Advanced Ultrasonic Evaluation Of Sentinel Lymph Nodes
Ernest Joseph Feleppa, Research Director
Riverside Research Institute
Grant 5R01CA100183-03 from National Cancer Institute, IRG: BMIT
Abstract: Riverside Research Institute and the University of Hawaii and its affiliated Kuakini Medical Center propose to investigate the use "of novel ultrasonic methods for discriminating between cancer-containing and cancer-free axillary lymph nodes of breast-cancer patients. Our emphasis will be on improving sentinel-node dissection biopsy procedures for breast-cancer patients; however, success in this project will benefit lymph- node evaluations of all types, not only for breast cancer, but also for a range of other cancers, including colorectal, epidermal (e.g., malignant melanoma), lymphatic, etc. Our premise is that the backscattering features of cancer-containing and cancer-free nodes differ sufficiently to differentiate between them using the proposed methods. Based on our extremely encouraging preliminary studies, our general hypothesis is that these methods can identify cancer-containing regions of dissected nodes using very-high-ultrasound frequencies with a simultaneous sensitivity and specificity of at least 90%. Our preliminary studies provide strong encouragement that our methods easily will validate this hypothesis. Our primary specific aims are to develop our methods when applied using very-high frequencies in the pathology laboratory to identify regions of nodes that warrant careful histologic examination. The methods we propose would be applied intra-operatively to better detect occult micrometastasis in sentinel-node dissections, and post-operatively to better detect metastasis in nodes excised by formal or radical dissections as well as in sentinel nodes. Our intention is to reduce markedly the failure of existing histopathological methods to detect metastases in 25% to 30% of excised nodes. We also aim to gain insight into underlying ultrasound-scattering mechanisms in lymph nodes. If we are successful in achieving our aims, major near-term benefits will result in evaluations of axillary lymph nodes in breast-cancer cases, and in the longer term, similar benefits will result in nodal evaluations for other cancers
Keywords: biopsy, breast neoplasm /cancer diagnosis, lymph node, method development, ultrasonography light scattering, metastasis, neoplastic process, radiowave radiation, surgery, women`s health clinical research, female, histopathology, human subject, light microscopy, patient oriented research, sectioning
Project start date: 2006-09-30
Project end date: 2010-07-31
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Advanced Ultrasonic Evaluation Of Sentinel Lymph Nodes
Ernest Joseph Feleppa, Research Director
Riverside Research Institute 9th Floor New York, Ny 10038
Grant 5R01CA100183-02 from National Cancer Institute, IRG: BMIT
Abstract: Riverside Research Institute and the University of Hawaii and its affiliated Kuakini Medical Center propose to investigate the use "of novel ultrasonic methods for discriminating between cancer-containing and cancer-free axillary lymph nodes of breast-cancer patients. Our emphasis will be on improving sentinel-node dissection biopsy procedures for breast-cancer patients; however, success in this project will benefit lymph- node evaluations of all types, not only for breast cancer, but also for a range of other cancers, including colorectal, epidermal (e.g., malignant melanoma), lymphatic, etc. Our premise is that the backscattering features of cancer-containing and cancer-free nodes differ sufficiently to differentiate between them using the proposed methods. Based on our extremely encouraging preliminary studies, our general hypothesis is that these methods can identify cancer-containing regions of dissected nodes using very-high-ultrasound frequencies with a simultaneous sensitivity and specificity of at least 90%. Our preliminary studies provide strong encouragement that our methods easily will validate this hypothesis. Our primary specific aims are to develop our methods when applied using very-high frequencies in the pathology laboratory to identify regions of nodes that warrant careful histologic examination. The methods we propose would be applied intra-operatively to better detect occult micrometastasis in sentinel-node dissections, and post-operatively to better detect metastasis in nodes excised by formal or radical dissections as well as in sentinel nodes. Our intention is to reduce markedly the failure of existing histopathological methods to detect metastases in 25% to 30% of excised nodes. We also aim to gain insight into underlying ultrasound-scattering mechanisms in lymph nodes. If we are successful in achieving our aims, major near-term benefits will result in evaluations of axillary lymph nodes in breast-cancer cases, and in the longer term, similar benefits will result in nodal evaluations for other cancers.
Keywords: biopsy, breast neoplasm /cancer diagnosis, lymph node, method development, ultrasonography, light scattering, metastasis, neoplastic process, radiowave radiation, surgery, women s health, clinical research, female, histopathology, human subject, light microscopy, patient oriented research, sectioning
Project start date: 2006-09-30
Project end date: 2010-07-31
5R01CA100183-02 (2007): $253049
Grants awarded to Ernest Joseph Feleppa
ULTRASONIC SAFETY AND THERAPY IN OPHTHAMALOGY
Ernest Joseph Feleppa, Research Director
Riverside Research Institute 9th Floor New York, Ny 10038
Grant 2R01EY010369-08 from National Eye Institute, IRG: DMG
Abstract: Verbatim from Applicant s ) This program combines biomedical engineering research at Riverside Research Institute (RRI) with biological and medical investigations at the Weill Medical College (WMC) of Cornell University. Its first objective is to develop noninvasive, focussed ultrasound procedures for treating malignant ocular tumors, which threaten life, and vitreous hemorrhages and membranes, which threaten sight. Its second objective is to support the safe use of diagnostic ultrasound techniques that promise fundamental advances in detecting and combating ocular disease. Both objectives involve comprehensive scientif aboutc investigations of how ultrasonic energy can modify the diverse tissues of the eye. Therapy investigations involve the development of novel ultrasonic beams to thermally necrose large segments of tumors before blood-flow cooling occurs. These investigations explore adaptively controlled beams whose geometry will allow the rapid treatment of entire tumor volumes while avoiding collateral damage. Novel concepts using crossed beams are being developed to mechanically disrupt vitreous hemorrhages and membranes, and to hasten their resorption before they lead to tractional retinal detachments and blindness. Monitoring procedures, using advanced diagnostic ultrasound concepts, are being investigated to monitor, and ultimately control, tumor and vitreous treatments. All procedures are thoroughly tested in animal-model experiments. Safety studies are investigating pulsed-Doppler and color-flow imaging of the eye, with particular attention to therrnal damage in the absorptive, avascular lens. Very-high-frequency systems, which can resolve fine-scale (50-llm) structures are also being examined. This program has performed the first study of ocular effects at these high frequencies (near 50 MHz). Research will now evaluate potential risks when these frequencies are used with ultrasonic contrast agents to evaluate ciliary-body perfusion in glaucoma assays. Safety will be determined using calibrated exposures in in-vivo animal eyes and comprehensive follow-up examinations. Results will be disseminated to support continued safety as new systems evolve.
Keywords: biomedical equipment development, diagnosis procedure safety, eye disorder diagnosis, eye neoplasm, retina hemorrhage, ultrasonography, ultrasound biological effect, biological model, biomedical equipment safety, computer simulation, diagnosis design /evaluation, eye surgery, glaucoma test, mathematical model, neoplasm /cancer therapy, neoplasm /cancer thermotherapy, nonhuman therapy evaluation, noninvasive diagnosis, ultrasound therapy, athymic mouse, bioimaging /biomedical imaging, laboratory rabbit, miniature swine
Project start date: 1994-04-01
Project end date: 2005-03-31
2R01EY010369-08 (2001): $382083
5R01EY010369-11 (2004): $434015
5R01EY010369-10 (2003): $413727
5R01EY010369-09 (2002): $393601
ULTRASONIC TISSUE ANALYSIS SYSTEM
Ernest Joseph Feleppa, Research Director
Riverside Research Institute
9th Floor
new York, Ny 10038
Grant 1S10RR008470-01 from National Center For Research Resources, IRG: SSS
Abstract: This Shared-Instrumentation Grant (SIG) supports an ultrasonic tissue analysis system for use by investigators at Riverside Research Institute (RRI) and collaborating researchers at the Cornell University Medical College (CUMC), Dr. Coleman, PI, NIH Grant EY-03183; the Columbia University College of Physicians and Surgeons (CUCPS), Dr. King, Co-PI, NIH Grant CA-38400; the Memorial Sloan-Kettering Cancer Center (MSKCC), Dr. Fair, Co-PI, NIH Grant CA-53561; the Medical College of Pennsylvania (MCP), Dr. Sigel, PI, NIH Grant HL-41874; and the New York University Medical Center (NYUMC), Dr. Shupack. The RRI investigators are Dr. Lizzi (NIH Grants EY-01212 and CA-38400) and Dr. Feleppa (NIH Grants CA-53561 and HL-41874). The computer-based SIG system. is a complete laboratory facility for acquiring and analyzing ultrasonic data, and displaying computed results in an interactive fashion. The system provides for advanced analysis of radio-frequency (rf) echo signals to characterize tissue microstructure. It includes two- and three-dimensional scanning and analysis, surface-roughness measurements, and very-high-resolution examinations. It will be used to test new concepts and theoretical results, to measure tissue properties, characterize new transducers, and to conduct new pilot studies. The system will expedite and enhance on-going NIH-sponsored research to evaluate the eye, abdominal organs, vasculature, and the prostate gland. It will also be used to examine new applications involving organs such as the skin, breast, and heart
Keywords: biomedical equipment purchase, biomedical equipment resource, computer data analysis, ultrasound scanning computer program /software, computer system hardware, information display, structural biology, tissue
Project start date: 1993-04-26
Project end date: 1994-07-25
1S10RR008470-01 (1993): $148000
ULTRASONIC SAFETY AND THERAPY IN OPHTHALMOLOGY
Ernest Joseph Feleppa, Research Director
Riverside Research Institute 9th Floor New York, Ny 10038
Grant 2R01EY010369-04 from National Eye Institute, IRG: ZRG7
Abstract: This research program combines biomedical engineering efforts at Riverside Research Institute (RRI) and biological and medical investigations at Cornell University Medical College (CUMC). The ultimate objectives of the research are 1) to develop reliable ultrasonic techniques for treating ocular tumors that threaten life and sight; and 2) to assure the safe use of promising new diagnostic ultrasound techniques that promise perhaps revolutionary advances for combatting ocular diseases. Both objectives involve comprehensive, scientific investigations of how ultrasonic energy modifies tissue. Therapy investigations involve the development of intense, short-term ultrasound exposures to treat tumors before blood-flow cooling and attendant uncertainties become significant. Special ultrasound transducers will be developed to reliably induce asymmetric lesions for producing efficient lesion matrices that cover extensive tumor volumes. A comprehensive computer simulation provides a model of relevant beam propagation and tissue heating. In-vivo ultrasonic spectrum analysis techniques and 3-D scanning are used together with histopathology and biologic assays to characterize induced in-vivo changes in human tumor explants. Remote temperature estimations are also being investigated. Safety studies involve ultrasonic pulsed Doppler exposures of the eye, with particular attention to the potential for thermal damage in the absorptive, avascular ocular lens. Very-high-frequency ultrasound systems, which can resolve fine-scale microstructures (e.g., 30-microM dimensions), are also under study; these systems apply frequencies (e.g., 50 MHz and above) that are much higher than those previously used in biological-effects experiments. The combined use of these systems with contrast agents will also be investigated from a safety perspective. Safety will be experimentally investigated by employing these techniques in animal eyes with comprehensive follow-up examinations. A theoretical model for safety will be established. These studies are intended to identify procedures and design criteria needed to support the continued development and safe use of modern ultrasonic capabilities. This program will result in a comprehensive data base and a validated model of ultrasonic effects for extrapolating results to humans. The model will also provide fundamental information regarding non-invasive tumor therapy and diagnostic safety for a broad spectrum of medical applications.
Keywords: biomedical equipment development, diagnosis procedure safety, eye disorder diagnosis, eye neoplasm, ultrasonography, ultrasound biological effect, biological model, computer simulation, diagnosis design /evaluation, eye surgery, neoplasm /cancer therapy, noninvasive diagnosis, ultrasound therapy, athymic mouse, laboratory rabbit, miniature swine
Project start date: 1994-04-01
Project end date: 2001-03-31
2R01EY010369-04 (1997): $445791
5R01EY010369-02 (1995): $358804
1R01EY010369-01 (1994): $349063
5R01EY010369-07 (2000): $327594
5R01EY010369-06 (1999): $309279
5R01EY010369-05 (1998): $357750
Ultrasonic Evaluation Of Ocular Tissues
Ernest Joseph Feleppa, Research Director
Riverside Research Institute 9th Floor New York, Ny 10038
Grant 5R01EB000238-32 from National Institute Of Biomedical Imaging And Bioengineering, IRG: ZRG1
Abstract: This research is conducted jointly by Riverside Research Institute (RRI) and Weill Medical College of Cornell University (W1MC). Its long-term objective is to advance the diagnosis, treatment planning, and treatment monitoring of ocular diseases, primarily glaucoma, by interwoven engineering, and clinical studies. The program uses advanced methods to analyze radio-frequency (RF) echo signals and extract tissue information not available with conventional ultrasound systems. To examine anterior sections of the eye, novel very-high-frequency ultrasound (VHFU) annular arrays will be used with synthetic aperture and frequency-domain apodization; these will substantially improve resolution and depth-of-focus. Digital RF data will be acquired during multi-plane VHFU scanning of the entire anterior segment to construct highly detailed 3-D representations of structures involved in glaucoma and hypotony. Elements as small as 20-gm will be resolved. Biometric data (dimensions, surface areas, volumes) will be derived for relevant ocular compartments, including the anterior chamber and ciliary processes. Microstructure will be evaluated in terms of the effective sizes, concentrations, mechanical properties, and morphologic shapes of tissue constituents. Sizes of cell-level structures (15 gm) will be estimated to within 1 p.m to monitor changes related to function and therapy. These assays will use advanced 1-D and 2-D spectral techniques designed using a theoretical scattering model of tissue microstructure. The methods will be validated in laboratory and animal experiments. Measured features will be compared with light microscopy to elucidate sensitivity to specific microstructural elements. Animal and clinical studies will assess the utility of these methods for evaluating glaucoma, hypotony, and small anterior tumors undergoing treatment. Glaucoma studies will document ciliary body microanatomy and drug responses. Related studies will employ new high frequency transducers (20-30 MHz) and new morphological analysis techniques to examine posterior ocular structures. They will extract detailed tissue information from regions inaccessible to other imaging modalities. The methods will be clinically evaluated in cases of age-related macular generation.
Keywords: diagnosis design /evaluation, diagnosis quality /standard, eye disorder diagnosis, glaucoma, ultrasonography, computer assisted diagnosis, eye neoplasm, hypotonia, macular degeneration, neoplasm /cancer diagnosis, athymic mouse, bioimaging /biomedical imaging, clinical research, computer program /software, computer system design /evaluation, glaucoma test, human subject, laboratory rabbit, light microscopy, radiowave radiation, three dimensional imaging /topography
Project start date: 1996-12-06
Project end date: 2009-06-30
5R01EB000238-32 (2007): $401049
5R01EB000238-31 (2006): $401040
5R01EB000238-30 (2005): $398775
2R01EB000238-29A1 (2004): $395027
5R01EB000238-28 (2003): $506148
5R01EY001212-26 (2001): $484090
2R01EY001212-25 (2000): $478688
Ultrasonic BioMicroscopy Conference 2004
Ernest Joseph Feleppa, Research Director
Riverside Research Institute 9th Floor New York, Ny 10038
Grant 1R13EB003685-01 from National Institute Of Biomedical Imaging And Bioengineering, IRG: DMG
Abstract: This R13 grant proposal requests support for the Fourth International Conference on Ultrasonic Biomicroscopy (UBM), a rapidly growing field of high-resolution medical imaging not yet adequately addressed in other conferences. The conference is held every 2 years by ad-hoc committees to stimulate further developments in UBM. UBM employs high-frequency (near 50 MHz) broadband transducers to provide in-vivo resolution near 30 txm. Examples of clinical applications being explored include the anterior eye (to diagnose ocular tumors and glaucoma etiology); skin (melanomas, psoriasis, etc.); perfusion measurements; vascular-plaque vulnerability (via intravascular probes); and intrasurgical tissues, ln-vivo UBM examinations of genetically altered mice are permitting serial studies of developmental anomalies over time, without sacrificing animals. Very high frequency acoustic microscopy can examine living unstained cells with resolution at least comparable to optical microscopy. The UBM conference, the fast in the United States, will convene on September 8 - 11, 2004 at Arden House, Harriman, New York, not far from New York City. Its goals are assess the current state-of-the-art in UBM; foster communication among diverse multi-disciplinary UBM fields; identify key problems and solutions; and, share insights with experts in other high-resolution imaging modalities. Participants include investigators with multidisciplinary expertise including biomedical engineering, medical imaging, transducer fabrication, acoustics, and high-resolution animal and clinical applications. Experts in other high-resolution techniques will lend perspective regarding UBM s ultimate role. Students with interests in these areas will also attend. Topics will include multidisciplinary UBM areas including high-frequency transducer fabrication; new system concepts; scattering models and acoustic phenomena at UBM frequencies; 3-D UBM imaging; mice imaging; bloodflow and plaque assays; clinical examinations (eye, skin, etc.); acoustic cell microscopy; complementary highresolution modalities (e.g., OCT, special MRI units). Thus the meeting should be of direct interest to various braches of NIH including NIBIB, NCI, NHLBI, and NEI.
Keywords: meeting /conference /symposium, microscopy, ultrasonography, interdisciplinary collaboration, three dimensional imaging /topography, bioimaging /biomedical imaging
Project start date: 2004-04-01
Project end date: 2005-03-31
1R13EB003685-01 (2004): $19290
ULTRASONIC EVALUATION OF OCULAR TISSUES
Ernest Joseph Feleppa, Research Director
Riverside Research Institute 9th Floor New York, Ny 10038
Grant 5R01EY001212-21 from National Eye Institute, IRG: RNM
Abstract: This collaborative research program is conducted jointly by Riverside Research Institute (RRI) and Cornell University Medical College (CUMC). Its long-term objective is to achieve fundamental advances in the diagnosis, treatment planning, and treatment monitoring of ocular diseases that threaten life and sight. To achieve these goals, interwoven engineering efforts (at RRI) and clinical studies (at CUMC) are investigating a variety of ultrasonic techniques that can describe tissue anatomy and microstructure. A computer-based system for acquiring and processing data and interactively displaying results has been developed and installed at CUMC to clinically evaluate these concepts. The primary technique in these studies involves calibrated spectrum analysis of radio-frequency (rf) echo signals. Spectral data have been used to establish multiparameter data bases permitting diagnosis and sub-classification of ocular tissue. In the proposed program, tissue analysis techniques will be expanded in terms of frequency coverage, volumetric averaging, types of measured features, two-dimensional spectra, and angular dependencies of echo features. Three-dimensional (3-D) scanning will be used to permit the above expansions and to provide 3-D maps of ocular anatomy and internal tissue features including tissue type, scatterer properties, and regions changed by therapy. These techniques will be used to establish data-bases to examine several ocular diseases that pose major threats to sight. In trauma and vitreous pathology studies, comprehensive anatomical descriptions together with tissue identification will be used to provide 3-D maps for surgical planning. In ocular tumor studies, data-bases will be expanded for more reliable tissue typing and subclassification, therapy planning, prognostic indices, and surgical monitoring. In glaucoma and myopia studies, morphological studies will be conducted to elucidate abnormal anatomical features and actions of therapeutic agents. Ancillary studies will provide basic knowledge concerning the interaction of tissue and ultrasound. These studies will include theoretical modelling, acoustic microscopy, and other diagnostic modalities.
Project start date: 1977-05-01
Project end date: 1996-11-30
5R01EY001212-21 (1995): $376331
5R01EY001212-20 (1994): $364446
5R01EY001212-19 (1993): $415782
2R01EY001212-18A1 (1992): $354508
ADVANCED CLINICAL ULTRASONIC TISSUE CHARACTERIZATION
Ernest Joseph Feleppa, Research Director
Riverside Research Institute
9th Floor
new York, Ny 10038
Grant 5R01CA038400-14 from National Cancer Institute, IRG: RNM
Abstract: This collaborative program is conducted by Riverside Research Institute (RRI) and the Columbia University College of Physicians and Surgeons (CUCPS). The goal of the program is to establish quantitative ultrasonic means for objectively diagnosing and monitoring diseases of the liver, pancreas and kidney. The program applies computer processing to radio-frequency (rf) echo signals from conventional ultrasonic scanners. A number of acoustic parameters are computed using spectrum analysis, with calibration procedures to remove system artifacts. As shown in our theoretical analyses, these parameters sense microstructural features such as the size, shape, concentration, and mechanical properties (density and compressibility) of internal tissue scatterers, even those too small to be resolved in ultrasonic images. Disease-indexed data bases are established using these parameters together with ancillary data, including biopsy results. Data-base studies are showing how this multi-parameter approach can be used to diagnose focal and diffuse diseases in abdominal organs. To refine these methods, we are including intraoperative as well as trans- abdominal clinical scans. We are also emphasizing the use of parameter images and "staining" to indicate the spatial distribution of characteristic parameter values. New parameters are being included to characterize tissue heterogeneity and to obtain absolute estimates of tissue properties unaffected by attenuation in intervening tissue. New acoustic microscopy procedures are also being combined with analytic investigations to provide insights that will help refine our characterization procedures and interpretation strategies
Keywords: design /development, kidney disorder diagnosis, liver disorder diagnosis, neoplasm /cancer diagnosis, ultrasonography carcinoma, cell type, hepatitis, image processing, kidney disorder, kidney transplantation, liver cirrhosis, liver neoplasm, metastasis, neoplasm /cancer radiodiagnosis, neuroblastoma, pancreas disorder, ultrasound scanning histopathology, human subject
Project start date: 1985-03-15
Project end date: 1996-03-31
5R01CA038400-14 (1994): $529307
5R01CA038400-13 (1993): $574814
2R01CA038400-12 (1992): $552947
CLINICAL ULTRASONIC CHARACTERIZATION OF THE PROSTATE
Ernest Joseph Feleppa, Research Director
Riverside Research Institute 9th Floor New York, Ny 10038
Grant 5R01CA053561-06 from National Cancer Institute, IRG: ZRG7
Abstract: The proposed study is a continuation of a 3-year study that has demonstrated the feasibility of typing prostatic tissue, particularly cancerous tissue, through the use of spectrum analysis of ultrasonic echo signals. These studies have shown that spectrum-analysis methods can effectively differentiate cancerous from benign conditions, including prostatic hyperplasia, with sufficient sensitivity and specificity to produce an ROC curve area of 0.88. As in the 3-year study, the proposed studies will be undertaken collaboratively by scientists and engineers at Riverside Research Institute (RRI) and medical personnel at the Memorial Sloan-Kettering Cancer Center (MSKCC) in New York City. The proposed studies have 2 general purposes 1) to expand the data base of spectrum- analysis parameters and histopathologically-determined prostatic-tissue types as obtained from biopsy, prostatectomy and male cystectomy, and 2) to evaluate the efficacy of parameter-value images for improving the planning and guidance of biopsy, surgery, cryotherapy, and radiation therapy and for monitoring therapies such as neoadjuvant (hormonal), conformal-radiation, and nutritional treatments. The proposed studies are planned to test specific hypotheses regarding the ability of spectrum analysis methods to differentiate among prostate-tissue types and to provide clinically-useful portrayals of tissue type that can enhance patient management, e.g., by reducing the number of true- and false- negative biopsies through better planning and guidance and by reducing the number of surgical treatments involving extracapsular cancer. Male patients of the Urologic Surgery Service and the Prostate Diagnostic Center of MSKCC will be scanned over the entire volume of the gland prior to prostate biopsy, prostatectomy, and cystectomy. Acquired ultrasonic signals will be analyzed and correlated with tissue assessments obtained histopathologically, and in the case of excised glands, in 3D. Patients who are not immediately treated surgically will be followed and the course of disease over time will be evaluated and biopsy results will be correlated with ultrasound-signal analyses. (Neoadjuvant treatment is administered prior to surgery and always ultimately provides histological information from excised glands for correlation with ultrasound-signal analyses.) RRI will be the prime grantee and MSKCC will participate through a subcontract with RRI.
Keywords: diagnosis design /evaluation, neoplasm /cancer diagnosis, prostate, prostate neoplasm, ultrasound scanning, biomarker, early diagnosis, neoplasm /cancer classification /staging, clinical research, histopathology, human subject, male
Project start date: 1992-07-01
Project end date: 1999-06-30
5R01CA053561-06 (1998): $315671
5R01CA053561-05 (1997): $270292
5R01CA053561-12 (2004): $389951
5R01CA053561-11 (2003): $379073
ULTRASONIC EVALUATION OF OCULAR TISSUES
Ernest Joseph Feleppa, Research Director
Riverside Research Institute 9th Floor New York, Ny 10038
Grant 5R01EY001212-05 from National Eye Institute, IRG: RAD
Abstract: The overall objective of the proposed program is to provide the comprehensive improvements in ophthalmic diagnosis and treatment monitoring which are needed to permit the optimal use of current and future therapeutic methods. The program will explore advanced ultrasonic spectrum analysis techniques and test them for reliability in a working clinical system. The objective will be to attain specificity of tissue diagnosis utilizing non-invasive ultrasonic methods. Characteristic histologic features will be assessed by "signatures" involving several sets of ultrasonic parameters. The precision of tissue characterization will enable detection and identification of a broad class of disorders including, most importantly, intraocular and orbital tumors. Tissue signatures will be determined from an advanced ultrasonic diagnostic system using mini-computer technology and digital processing techniques including deconvolution and cepstrum analysis. A computer library of these spectral parameters will serve as the focal point of efforts to identify sets of characteristics associated with specific diseases. Concurrently, experience gained with on-line clinical processing will be used to formulate techniques and diagnostic protocols which will allow the most efficacious use of these signatures in arriving at diagnostic decisions. The research is a collaborative effort with clinical studies performed at the E.S. Harkness Eye Institute and engineering efforts performed at Riverside Research Institute.
Keywords: EYE DISORDERS DIAGNOSIS, ULTRASONIC ECHOOCULOGRAPHY, PHYSICAL PROPERTIES, SOUND, ULTRASONOGRAPHY, RADIATION STUDY SECTION, BIOMEDICAL ENGINEERING, INSTRUMENTATION CLINICALLY ORIENTED, BIOMEDICAL SYSTEMS AUTOMATED, COMPUTER PROCESSING OF CLINICAL DATA, NEOPLASMS DIAGNOSIS, NEOPLASMS OF SENSE ORGANS, EYE NEOPLASMS, PHYSICAL PROPERTIES, SOUND, ULTRASONIC SCANNING, HUMAN, CLINICAL
Project start date: 1977-05-01
Project end date: 1980-04-30
Advanced Ultrasonic Evaluation Of Sentinel Lymph Nodes
Ernest Joseph Feleppa, Research Director
Riverside Research Institute
Grant 5R01CA100183-03 from National Cancer Institute, IRG: BMIT
Abstract: Riverside Research Institute and the University of Hawaii and its affiliated Kuakini Medical Center propose to investigate the use "of novel ultrasonic methods for discriminating between cancer-containing and cancer-free axillary lymph nodes of breast-cancer patients. Our emphasis will be on improving sentinel-node dissection biopsy procedures for breast-cancer patients; however, success in this project will benefit lymph- node evaluations of all types, not only for breast cancer, but also for a range of other cancers, including colorectal, epidermal (e.g., malignant melanoma), lymphatic, etc. Our premise is that the backscattering features of cancer-containing and cancer-free nodes differ sufficiently to differentiate between them using the proposed methods. Based on our extremely encouraging preliminary studies, our general hypothesis is that these methods can identify cancer-containing regions of dissected nodes using very-high-ultrasound frequencies with a simultaneous sensitivity and specificity of at least 90%. Our preliminary studies provide strong encouragement that our methods easily will validate this hypothesis. Our primary specific aims are to develop our methods when applied using very-high frequencies in the pathology laboratory to identify regions of nodes that warrant careful histologic examination. The methods we propose would be applied intra-operatively to better detect occult micrometastasis in sentinel-node dissections, and post-operatively to better detect metastasis in nodes excised by formal or radical dissections as well as in sentinel nodes. Our intention is to reduce markedly the failure of existing histopathological methods to detect metastases in 25% to 30% of excised nodes. We also aim to gain insight into underlying ultrasound-scattering mechanisms in lymph nodes. If we are successful in achieving our aims, major near-term benefits will result in evaluations of axillary lymph nodes in breast-cancer cases, and in the longer term, similar benefits will result in nodal evaluations for other cancers
Keywords: biopsy, breast neoplasm /cancer diagnosis, lymph node, method development, ultrasonography light scattering, metastasis, neoplastic process, radiowave radiation, surgery, women`s health clinical research, female, histopathology, human subject, light microscopy, patient oriented research, sectioning
Project start date: 2006-09-30
Project end date: 2010-07-31
1R01CA100183-01A2 (2006): $262537
CLINICAL ULTRASONIC CHARACTERIZATION OF THE PROSTATE
Ernest Joseph Feleppa, Research Director
Riverside Research Institute 9th Floor New York, Ny 10038
Grant 5R01CA053561-03 from National Cancer Institute, IRG: RNM
Abstract: Riverside Research Institute (RRI) and the Memorial Sloan-Kettering Cancer Center (MSKCC) propose to collaboratively investigate the application of advanced digital ultrasonic tissue characterization (UTC) techniques developed by RRI to detecting, diagnosing and staging prostate cancer and other prostate diseases, and to monitoring and evaluating the effectiveness of prostate-cancer therapies. The proposed research will emphasize application to prostate cancer, the second leading cause of cancer death in American men. RRI and its medical collaborators have shown these computer-based UTC methods to be clinically valuable in diagnosing ocular and abdominal cancers. They currently are being applied to characterizing venous and arterial thrombi. In its initial phase, the proposed research will utilize in-vitro surgical or transurethral-resection specimens to establish a range of potentially useful characterization parameters. Following these initial studies, the research will stress in-vivo studies involving acquisition of ultrasonic radio frequency (rf) data from patients undergoing transrectal ultrasound scanning at MSKCC for known or suspected prostate or bladder disease. Patients subjected to hormonal, radiation, chemotherapeutic and surgical treatments of the prostate will be scanned to establish UTC parameters for planning, monitoring and evaluating protocols. Patients undergoing radical cystectomy, in which the prostate routinely is removed as part of the surgical procedure, will be scanned prior to surgery and used as controls. Ultrasonic results will be correlated with whole-mount pathology specimens whenever possible, including malignant tissue excised in prostatectomies and normal and benign prostate tissue excised in the course of cystectomies. All acquired radio frequency (rf) ultrasonic data will be retained for long-term studies, and all signal-processing results will be entered into a data base along with clinical and histopathological results for statistical analysis. Over the proposed five-year research period, the very large patient population of the Urology Service at MSKCC will provide ample data to assure statistical confidence. RRI will serve as the primary grantee, and the efforts at MSKCC will be supported through a sub-contract with RRI.
Project start date: 1992-07-01
Project end date: 1996-12-31
5R01CA053561-03 (1994): $249029
5R01CA053561-02 (1993): $284737