vetted software solution is urgently needed to enable these state-of-the-art fMRI methods to benefit patients beyond the limitations of TB-fMRI.

We hypothesize that enhancing, optimizing, and validating our preliminary software and integrating it with an established commercial fMRI platform will create robust solutions for clinical mapping of RSN and CVR. Through three specific aims, the software solutions will be optimized and tested with RS-fMRI and CVR datasets from approximately 350 patients with brain tumors or epilepsy at three institutions.

Aim 1 is to create the software for mapping RSNS and determine optimized workflows for localizing eloquent areas including primary visual, motor (hands, tongue, and feet), and language (primary and secondary) areas. Both seed-based correlation and independent component analysis will be incorporated.

Aim 2 is to create the software for mapping CVR and determine the optimized workflow for identifying and visualizing brain areas with potential false-negative fMRI results. The software will include a multiple-latency general linear model and a unique graphical user interface to visualize the NVU.

Aim 3 is to test and validate the software with presurgical fMRI datasets. The results will be compared against those obtained from (1) processed using widely used research software packages, (2) TB-fMRI, and (3) intraoperative direct cortical stimulation.

This research is anticipated to create robust and clinically available software that will greatly increase the patient population who can benefit from presurgical fMRI and will improve confidence in functional localization for surgical planning. This will directly benefit patients by preserving their post-surgical functions while allowing surgeons to safely maximize the resection of brain lesions.

The Univeristy Of Texas M.D. Anderson Cancer Center

TO IMPROVE SCREENING AND EARLY DETECTION STRATEGIES AND TO DEVELOP ACCURATE DIAGNOSTIC TECHNIQUES AND METHODS FOR PREDICTING THE COURSE OF DISEASE IN CANCER PATIENTS. SCREENING AND EARLY DETECTION RESEARCH INCLUDES DEVELOPMENT OF STRATEGIES TO DECREASE CANCER MORTALITY BY FINDING TUMORS EARLY WHEN THEY ARE MORE AMENABLE TO TREATMENT. DIAGNOSIS RESEARCH FOCUSES ON METHODS TO DETERMINE THE PRESENCE OF A SPECIFIC TYPE OF CANCER, TO PREDICT ITS COURSE AND RESPONSE TO THERAPY, BOTH A PARTICULAR THERAPY OR A CLASS OF AGENTS, AND TO MONITOR THE EFFECT OF THE THERAPY AND THE APPEARANCE OF DISEASE RECURRENCE. THESE METHODS INCLUDE DIAGNOSTIC IMAGING AND DIRECT ANALYSES OF SPECIMENS FROM TUMOR OR OTHER TISSUES. SUPPORT IS ALSO PROVIDED FOR ESTABLISHING AND MAINTAINING RESOURCES OF HUMAN TISSUE TO FACILITATE RESEARCH. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.394 - Cancer Detection and Diagnosis Research

National Cancer Institute (NCI) [HHS - NIH]

Houston, Texas 770304009 United States

Single Zip Code

Academic-Industrial Partnerships for Translation of Technologies for Diagnosis and Treatment (R01 - Clinical Trial Optional) (PAR-18-530)

Amendment Since initial award the total obligations have increased 306% from $402,421 to $1,633,007.