The Use of 68Ga-DOTATOC and 18F-FDG PET/CT Imaging in the Evaluation of Newly Dia

68Ga-DOTATOC 和 18F-FDG PET/CT 成像在新直径评估中的应用

• 批准号: 8195984
• 负责人: Ronald Clark Walker
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-10-01 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8195984
• 关键词: Academic Medical Centers; Acids; Adenocarcinoma; Affect; American; Appointment; Benign; Biological Markers; Biometry; Biopsy; Blood Tests; Bronchi; Bronchiolo-Alveolar Adenocarcinoma; Bronchoscopy; Calcified; Caliber; Cancer Biology; Cancer Burden; Cancer Center; Cancer Diagnostics; Cancer Etiology; Cancer Patient; Carcinoid Tumor; Caring; Cells; Cessation of life; Characteristics; Clinical; Collaborations; Computer software; Cytology; Data; Demographic Aging; Deoxyglucose; Development; Diagnosis; Diagnostic; Diagnostic Procedure; Discrimination; Disease; Distant; Doctor of Philosophy; Drops; Early Diagnosis; Educational process of instructing; Enrollment; Evaluation; Excision; Faculty; Fine needle aspiration biopsy; Funding; Future; General Population; Glass; Glucose; Grant; Grant Review; Granuloma; Healthcare; Healthcare Systems; Histologic; Hospitals; Image; Imaging Techniques; Incidence; Inflammatory; Investigation; Isotopes; Joints; Label; Lead; Lesion; Literature; Lung; Lung nodule; Malignant - descriptor; Malignant Neoplasms; Malignant neoplasm of lung; Malignant neoplasm of prostate; Measurement; Medical Imaging; Methods; Microscopic; Modeling; Neoplasm Metastasis; Newly Diagnosed; Nodule; Octreotide; Operative Surgical Procedures; Outcome; PET/CT scan; Pain; Patient observation; Patients; Performance; Population; Population Study; Positioning Attribute; Positron-Emission Tomography; Procedures; Proteomics; Pulmonary Coin Lesion; Radioactive; Relative (related person); Relative Risks; Reporting; Research; Research Personnel; Scanning; Sensitivity and Specificity; Serum; Specimen; Staging; Statistical Data Interpretation; Taxes; Techniques; Tennessee; Thoracotomy; Time; Tumor Biology; Tumor Volume; United States National Institutes of Health; Unnecessary Surgery; Veterans; Woman; X-Ray Computed Tomography; abstracting; age related; anticancer research; base; cancer diagnosis; cost effective; cyclen; experience; fluorodeoxyglucose; improved; insight; lifetime risk; male; member; men; mortality; novel; outcome forecast; public health relevance; respiratory; skills; success; sugar; uptake; wasting

Project Summary/Abstract Lung cancer is the leading cause of cancer death in Veterans and in the general U.S. population. In 2004, an estimated 173,700 Americans were diagnosed with lung cancer; of these, about 164,440 (95%) will ultimately die of their disease. Despite decades of research, the prognosis for lung cancer remains dismal, with an overall five-year survival combining all stages of 16%. Nonetheless, lung cancer can be cured if detected early, with a 5 year survival for Stage 1 of up to 70%, establishing the importance of early diagnosis and definitive treatment. The lifetime risk for developing cancer of the lung and bronchus for the general population in the US is 1 in 12 for men and 1 in 16 for women. Relative risk for male patients using VA hospitals is approximately twice that of the general population. Though the relative age-related incidence of lung cancer is declining, because of the age demographics of the US population, the total number of newly diagnosed lung cancers in the US is expected to increase from about 225,000 in the year 2010 to about 410,000 in the year 2050. Clearly there is a great societal need, especially within the Veteran population, to improve early and cost-effective diagnosis of lung cancer and to gain new insights into tumor biology that can be exploited for novel treatments. Current lung cancer diagnostic methods include the use of "PET" scans (typically combined with an integrated CT scanner into a PET/CT), which has greatly improved our ability to discriminate between benign and malignant lung nodules and to improve the staging of lung cancer. However, current clinical PET/CT, based on the distribution of a radioactive form of glucose, is limited by both false positive (FP) and false negative (FN) results. For diagnosis of indeterminate lung nodules, FN results are common for nodules less than 1 cm in diameter or for cancers that are relatively less aggressive than most (e.g. typical carcinoid tumor, well- differentiated adenocarcinoma, bronchioloalveolar carcinoma (BAC), and some metastases). These FN results delay diagnosis while the nodule is watched via CT, allowing time for possible metastases to occur and a potential cure to be missed. FN results in staging lung cancer result in the patient being treated inappropriately for his/her stage, adversely affecting outcome and wasting healthcare dollars. FP results are common with infectious/inflammatory lesions, such as non-calcified or poorly calcified granulomas, leading to unnecessary surgery or biopsies, painful and sometimes dangerous procedures that also waste healthcare dollars. We hypothesize that combining results from serial PET/CT scans usingthe standard radioactive sugar ("18F-FDG) with an experimental PET scanning agent called 68Ga-labeled DOTATOC will reduce the number of FP and FN examinations, improving accuracy for non- invasive diagnosis of lung nodules and for staging of lung cancer, and possibly to provide new insights into tumor biology that might suggest novel treatments. We will also use state-of-the-art enhancements for automatic tumor volume calculation and respiratory "gating" to improve the accuracy of these measurements. Finally we will combine these imaging data with a serum proteomic analysis and other patient information to develop a new multivariate model for the diagnosis of lung cancer.

项目总结/摘要 肺癌是退伍军人和美国普通民众癌症死亡的主要原因。 人口2004年，估计有173，700名美国人被诊断患有肺癌; 其中约164，440人（95%）最终死于疾病。尽管经过几十年的研究， 肺癌的预后仍然令人沮丧，总的五年生存率结合所有 阶段16%。尽管如此，如果早期发现肺癌是可以治愈的，生存期为5年 1期高达70%，确立了早期诊断和明确治疗的重要性。 一般人患肺癌和支气管癌的终生风险 在美国的人口中，男性为1/12，女性为1/16。男性患者的相对风险 使用退伍军人医院的人数大约是普通人群的两倍。尽管这种相对 由于美国的年龄人口统计学，与年龄相关的肺癌发病率正在下降 预计美国新诊断的肺癌总数将增加 从2010年的约225，000到2050年的约410，000。显然，有一个伟大的 社会需要，特别是退伍军人群体，以改善早期和成本效益 肺癌的诊断，并获得新的见解肿瘤生物学，可用于 新的治疗方法。 目前的肺癌诊断方法包括使用“PET”扫描（通常是“PET”扫描）。 与集成的CT扫描仪结合到PET/CT中），这大大提高了我们的能力， 鉴别肺结节的良恶性，提高肺结节的分期， 癌然而，目前的临床PET/CT，基于放射性形式的分布， 葡萄糖，受到假阳性（FP）和假阴性（FN）结果的限制。诊断 不确定的肺结节，FN结果常见于直径小于1 cm的结节或 对于侵袭性相对较低的癌症（例如典型的类癌肿瘤， 分化腺癌、细支气管肺泡癌（BAC）和一些转移瘤）。 这些FN结果延迟了诊断，而结节通过CT观察， 发生转移和潜在的治疗被错过。FN导致肺癌分期结果 患者因其分期而接受不适当治疗，对结局产生不利影响， 浪费医疗费用。FP结果常见于感染性/炎性病变，如 作为非钙化或钙化不良的肉芽肿，导致不必要的手术或活组织检查， 痛苦的，有时是危险的程序，也浪费了医疗费用。 我们假设，结合使用标准PET/CT扫描的结果， 放射性糖（18F-FDG）与实验性PET扫描剂（称为68 Ga标记的 DOTATOC将减少FP和FN检查的数量，提高非 肺结节的侵入性诊断和肺癌分期，并可能提供新的 对肿瘤生物学的深入了解，可能会提出新的治疗方法。我们还将使用最先进的 增强自动肿瘤体积计算和呼吸“门控”功能， 这些测量的准确性。最后，我们将联合收割机结合这些成像数据与血清 蛋白质组学分析和其他患者信息，以开发新的多变量模型， 肺癌的诊断