Multimodal Image-Guided Intervention System for Lung-Cancer Diagnosis and Staging

项目描述（由申请人提供）：本项目旨在构建一个多模式图像引导干预（IGI）系统，用于支气管镜检查的规划和指导。该系统将具有以下特点：1)易于使用，不依赖于医生的技能和经验；2)实现更精准、更自信的组织采样，减少患者并发症；3)提供稳健的指导；4)更好地利用可用的图像资源。肺癌是全球癌症死亡的主要原因。近年来，在多模态放射成像和支气管镜检查方面出现了许多技术创新，以对抗肺癌。多探测器计算机断层扫描（MDCT）扫描仪提供三维（3D）亚毫米分辨率的胸部x射线CT图像，正电子发射断层扫描（PET）扫描仪提供互补的分子成像信息，新型集成PET/CT扫描仪结合了两种方式的优势。最先进的支气管镜提供生动的支气管内视频，使导航深入气道树周围，而互补的支气管内超声（EBUS）显示气道外解剖结构的局部视图。然而，肺癌患者的5年生存率仍然低于15%，这意味着这些新工具尚未得到充分利用。现在的目标是设计一个IGI系统，在整个肺癌评估过程中结合多模态成像技术。特别是，该项目是由以下假设驱动的：多模态3D成像和支气管镜检查的协同整合，加上基于计算机的图像处理，改进了当前肺癌的诊断和分期技术。该项目的具体目标如下：目标1：设计多模式手术计划和图像引导支气管镜检查的方法。目标2：构建一个完全集成的多模式图像引导干预系统。目标3：进行人体研究以优化和验证整个系统。如果成功，所提出的多模式成像、活检和治疗计划技术可以在几乎所有患者的术前正确诊断和分期肺癌。此外，拟议的技术将极大地促进其他正在进行的发展，努力定位早期肺癌，并协助肺气肿和其他肺部疾病的治疗。最后，许多提出的基本方法应该适用于其他领域，如泌尿外科、胃肠病学、肾脏病学、妇科和神经病学。

DESCRIPTION (provided by applicant): The goal of this project is to construct a multimodal image-guided intervention (IGI) system for the planning and guidance of bronchoscopy. The system will have the following features: 1) be easy to use, independent of physician skill and experience; 2) enable better-focused, confident tissue sampling, with fewer patient complications; 3) offer robust guidance; and 4) better exploit the available image sources. Lung cancer is the leading cause of cancer death worldwide. Many technical innovations in multimodal radiologic imaging and bronchoscopy have emerged recently in the effort against lung cancer. Multidetector computed-tomography (MDCT) scanners provide three-dimensional (3D) sub-millimeter-resolution X-ray CT images of the chest, positron emission tomography (PET) scanners give complementary molecular-imaging information, and new integrated PET/CT scanners combine the strengths of both modalities. State-of-the- art bronchoscopes provide vivid endobronchial video enabling navigation deep into the airway-tree periphery, while complementary endobronchial ultrasound (EBUS) reveals local views of anatomical structures outside the airways. Nevertheless, the 5-year survival rate of lung-cancer patients remains under 15%, implying that these new tools have not yet been fully exploited. The objective now is to devise an IGI system that incorporates multimodal imaging techniques throughout the lung-cancer assessment process. In particular, the project is driven by the following hypothesis: A synergistic integration of multimodal 3D imaging and bronchoscopy, coupled with computer-based image processing, improves current techniques for the diagnosis and staging of lung cancer. The specific aims of the project are as follows: Aim 1: Devise methods for multimodal procedure planning and image-guided bronchoscopy. Aim 2: Construct a fully integrated multimodal image-guided intervention system. Aim 3: Perform human studies to optimize and validate the complete system. If successful, the proposed multimodal imaging, biopsy, and treatment-planning techniques could enable correct diagnosis and staging of lung cancer preoperatively in virtually all patients. In addition, the proposed techniques would greatly facilitate other ongoing developments striving to localize early lung cancers and assist in the treatment of emphysema and other lung diseases. Finally, many of the proposed basic methods should be applicable to other areas, such as urology, gastroenterology, nephrology, gynecology, and neurology.