Breast PETX: Mammography Machine PET Scanner with Biopsy Guidance

描述（由申请人提供）：乳腺癌通常为1期（<2cm），由于空间分辨率有限，这限制了早期乳腺癌检查中常用功能成像方式的使用。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，为局部晚期乳腺癌提供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将与临床乳房x线摄影或断层合成和活检指导方法相结合，以实现这一目标。本课题的目标是：(1)利用单片闪烁晶体与盖革模式硅光倍增器耦合设计一个PET探测器单元；(2)构建并测试一个完整的层析PET扫描仪，该扫描仪与传统的乳房x线摄影/断层合成龙门相匹配，用于乳房x线摄影套件中的PET和x射线联合成像；(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指导相结合；(4)对原型进行表征，并通过试点患者研究进行测试。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，基本探测器的开发将由GRC领导，UW的合作研究人员密切参与；GRC团队还将领导系统集成到乳房x光检查设备上；整个系统的性能和临床实施将在华盛顿大学率先。这项工作的结果将是一个专用的乳房PET系统，在乳房x光检查套件中操作；最初用于扩大目前正在使用临床PET治疗晚期乳腺癌的治疗评估试验。该设备将使研究使用PET作为早期疾病的生物标志物，包括使用来自UW放射化学回旋加速器的各种PET示踪剂。这将是一个商业准备设计的原型，可以在其他机构复制部署。该系统将提供一种临床工具，有效地研究PET治疗早期乳腺癌的可能用途。

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.