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.

项目摘要/摘要 肺癌是退伍军人和美国一般癌症死亡的主要原因 人口。 2004年，估计有173,700名美国人被诊断出患有肺癌。的 这些大约164,440（95％）最终将死于其疾病。尽管进行了数十年的研究， 肺癌的预后仍然令人沮丧，总体五年生存结合了所有 阶段为16％。尽管如此，如果早点检测到肺癌，可以治愈5年生存 对于高达70％的第1阶段，确定了早期诊断和确定治疗的重要性。 终身患肺和支气管癌的风险 美国的人口为男性为12分之一，女性为16分之一。男性患者的相对风险 使用VA医院约为一般人群的两倍。虽然是亲戚 由于美国的年龄人口统计，与年龄有关的肺癌发生率正在下降 人口，预计在美国新诊断的肺癌的总数将增加 从2010年的大约225,000到2050年约410,000。显然，有一个很棒的 社会需求，尤其是在退伍军人人口中，以提高早期和成本效益 诊断肺癌并获得有关肿瘤生物学的新见解，可以利用 新颖的治疗方法。 当前的肺癌诊断方法包括使用“ PET”扫描（通常 结合一个集成的CT扫描仪到宠物/CT），这极大地提高了我们的能力 区分良性和恶性肺结节并改善肺的分期 癌症。但是，基于放射性形式的分布的当前临床PET/CT 葡萄糖受到假阳性（FP）和假阴性（FN）结果的限制。用于诊断 不确定的肺结节，FN结果对于小于1 cm的结节很常见或 对于相对攻击性的癌症（例如，典型的类癌肿瘤，良好） 分化的腺癌，支气管肺泡癌（BAC）和一些转移酶）。 这些FN结果延迟诊断，而通过CT观看结节，从而使时间有可能 发生的转移和潜在的治疗要遗漏。 FN导致分期肺癌结果 在患者中，因其阶段不适当地治疗，不利地影响结果和 浪费医疗保健资金。 FP结果在感染/炎症病变中很常见，例如 作为未钙化或钙化较差的颗粒瘤，导致不必要的手术或活检， 痛苦甚至危险的程序也浪费了医疗保健资金。 我们假设使用标准组合串行PET/CT扫描结果 带有实验性PET扫描剂的放射性糖（“ 18F-FDG）称为68GA标记 DOTATOC将减少FP和FN检查的数量，从而提高非 - 肺癌的侵入性诊断和用于肺癌的分期，可能提供新的 对可能暗示新疗法的肿瘤生物学的见解。我们还将使用最先进的 自动肿瘤体积计算和呼吸“门控”的增强，以改善 这些测量的准确性。最后，我们将将这些成像数据与血清结合在一起 蛋白质组学分析和其他患者信息，以开发新的多元模型 肺癌的诊断。