Orthogonal ultrasound for cancer detection and therapy

描述(由申请人提供)： 这项R21应用的主要目标是开发3D正交复合超声(OCU)方法，用于两个潜在的应用：(A)间质前列腺癌治疗指导和验证；(B)乳腺癌诊断。OCU是我们最近在基于超声波的种子检测研究中出现的一种技术。初步数据表明，OCU提高了信噪比和对比度噪声比，减少了阴影伪影和斑点噪声。 目前超声组织分型、图像引导和治疗验证的标准技术是基于单一视角的二维超声成像，这是众所周知的存在噪声和伪影的问题。虽然3D超声在一些应用中被引入，但3D图像立方体仍然是由多个单平面图像构成的。在手术室中，前列腺靶的自动跟踪和植入种子的定位并不是始终如一的。乳腺组织良恶性病变之间的类型区分也是不确定的，导致特异性低，因此在临床应用中有相当大比例的不必要的活检。 三维正交复合超声(OCU)成像技术就是为了克服这些缺点而提出的。它使用标准超声探头从横向、纵向或旋转扫描中获取两个垂直间隔的3D图像体积，然后将其重建、配准并合并为复合体积。根据IRB批准的方案，OCU对18名患者的前列腺治疗的数据收集已经在进行中。建议进行定量研究，以确定靶组织识别和治疗验证方面的改进。 此外，还提出了OCU在乳腺癌检测中的数据收集以及与50例患者的病理结果的相关性。 长期目标是(A)使用OCU成像作为前列腺癌诊断和肿瘤内治疗的标准指导和实时验证方法；(10)开发OCU上用于乳腺癌诊断和筛查的计算机辅助组织分型；以及(C)开发颅内、甲状腺和经腹/盆腔超声的正交组合方法。

DESCRIPTION (provided by applicant): The major goal of this R21 application is to develop methods for 3D orthogonal compound ultrasound (OCU) for two potential applications: (a) interstitial prostate therapy guidance and verification; (b) breast cancer diagnosis. OCU is a technique that emerged in our recent studies on ultrasound-based seed detection. Preliminary data indicate that OCU provides increased signal-to-noise and contrast-to-noise ratios, and reduces shadowing artifacts and speckle noise. Current standard techniques of ultrasound tissue typing, image guidance and therapy verification are based on 2D ultrasound imaging from a single look angle, which is known to suffer from noise and artifacts. Although 3D ultrasound is being introduced in some applications, the 3D image cube is still constructed from multiple single plane images. Automatic tracking of the prostate target and localization of implanted seeds are not consistently achievable in the operating room. Breast tissue type discrimination between benign vs. malignant changes is also uncertain, resulting in low specificity and therefore significant percent of unnecessary biopsies in clinical applications. The 3D orthogonal compound ultrasound (OCU) imaging technique is proposed to overcome these drawbacks. It uses a standard ultrasound probe to acquire two orthogonally spaced 3D image volumes from transverse, longitudinal or rotational scans, which are then reconstructed, registered and combined into a compounded volume. Data collection for OCU in prostate therapy of 18 patients is already underway under an IRB approved protocol. Quantitative studies to determine improvements in target tissue identification and therapy verification are proposed. Data collection for OCU in breast cancer detection and correlation with pathological findings in 50 patients are additionally proposed. The long-term goals are (a) to use OCU imaging as a standard guidance and real-time verification method for prostate cancer diagnosis and intratumoral therapy deliveries; (10) to develop computer-aided tissue typing on OCU for breast cancer diagnosis and screening; and (c) to develop methods for orthogonal compounding of intra-cranial, thyroid and trans-abdominal/pelvic ultrasound.