Multimodality virtual endoscopy with hybrid PET/CT units

描述（由申请人提供）：内窥镜检查是一种侵入性手术，其中柔性光纤（内窥镜）用于目视检查器官的内衬，例如气道（支气管镜检查）或结肠（结肠镜检查）。虚拟内窥镜（VE）使用计算机断层扫描（CT）或磁共振（MR）数据在计算机上重建和显示气道（VB）或结肠（VC）表面，从而无需插入内窥镜。迄今为止，基于CT或MR的仿真内窥镜仅检查结构的表面。使用氟脱氧葡萄糖（FDG;葡萄糖的类似物）或其他示踪剂的正电子发射断层扫描（PET）可以根据癌组织表现出的分化代谢（FDG的糖酵解活性）来表征癌组织。通过将PET与CT数据相结合，我们可以创建一种新的模式：PET增强虚拟内窥镜（PaVE），它提供了CT提供的解剖定义，但也可以根据PET显示的糖酵解活性（与FDG）进一步评估可能的恶性病变。通过在多学科环境中对新的优化协议和软件工具进行临床整合，我们的目标是提高我们在VE范例中有效地将联合收割机PET和CT数据集结合的能力，从而提高诊断准确性和指导微创（MI）组织分期程序（如用于胸部和肺部癌症的支气管镜经支气管活检和肿瘤切除术）的前景。最近推出的组合PET/CT单元，产生PET和CT数据集在一个单一的研究将有助于我们的建议。我们的机构是率先将这些混合机器应用于癌症诊断和管理的机构之一，并通过呼吸门控进一步扩大其使用和准确性。因此，当前提案是这一奋进的自然补充和扩展，符合PA-04-045的一般目的，特别是主题3（图像显示和分析）和主题4（图像引导的癌症干预）。

DESCRIPTION (provided by applicant): Endoscopy is an invasive procedure in which a flexible optical fiber (the endoscope) is used for visually inspecting the inner lining of organs such as the airways (bronchoscopy) or the colon (colonoscopy). Virtual endoscopy (VE) uses computed tomography (CT) or magnetic resonance (MR) data to reconstruct and display airway (VB) or colon (VC) surfaces on computers, thereby eliminating the need for the insertion of an endoscope. To date, CT or MR-based virtual endoscopy only examines the surface of the structures. Positron emission tomography (PET) with fluoro-deoxy-glucose (FDG; an analog of glucose) or other tracers can characterize cancerous tissues based on the differentiated metabolism (glycolytic activity for FDG) they exhibit. By combining PET with CT data, we can create a novel modality: PET-augmented virtual endoscopy (PaVE), that offers the anatomical definition provided by CT, but also enables further evaluation for possible malignant involvement based on the glycolytic activity (with FDG) exhibited through PET. Through the clinical integration of new optimized protocols and software tools in a multidisciplinary environment, we aim to improve our ability to effectively combine PET and CT data sets in a VE paradigm with the prospect of increasing diagnostic accuracy and of guiding minimally invasive (Ml) tissue staging procedures such as bronchoscopic transbronchial biopsies and tumor resections for cancers of the chest and lungs. Recently introduced combination PET/CT units that yield both PET and CT data sets in a single study will be instrumental to our proposal. Our institution has been among the very first ones to pioneer the application of these hybrid machines to cancer diagnosis and management, and to further expand their use and accuracy through respiratory gating. The current proposal is therefore a natural complement and extension of this endeavor that conforms to the general purpose of PA-04-045 and especially to topics 3 (image displays and analyses) and 4 (image-guided cancer intervention).