Comprehensive MR Imaging of Elderly Vascular Function
This Small Business Technology Transfer (STTR) proposal responds to program announcement PAS-06-131 entitled, "Applications of Imaging and Sensor Technologies for Clinical Aging Research". The purpose of the announcement is to improve imaging methods for measuring age-related changes in regulation of complex physiologic systems, including responses to stimuli or stressors. Our proposal responds to this request through the development and validation of a software platform that enables processing and reporting of noninvasive magnetic resonance imaging (MRI) data related to cardiovascular blood flow and function in elderly patients. For the elderly, disorders of the cardiovascular system are the most frequent cause of morbid and mortal events. Disturbances of coronary, aortic, and peripheral arterial blood flow and vascular function (sheer stress, endothelial function) are integral in the pathophysiology of these disorders. Current clinically available methods for measuring flow and function are invasive (thus expose the patient to a risk of bleeding, vessel damage, and infection), require ionizing radiation (increasing the risk of cancer), use iodinated contrast (nephrotoxic), or offer suboptimal image quality (ultrasound testing). Moreover, many of the currently clinically available testing modalities are better suited for assessing cardiovascular anatomy rather than blood flow or vascular function. These shortcomings not only contribute to increased patient burden and suboptimal diagnoses, but also contribute to rising health-care expenditures. Our proposed software platform provides physicians with the capability to use MRI generated image data for rapid, accurate measurement and reporting of blood flow and vascular function. This platform will be developed and compared to existing software prototypes that have been validated and demonstrated effective on MRI scanners from the 2 largest vendors over the past 10 years in elderly patients with disorders of blood flow and function. The processes we propose are faster, safer, relatively inexpensive, and more accurate than existing technologies. In addition, these processes render physicians capable of measuring 5 unique functions of the vascular system that have been individually shown to independently predict adverse cardiovascular morbidity and mortality in the elderly. They do not incorporate ionizing radiation or contrast materials. In Phase I of this application, we will develop and compare a commercial software platform to our existing, validated research prototypes. In a subsequent Phase 2 application, we will rigorously analyze the clinical utility and financial impact of the technology by comparing coronary, central, and peripheral arterial blood flow and function data generated and reported with this new software platform to the same data generated using the current non-MRI technologies employed in clinical practice with the intent of defining the most clinically appropriate, cost-effective mechanism for delivery of this new platform into the health-care system.