Development of a High Performance Clinical Cardiac SPECT/TCT System

描述(申请人提供)：由于冠状动脉疾病(CAD)的患病率和SPECT的S成本效益评估冠状动脉疾病，心脏SPECT程序占美国每年1800万例核成像的近60%。然而，大多数用于心脏研究的SPECT系统还没有针对心脏成像进行优化。因此，这项技术的应用范围和诊断准确性几十年来没有显著变化。迫切需要开发改进的心脏SPECT系统和技术，以满足现有和未来临床和研究应用的需求。为了满足这一需求，我们开发了一种新的心脏SPECT成像平台-C-SPECT。它的基础是使用大面积等高线探测器进行有效检测，以及使用多功能准直器系统从放置心脏的小体积进行有效采样。我们的设计有许多独特的条款来优化大多数患者的成像，并将首次使自适应SPECT在临床上实用。它还包括一个集成的高性价比TCT，可为定量SPECT成像提供高质量的衰减图。我们的长期目标是帮助临床心脏SPECT实现其定量成像潜力。我们的方法是通过优化仪器设备来提高SPECT的性能并扩展其临床功能。在这个项目中，我们的目标是开发第一个实验室原型C-SPECT-I，以实现其优越的性能和多功能性。我们建议由Rush和Penn两个ECT小组组成的生物工程研究伙伴关系来最终完成设计并构建原型，为其未来转换为临床原型铺平道路。宾夕法尼亚大学的团队将带来他们在PET探测器、SPECT准直仪和图像重建方面的专业知识，以补充Rush的系统设计。这是一个学术研究合作组织，将PET、SPECT和CT技术的硬件和软件专业知识结合在一起。根据两个小组在开发ECT系统方面的记录，我们的合作伙伴关系处于非常有利的地位，可以承担这一项目。我们预计，在相同的系统分辨率下，C-SPECT-I将比传统系统具有更多的通用性和更高的几何效率(2-2.5倍)。最近，在几种新的心脏SPECT系统中，新的分辨率恢复重建(RRR)技术被认为在不影响诊断质量的情况下，有效效率提高了许多倍(3-9倍)。我们将在C-SPECT-I中实施和优化这些软件处理技术的使用。经过优化的硬件和先进的软件，C-SPECT-I可以在相同成像质量的情况下，对心脏SPECT成像具有前所未有的有效效率。此外，随着快速和动态成像所需的图像质量降低，C-SPECT-I可以获得比现有系统高出一个数量级的灵敏度或速度的增益。我们相信，随着性能、通用性和功能性的潜在改进，C-SPECT平台将有助于开辟新的天地，并导致患者护理质量的提高和成本的降低。 公共卫生相关性：拟议的研究与公共健康相关，因为如果开发拟议的C-SPECT-I成像系统，将提高诊断心脏成像这一高要求领域的患者护理质量。因此，该项目与NIH提高质量和降低医疗成本的核心使命直接相关，因为潜在的成像系统将提供前所未有的多功能性和性能，并降低患者的辐射负担。

DESCRIPTION (provided by applicant): Because the prevalence of coronary artery disease (CAD) and SPECT 's cost-effectiveness for evaluation of coronary artery disease, cardiac SPECT procedures account for nearly 60% of the 18 millions nuclear imaging performed yearly in the US. However, most SPECT systems used for cardiac studies are not yet optimized for cardiac imaging. As a result, the scope of applications and diagnostic accuracy of the technique have not changed significantly for decades. There is an urgent need to develop improved cardiac SPECT systems and techniques to meet the existing and future demands for clinical and research applications. To address this need, we have developed a new platform - C-SPECT- for cardiac SPECT imaging. It is based on using a large-area contoured detector for efficient detection and a versatile collimator system for effective sampling from a small volume, in which the heart is placed. Our design has many unique provisions to optimize imaging for the majority of patients, and will make adaptive SPECT clinically practical for the first time. It also includes an integrated cost-effective TCT to provide quality attenuation maps for quantitative SPECT imaging. Our long-term goal is to help clinical cardiac SPECT to realize its quantitative imaging potential. Our approach is to improve the performance and expand the clinical functionality of SPECT through optimized instrumentation. In this project, our objective is to develop the first lab-prototype, C-SPECT-I, to realize its superior performance and versatility. We propose this Bioengineering Research Partnership, formed by the two ECT groups of Rush and Penn, to finalize the design and construct the prototype to pave the way for its future conversion to a clinical prototype. The group at Penn will bring their expertise in PET detectors, SPECT collimators, and image reconstruction to complement Rush's system design. This is an academic research collaboration formed to combine hardware and software expertise in PET, SPECT and CT technologies. Our partnership is in an excellent position to take on this project based on both groups' track records in developing ECT systems. We anticipate that the C-SPECT-I will have far more versatility and higher (2-2.5X) geometric efficiency than that of conventional systems at the same system resolution. Recently, the new resolution recovery reconstruction (RRR) techniques have been credited with many folds (3-9X) of increase in effective efficiency without compromising diagnostic quality in several new cardiac SPECT systems. We will implement and optimize the use of these software processing techniques in C-SPECT-I. With optimized hardware and advanced software, the C-SPECT-I could have an unprecedented effective efficiency for cardiac SPECT imaging for the same imaging quality. In addition, with reduced image quality required for fast and dynamic imaging, a gain of an order of magnitude higher sensitivity or speed could be achieved in C-SPECT-I relative to existing systems. We believe that with the potential improvements in performance, versatility and functionality, C-SPECT platform will help break new grounds and lead to improved quality and reduced cost of patient care. PUBLIC HEALTH RELEVANCE: The proposed research is relevant to public health because the proposed C-SPECT-I imaging system, if developed, will improve quality of patient care in the highly demanded area of diagnostic cardiac imaging. Thus, this project is directly relevant to NIH's core mission of improving quality and reducing cost of healthcare, because the potential imaging system will offer unprecedented level of versatility and performance, and with reduced radiation burden to patients.