Breast PETX: Mammography Machine PET Scanner with Biopsy Guidance

描述(由申请人提供)：PET在乳腺癌的治疗中发挥着越来越大的作用，特别是在乳腺癌的特征和评估其治疗反应方面。然而，由于很难准确识别和量化较小乳腺肿瘤的示踪剂摄取，PET在乳腺癌的临床应用在很大程度上局限于局部晚期或转移性疾病。为了克服这一限制，其他研究人员已经设计和测试了专用设备来改进初级乳腺癌的检测；然而，这些设备不太适合，也不打算用于图像量化，而且通常无法使用PET信息来指导活检，这是确认PET确定的肿瘤特征所必需的。为了满足对定量成像和活检能力的需求，并出于对较小乳腺肿瘤的特征和跟踪其治疗反应的需求，我们将建造和实施一种专用的高分辨率乳房正电子发射断层扫描仪(PET)设备，该设备连接到传统的乳房X光机。宠物图像和数字乳房X光照片将在图像采集之间不移动适度压缩的乳房的情况下进行采集。我们建议的系统的一个关键方面是它将是一个真正的断层成像PET设备，而不是正电子发射乳房X光扫描仪(PEM)。因此，与PEM不同，PET图像将是定量的。定量的生理信息可用于研究肿瘤的生物异质性、分子标志物的摄取以及对治疗的反应。拟议的系统还将容纳活检引导机构，该机构将允许活检针由PET图像或合并的PET-乳房X光图像引导。这种方法将为较小的早期乳腺肿瘤提供定量成像，并提供活检指导，这对于我们正在进行的乳腺癌特征和治疗反应的研究都是必要的。公共卫生相关性：该项目旨在开发一种针对分子乳房成像进行优化的扫描仪，该扫描仪能够补充乳房X光检查，能够进行活组织检查针引导，并与乳房X光照相机相连操作。这种扫描仪将极大地降低功能性PET乳腺癌成像的门槛，从大约20毫米降到大约5毫米，这将允许在疾病过程的早期进行表征，为最佳治疗选择提供更多机会。随着乳腺癌分子通路的多样性被发现，这一工具将有助于乳腺癌的复杂特征，这被证明是患者预后中越来越重要的任务。

DESCRIPTION (provided by applicant): PET plays an increasing role in the management of breast cancer, especially in characterizing breast cancer and evaluating its response to treatment. However, the clinical use of PET in breast cancer has been largely restricted to locally advanced or metastatic disease due to the difficulty of accurately identifying and quantifying tracer uptake in smaller breast tumors. To overcome this limitation, other investigators have designed and tested dedicated devices to improve primary breast cancer detection; however these devices were not well suited, nor intended, for image quantification and generally were not able to use the PET information to direct biopsy, necessary to confirm tumor features identified by PET. To address the need for quantitative imaging and biopsy capability, and motivated by the desire to characterize smaller breast tumors and follow their response to therapy, we will build and implement a dedicated high-resolution breast positron emission tomograph (PET) device that attaches to a conventional mammography machine. PET images and digital mammograms will be acquired without moving the moderately compressed breast between image acquisitions. A key aspect of our proposed system is that it will be a true tomographic imaging PET device, rather than a positron emission mammographic (PEM) scanner. Thus the PET images will be quantitative, unlike PEM. The quantitative physiological information can be used to investigate biological heterogeneity of the tumor, uptake of molecular markers, and response to treatments. The proposed system will also accommodate a biopsy guidance mechanism that will allow a biopsy needle to be guided by the PET image, or the merged PET- mammogram image. This approach will provide quantitative imaging of smaller, earlier stage breast tumors, with biopsy direction, both necessary for our ongoing studies of breast cancer characterization and response to treatment. PUBLIC HEALTH RELEVANCE: This project aims to develop a scanner optimized for molecular breast imaging that complements mammography, is capable of biopsy needle guidance, and operates attached to a mammography machine. This scanner will greatly reduce the threshold of functional PET breast cancer imaging, from around 20 mm to around 5 mm, which will allow characterization earlier in the course of the disease giving more opportunity for the best treatment selection. This tool will assist in the complex characterization of breast malignancies that is proving to be an increasingly important task in patient prognosis as the multiplicity of breast cancer molecular pathways is uncovered.