CT Characteristics of Emphysema for Evaluation of Pulmonary Nodules

项目摘要/摘要 K23项目的原始描述不会改变--如下所述： 研究：国家肺部筛查试验(NLST)显示，使用该药可降低20%的死亡率 每年进行CT筛查，但由于为评估94%的患者而进行的程序导致显著发病率 非癌变的结节。这项建议的目标是提高区分 根据与肺气肿相关的数量特征，这些“不确定”的结节中有一种是肺癌 只需一次CT扫描即可获得。我们的初步数据表明，中度小叶中心性肺气肿(MCE)， 及其相关的血管特征，为新生肺的生长提供了一个利基环境。以创新的方式 这一建议是利用结节周围肺球内微血管造影的特征来提高检测的特异性。 癌症。然而，增加特异性会导致敏感性降低。在肺癌筛查的情况下 更多的“漏诊”癌症可能会增加肺癌死亡人数。要了解敏感度降低对 死亡率我们将使用新的UVM肺癌模型，它准确地概括了肺癌死亡和 CT筛查率，在众多筛查中确定一组用于识别癌症的最佳生物标志物 检测到结节。 候选人：金赛博士的临床实践是介入肺，这是一个专注于处理 不确定的结节问题。他已经应用了他的公共卫生硕士流行病学和生物统计学训练， 凭借在定量CT成像方面的经验，开始解决结节不确定的问题 COPD基因数据集，作为UVM分子、表观遗传学和放射学的主要研究人员 胸癌生物标志物(MEROPTIC)研究。然而，在这个过程中，他还需要进一步的培训。 开发CT特征作为成像生物标记物和计算机建模，这将使他能够理解 这些生物标志物的部署对肺癌死亡率的影响。要解决这些关键差距， 他的主要导师杰森·贝茨博士设计了一个教学培训计划，并在他的指导下 这项研究将推动金赛博士成为肺癌诊断领域的独立研究员。 环境：金赛博士的主要导师贝茨博士因其在肺病方面的工作而受到国际认可 生理学和计算机建模，并在培训调查人员和医生方面有良好的记录 科学家。联合导师乔治·沃什科博士是定量成像分析方面的专家，并拥有 与金赛博士建立了指导关系。一个具有成熟专业知识的科学咨询委员会 放射学、生物统计学、肺癌和生物标记物开发与这个杰出的指导团队相辅相成。 在佛蒙特州的赞助下，金赛博士得到了个人和资源网络的进一步支持 肺中心和佛蒙特州大学癌症中心，即致力于青少年的发展 调查人员。

PROJECT SUMMARY/ABSTRACT The original description of the K23 project will not change – as re-iterated below: Research: The National Lung Screening Trial (NLST) demonstrated a 20% reduction in mortality with the use of annual CT screening but with significant morbidity due to procedures performed for evaluation of the 94% of nodules that were not cancerous. The goal of this proposal is to improve the specificity for distinguishing which of these “indeterminate” nodules is lung cancer by using quantitative features associated with emphysema available from a single CT scan. Our preliminary data indicate that moderate centrilobular emphysema (MCE), and its associated vascular features, provide a niche for the growth of nascent lung. An innovative approach of this proposal is to use features of MCE in the sphere of lung around a nodule to improve specificity for detecting cancer. However, increasing specificity results in decreasing sensitivity. In the case of lung cancer screening more “missed” cancers may increase lung cancer deaths. To understand the effect of decreasing sensitivity on mortality we will use the novel UVM Lung Cancer Model, which accurately recapitulates lung cancer death and CT screening rates, to identify an optimal set of biomarkers for identifying cancer among the many screen detected nodules. Candidate: Dr. Kinsey's clinical practice is in Interventional Pulmonary, a specialty that focuses on dealing with the problem of indeterminate nodules. He has applied his MPH epidemiology and biostatistical training, coupled with experience in quantitative CT imaging, to begin to address the problem of indeterminate nodules in the COPD Gene data set and as the Principal Investigator of the UVM Molecular, Epigenetic, and Radiologic Biomarkers for Thoracic Cancers (MEROPTIC)study. However, he needs further training in the process of developing CT features as imaging biomarkers and in computer modeling, which will allow him to understand the effect of deployment of these biomarkers on lung cancer mortality. To address these critical gaps in knowledge his primary mentor, Dr. Jason Bates, has designed a program of didactic training and supervised research that will propel Dr. Kinsey to an independent investigator in the field of lung cancer diagnosis. Environment: Dr. Kinsey's primary mentor, Dr. Bates, is internationally recognized for his work in pulmonary physiology and computer modeling and has a proven track record of training investigators and physician scientists. The co-mentor, Dr. George Washko, is an expert in quantitative imaging analysis and has an established mentoring relationship with Dr. Kinsey. A scientific advisory committee with established expertise in radiology, biostatistics, lung cancer, and biomarker development complements this outstanding mentoring team. Dr. Kinsey is further supported by a network of individuals and resources, under the auspices of the Vermont Lung Center and University of Vermont Cancer Center, that is committed to the development of junior investigators.