Breast PETX: Mammography Machine PET Scanner with Biopsy Guidance

描述（由申请人提供）：乳腺癌通常是1期（<2cm），由于空间分辨率有限，这限制了常见功能成像模式在早期乳腺癌检查中的使用。在华盛顿大学（UW），正电子发射断层扫描（PET）已被成功地用作生物标志物，以提供局部晚期乳腺癌的预后信息和评估治疗。我们在这个项目中的长期目标是扩大PET作为乳腺癌治疗反应的生物标志物的使用。这将更具体地指导治疗选择，从而改善结果并防止与无效治疗相关的成本和副作用。高分辨率定量准确的PET将与临床乳腺X线摄影或断层合成和活检引导方法相结合，以实现这一目标。该项目的目标是：（1）设计一个PET探测器单元，使用与盖革模式硅光电倍增器耦合的单片闪烁晶体;（2）构建和测试一个完全断层PET扫描仪，该扫描仪与传统的乳房X线摄影/断层合成机架相匹配，用于乳房X线摄影套件中的PET和X射线成像;（3）将PET扫描仪与临床乳房X线摄影或断层合成设备和活检引导相集成;（4）对原型进行表征，并通过试点患者研究对其进行测试。这将是华盛顿大学和通用电气全球研究中心之间的合作。使用在UW开发的单片晶体探测器方法，基本探测器开发将由GRC领导，UW共同研究者密切参与; GRC团队还将领导系统集成到乳腺X射线摄影设备上;整体系统性能和临床实施将在UW率先进行。这项工作的结果将是一个专用的乳房PET系统，在乳房X线摄影套件中运行;最初用于扩大目前正在进行的使用临床PET治疗晚期乳腺癌的治疗评估试验。该设备将使使用PET作为早期疾病的生物标志物的研究成为可能，包括使用UW放射化学回旋加速器提供的各种PET示踪剂。这将是一个商业化设计的原型，可以在其他机构复制部署。拟议的系统将提供一个临床工具，以有效地研究PET在对抗早期乳腺癌方面的可能用途。 公共卫生相关性：正电子发射断层扫描（PET）可用于评估对乳腺癌治疗的早期反应，并可允许个性化，优化治疗选择，包括避免管理治疗的成本和副作用，结果证明是无效的。然而，目前的PET扫描仪无法准确测量早期乳腺癌的反应，而早期乳腺癌在诊断时是最普遍的。该项目将开发PET-乳房X线摄影-活检组合系统，该系统能够进行与传统乳腺癌成像（乳房X线摄影）和活检指导相关的治疗反应测量（PET），以确认早期疾病的结果，从而优化当前的治疗药物，并评估新药和疗法。

DESCRIPTION (provided by applicant): Breast cancers are typically Stage-1 (<2cm) at presentation, which limits the use of common functional imaging modalities in the work-up of early breast cancer because of limited spatial resolution. At the University of Washington (UW), positron emission tomography (PET) has been used with success as a biomarker to provide prognostic information about and evaluate therapy in locally advanced breast cancers. Our long-term goal in this project is to expand the use of PET as a biomarker for treatment response in breast cancer. This will more specifically direct therapy selection, resulting in improved outcomes and preventing cost and side effects associated with ineffective therapy. High resolution quantitatively accurate PET will be integrated with clinical mammography or tomosynthesis and biopsy-guidance methods to achieve this goal. The aims of this project are: (1) design a PET detector unit using monolithic scintillation crystals coupled to Geiger-mode silicon photo-multipliers; (2) build and test a fully tomographic PET scanner that mates to a conventional mammography/tomosynthesis gantry for combined PET and x-ray imaging within the mammography suite; (3) integrate the PET scanner with clinical mammography or tomosynthesis equipment and biopsy guidance; (4) characterize the prototype and test it with pilot patient studies. This will be a collaboration between the UW and the GE Global Research Center. Using monolithic crystal detector methodologies developed at UW, the basic detector development will be lead by GRC with close involvement of UW co-investigators; GRC team will also lead systems integration onto mammography equipment; the overall system performance and clinical implementation will be spearheaded at the UW. The result of this work will be a dedicated breast PET system that operates in a mammography suite; initially used to expand therapy evaluation trials currently underway for advanced breast cancer using clinical PET. The device will enable investigation of using PET as a biomarker in early stage disease, including the use of diverse PET tracers available from the UW Radiochemistry cyclotron. It will be a prototype for a commercial-ready design that can be replicated for deployment at other institutions. The proposed system will provide a clinical tool to effectively investigate possible uses of PET to fight early-stage breast cancer. PUBLIC HEALTH RELEVANCE: Positron emission tomography (PET) can be used for evaluating early response to breast cancer treatments and may allow individualized, optimized therapy selection, including avoiding the costs and side effects of administering treatments that turn out to be ineffective. However, current PET scanners cannot accurately measure response in early-stage breast cancer that is by far most prevalent at diagnosis. This project will develop combined PET-mammogram-biopsy system capable of therapy response measurements (PET) correlated with conventional breast cancer imaging (mammography) and biopsy guidance to confirm results in early stage disease, thus enabling optimization of current therapy agents, and evaluation of new drugs and therapies.