R01HL159200

Multi-Center Implementation and Validation of Efficient Magnetic Resonance Imaging and Analysis of Atherosclerotic Disease of the Cervical Carotid - Abstract:

Numerous investigations over the past decades have yielded substantial innovations in MR methods for the characterization of extracranial carotid atherosclerosis. Images obtained with these innovations under ideal conditions have given clinicians rich information about disease in the arterial wall and the hope for tools critically needed for adequate management of this insidious disease.

Despite this, the great potential power of this technology has not made it into the routine clinical armamentarium. Indeed, because of the need for gadolinium-based contrast agents (GBCA), the long exam time (typically about 45 minutes to obtain the multiple contrasts in the 5 or 6 necessary sequences), and the steep learning curve required to interpret multi-contrast MRI, most practitioners still revert to the simplified metric of diameter stenosis in assessing risk.

After many collective years of investigations, the consortium of investigators collaborating on this proposal believes that the time is right to address these remaining limitations and ultimately shift the clinical paradigm.

Overarching Hypothesis: To achieve the great potential in the management of cervical carotid disease, a highly efficient and easily used MRI technique is required. Our hypothesis is that this can be accomplished using multi-parametric non-contrast MRI sequences coupled with the latest high signal to noise ratio (SNR) neck-shape-specific (NSS) RF coils and innovative machine learning (deep neural network) analysis methods.

Aim 1: We will install identical RF coils, MRI sequences, and protocols at each of our 5 participating centers as well as rigorously test the accuracy of measurements and reproducibility of image quality from all centers.

Aim 2: We will develop, train, and validate a user-friendly, deep learning neural network system for the quantitative analysis of several key components considered to be present in the vulnerable atherosclerotic plaque.

Aim 3: We will apply the analysis to a cohort of carotid disease subjects to establish the repeatability of the quantitative measures, as well as the accuracy of characterization in comparison to histopathology.

Although we will develop and test the image quality, reproducibility, and reliability in a network of highly skilled academic centers, we will design these methods to be applicable in the community hospital setting.

At the conclusion of this project, we propose to have an integrated solution that can be used in subsequent investigations such as: the effect of pharmacologic intervention in modifying the composition of the plaque; studying the evolution of features of the untreated atheromatous disease over time; and, eventually, investigating the metrics that are predictive of deleterious outcomes, and that can be used in improving intervention strategies in this population.

On successful completion, the RF coils and MRI sequences and analysis methods will be made available to other imaging centers in a manner that ultimately changes the paradigm of diagnosis and managing the treatment of cervical carotid atherosclerotic disease.

University Of Utah

TO FOSTER HEART AND VASCULAR RESEARCH IN THE BASIC, TRANSLATIONAL, CLINICAL AND POPULATION SCIENCES, AND TO FOSTER TRAINING TO BUILD TALENTED YOUNG INVESTIGATORS IN THESE AREAS, FUNDED THROUGH COMPETITIVE RESEARCH TRAINING GRANTS. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO STIMULATE TECHNOLOGICAL INNOVATION, USE SMALL BUSINESS TO MEET FEDERAL RESEARCH AND DEVELOPMENT NEEDS, FOSTER AND ENCOURAGE PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY SOCIALLY AND ECONOMICALLY DISADVANTAGED PERSONS, AND INCREASE PRIVATE-SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE TECHNOLOGICAL INNOVATION, FOSTER TECHNOLOGY TRANSFER THROUGH COOPERATIVE R&D BETWEEN SMALL BUSINESSES AND RESEARCH INSTITUTIONS, AND INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL R&D.

93.837 - Cardiovascular Diseases Research

National Heart Lung and Blood Institute (NHLBI) [HHS - NIH]

Salt Lake City, Utah 841081218 United States

Single Zip Code

NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed) (PA-20-185)

Amendment Since initial award the total obligations have increased 361% from $1,331,073 to $6,132,273.