多模态MR影像揭示软组织肉瘤组织学类型及浸润边界的实验研究

Soft tissue sarcomas (STSs) are malignant soft tissue tumors with invasive growth and potential for recurrence. preoperative precise diagnosis is extremely important for formulating individualized treatment plan. Currently, few studies have focused specifically on accurate preoperative diagnosis of STSs. previous studies have demonstrated that it was valuable for evaluating biological behavior of STSs by using a combined structure MR imaging (sMRI) and functional imaging (fMRI) approach. It is confirmed that fMRI parameters performances were highly in correlation with some histological patterns. It is helpful in determining histological patterns and infiltrating boundary of STSs with Cho-NAA、DWI-ADC by MRS. MR molecular imaging (mMRI) uses highly selective contrast agent combined with tumor specificity characteristic materials to achieve targeted MR imaging. It is limited to a few tumor animal experimental studies. However, sMRI and fMRI/mMRI have shown both advantage and insufficiency in revealing pathological characteristic information. In this study, on base of STSs mice model-multimodality MR imaging followed by plane-to-plane/point-to-point control research with pathological characteristics, We’ll develop MR ligands special to some STSs which have clear break apart probe, such as liposarcoma, synovial sarcoma, rhabdomyosarcoma and ES/PNET.Then further reveal the MR imaging information precisely representing histological patterns and infiltrating boundary of STSs. It is expected that such research would open up a new path in precise preoperative diagnosis of STSs.

软组织肉瘤（STSs）有侵袭性生长和复发潜能，术前能否做精确诊断对制定治疗方案至关重要。前期研究发现，MR结构成像（sMRI）结合功能成像（fMRI）有助于评价STSs生物学行为，fMRI功能参数与STSs某些组织学类型有关；Cho-NAA、ADC值有助于确定部分肿瘤组织类型或浸润范围，以特异标记物为靶点的MR分子成像（mMRI）能识别肿瘤边界，但仅限于部分肿瘤动物实验。fMRI/mMRI与sMRI反映病理特征各有优势与不足，针对多模态MRI能否评价STSs组织学类型和浸润边界的研究不足问题，我们拟在STSs动物模型多模态MR影像层面、ROI与病理切面、组织取材面对面、点对点精准对照基础上，对有明确分离探针的脂肪肉瘤、滑膜肉瘤、横纹肌肉瘤及ES/PNET等STSs研制相应MR靶向分子探针配体开展研究，揭示反映其组织学类型及浸润边界的MRI特征，有望为今后术前MRI精确诊断STSs开辟新途。

项目组在国家自然科学基金项目资助下， 经过2018-2021年四年对MR影像揭示软组织肉瘤组织学类型及浸润边界的实验研究，完成了在STSs 动物模型各种sMRI、fMRI 及mMRI 图像层面、ROI与病理学大体切面、组织取材点的精确对应的第一个研究目标，并在全球首次研发出《四肢躯干软组织肿瘤影像-病理“面对面、点对点”精准对照方法》。相应研究成果有三篇不同类型论文已发表。经过三年反复使用，效果良好，并成功推广到临床使用。.项目组在上述重要研究方法基础上，完成了软组织肿瘤影像-病理对照研究的十多个子课题，取得了系列进展和重要结果，共发表了17篇相关论文。其中通过多模态MR 影像与病理的精准对照研究，所获的动物模型及临床多模态MR 影像能精确反映STSs 的组织学类型及浸润边界，已经完成预定的研究目标。相应研究成果已发表。.项目组基于部分软组织肉瘤亚型动物模型尚未建全以及MR 靶向分子探针配体制作未能实现的原因，对研究内容做了部分调整，即在已经成功建模的横纹肌肉瘤、纤维肉瘤、脂肪肉瘤和滑膜肉瘤等亚型上探索多模态MRI揭示相应软组织肉瘤亚型的病理学特征的实验研究及软组织肉瘤MRI-病理对照的临床研究，并且取得了具有良好应用前景的成果，为临床医师通过MR影像揭示复杂多变的软组织肉瘤异质性提供了科学依据。