Augmenting Dual Energy CT for Novel Contrast Agents

项目概要/摘要 我们的长期目标是为数百万美国人彻底改变CT成像的有效性。 广泛的腹部疾病。双能CT（DECT）具有强大的临床诊断潜力， 尽管扫描仪广泛可用，但仍严重未得到充分利用。DECT允许区分材料 基于它们在低能量X射线谱与高能量X射线谱下的相对X射线衰减。不幸的是，目前的DECT 工作流程高度分散：没有第三方图像处理和通信系统 医生用来查看临床图像的PACS系统可以处理DECT图像;每个DECT扫描仪的 图像只能由特定扫描仪供应商的软件处理。更糟糕的是，DECT信号单元 扫描仪专用，与历史120 kVp单能量CT（SECT）Hounsfield单位（HU）不兼容 它仍然是当今最常用的CT信号单位，也是大多数诊断CT阈值的基础 的搜索.多对比度DECT的深远未来，其中多个同时成像的对比度 在DECT处将代理分离，以提供复杂解剖结构的丰富诊断信息，还保留 未实现。商业DECT软件无法定量分离当前碘造影剂与新型碘造影剂 高Z和硅试剂。在我们的STTR第一阶段，我们开发了一种新型对比材料提取工艺 （CMEP），其在DECT处生动地分离单独的造影剂信号，包括钙的信号。我们 建议在所有商业临床DECT扫描仪类型中进一步验证这些方法，并整合 将它们转换为迫切需要的供应商无关DECT处理软件（VADS），以实现广泛的低成本 分发和集成到临床PACS工作流程中。我们的总体假设是， 四种可用的临床DECT扫描仪类型可以使用通用界面进行处理和显示，并且 该接口可以允许所有DECT和SECT扫描仪之间的定量扫描比较， 统一的120 kVp SECT样HU。一旦FDA批准，VADS将使FDA批准许多紧急 需要DECT造影剂来实现多对比度DECT的承诺。我们的具体目标是：（1） 构建涵盖人体组织和造影剂范围的标准化DECT体模 目前可用，并在开发中，以获得一个全面的图像库，为每个商业 临床DECT扫描仪; 2）在此图像库上实施并验证VADS，以允许所有DECT图像 在通用软件界面中进行处理，该软件界面设计为可获得510（k）批准并易于集成到 PACS或其他第三方查看工作站; 3）使用图像库定义“统一Hounsfield单元”， 与120 kVp SECT兼容，允许所有DECT扫描仪类型和SECT，无论kVp设置如何， 进行定量比较。在这项提案结束时，我们将制定破坏性的510（k） 可批准的软件，以简化日常临床DECT工作流程，并提供必要的基础设施， 未来变革性的高诊断性多对比增强DECT。

Project Summary / Abstract Our long term goal is to revolutionize the effectiveness of CT imaging for millions of Americans across a broad range of abdominal disease. Dual energy CT (DECT) provides powerful clinical diagnostic potential but remains heavily underutilized despite wide scanner availability. DECT allows materials to be differentiated based on their relative X-ray attenuation at low versus high energy X-ray spectra. Unfortunately, current DECT workflow is highly fragmented: None of the 3rd party Picture Archiving and Communications Systems (PACS) that physicians use to view clinical images can process DECT images; each DECT scanner's images can only be processed by that specific scanner vendor's software. Worse, DECT signal units are scanner-specific and not compatible with historical 120 kVp single energy CT (SECT) Hounsfield Units (HU) which remain the most commonly used CT signal unit today, and the basis of most diagnostic CT threshold criteria. The profound future of multi-contrast DECT, whereby multiple simultaneously imaged contrast agents are separated at DECT to give rich diagnostic information of complex anatomy, also remains unrealized. Commercial DECT software fails in quantitative separation of current iodine contrast from novel high-Z and silicon agents. In our STTR Phase I we developed a novel Contrast Material Extraction Process (CMEP) that vividly separates individual contrast agent signals, including that of calcium, at DECT. We propose to further validate these methods across all commercial clinical DECT scanner types and integrate them into an urgently needed Vendor-Agnostic DECT processing Software (VADS) for wide low-cost distribution and integration into clinical PACS workflow. Our overall hypothesis is that images from each of the four available clinical DECT scanner types can be processed and displayed using a common interface, and this interface can allow quantitative scan comparisons between all DECT and SECT scanners through a Unified 120 kVp SECT-like HU. Once FDA-approved, VADS will enable FDA-approval of many urgently needed DECT contrast agents to fulfill the promise of multi-contrast DECT. Our Specific Aims are to 1) Construct standardized DECT phantoms spanning the range of human tissues and contrast agents currently available and in development to obtain a comprehensive image library for each of the commercial clinical DECT scanners; 2) Implement and validate VADS on this image library to allow all DECT images to be processed in a common software interface designed to be 510(k) approvable and readily integrated into PACS or other 3rd party viewing workstations; 3) Use the image library to define a “Unified Hounsfield Unit,” compatible with 120 kVp SECT, to allow all DECT scanner types and SECT, regardless of kVp setting, to be quantitatively compared. At the conclusion of this proposal, we will have developed disruptive 510(k) approvable software to streamline daily clinical DECT workflow and provide necessary infrastructure for future transformative highly diagnostic multi-contrast enhanced DECT.