High-resolution lower dose dedicated breast CT

高分辨率低剂量专用乳腺 CT

• 批准号: 9925061
• 负责人: Andrew Karellas
• 金额: $ 57.8万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9925061
• 关键词: Address; Air; Area; Axilla; Benign; Biomedical Engineering; Biopsy; Breast; Breast Magnetic Resonance Imaging; Breast Microcalcification; Breast-Conserving Surgery; Calibration; Cancer Detection; Chest wall structure; Clinical; Clinical Research; Development; Diagnosis; Diagnostic; Digital Breast Tomosynthesis; Digital Mammography; Discrimination; Dose; Early Diagnosis; Electrons; Eligibility Determination; Emerging Technologies; Enhancing Lesion; Ensure; Evaluation; Feasibility Studies; Generations; Geometry; Goals; Image; Image Analysis; Lesion; Low Dose Radiation; Malignant - descriptor; Malignant Neoplasms; Mammary Gland Parenchyma; Mammographic screening; Mammography; Masks; Measurement; Measures; Methods; Monitor; Motion; Neoadjuvant Therapy; Noise; Operative Surgical Procedures; Organ; Participant; Patients; Performance; Phase; Population; ROC Curve; Radiation Dose Unit; Reader; Reporting; Research; Research Project Grants; Residual state; Resolution; Risk; Roentgen Rays; Scanning; Series; Shapes; Slice; System; Techniques; Technology; Three-Dimensional Image; Time; Tissues; Translating; Translational Research; Tumor Volume; Visualization; Woman; X-Ray Computed Tomography; base; breast cancer diagnosis; breast density; breast imaging; calcification; cancer imaging; cancer invasiveness; chemotherapy; clinical decision-making; clinical imaging; clinical translation; clinically relevant; contrast enhanced; design; detector; high resolution imaging; high risk; improved; in vivo; innovation; irradiation; malignant breast neoplasm; next generation; predicting response; prospective; prototype; public health relevance; quantitative imaging; quantum; recruit; research study; response; screening; standard of care; tool; tumor

 DESCRIPTION (provided by applicant): Dedicated breast CT is an emerging technology with less than 10 clinical prototypes worldwide. It can eliminate breast tissue superposition and provides 3D images at near-isotropic spatial resolution. Earlier generations of breast CT used detectors that were suboptimal in terms of inactive region near the chest wall (chest-wall dead space), limited resolution and frame rate, and higher electronic (system) noise. Newer detectors such as the one proposed in this research reduces electronic noise by a factor of 20-30, increases the spatial resolution by a factor of at least 2, and has chest-wall dead space similar to mammography that would enable excellent posterior coverage. However, these detectors are smaller in size and it is a challenge to cover large breasts. Hence, in this research we propose to design, develop and integrate the high-resolution, low-noise detector in a laterally-shifted imaging geometry that would cover the largest breast. The three major concerns regarding breast CT are, chest-wall and axillary coverage, ability to visualize microcalcification clusters, and the ability to provide diagnostic quality images at radiation dose equivalent to screening mammography. We hypothesize that the proposed technological approach will address all of these concerns. Chest-wall coverage will be improved with the proposed detector due to its chest-wall dead space of 3 mm compared to 34.2 mm used in previous clinical studies. With the proposed detector, the combination of smaller pixel size (0.15 mm compared to 0.388 mm detector pixel size in previous generations) and lower electronic noise (~200 electrons compared to ~6,000 electrons in previous generations) will allow low-dose high-resolution imaging. Additionally, it allows for completing the scan in less than 4 seconds compared to at least 10 seconds in previous generations, reducing the possibility of patient motion. The study will also integrate a beam shaping filter that further reduces the radiation dose and will incorporate scatter-reduction and residual scatter-correction methods that will improve the quantitative accuracy. This would allow for more reliable use of the Hounsfield scale (CT numbers) that can allow for better discrimination between benign and malignant findings. The research is broadly organized in three phases. In the first phase, all aspect of the design will be verified and validated on a bench-top platform to determine the best choice of parameters. In the second phase, these results will be used to design, modify and integrate the approach to a clinical prototype breast CT system. In the third phase, we will conduct a clinical feasibility stuy that will recruit BIRADS 4 or 5 subjects with microcalcifications to determine if the implemented technological advancements translate to improved visualization of microcalcifications and better discrimination between benign and malignant calcification-based lesions. Thus, the proposed research will provide an innovative design concept for unprecedented improvements that will enable imaging without physical compression of the breast and at radiation dose approximately similar to screening mammography.

 描述（由申请人提供）：专用乳腺CT是一项新兴技术，全球临床原型不到10个。它可以消除乳腺组织的重叠，并提供近各向同性的空间分辨率的三维图像。早期几代乳腺CT使用的探测器在胸壁附近的非活动区域（胸壁死腔）、有限的分辨率和帧速率以及较高的电子（系统）噪声方面是次优的。较新的探测器，如本研究中提出的一个，减少了20-30倍的电子噪声，增加了至少2倍的空间分辨率，并具有类似于乳房X线摄影的胸壁死腔，这将使良好的后方覆盖。然而，这些探测器的尺寸较小，覆盖大乳房是一个挑战。因此，在这项研究中，我们建议设计，开发和集成的高分辨率，低噪声探测器的横向偏移成像几何形状，将覆盖最大的乳房。关于乳腺CT的三个主要问题是，胸壁和腋窝覆盖，可视化微钙化簇的能力，以及在与筛查乳腺X线摄影相当的辐射剂量下提供诊断质量图像的能力。我们假设所提出的技术方法将解决所有这些问题。与之前临床研究中使用的34.2 mm相比，申报探测器的胸壁死腔为3 mm，因此胸壁覆盖范围将得到改善。使用所提出的探测器，更小的像素尺寸（0.15 mm，相比前几代的0.388 mm探测器像素尺寸）和更低的电子噪声（~200个电子，相比前几代的~ 6，000个电子）的组合将允许低剂量高分辨率成像。此外，它允许在不到4秒的时间内完成扫描，而前几代产品至少需要10秒，从而降低了患者移动的可能性。该研究还将整合一个光束整形滤波器，进一步降低辐射剂量，并将纳入散射减少和残余散射校正方法，提高定量准确性。这将允许更可靠地使用Hounsfield量表（CT数字），从而可以更好地区分良性和恶性结果。研究大致分为三个阶段。在第一阶段，设计的所有方面都将是 在台式平台上进行验证和确认，以确定参数的最佳选择。在第二阶段，这些结果将用于设计，修改和整合的方法，临床原型乳腺CT系统。在第三阶段，我们将进行一项临床可行性研究，招募4或5名BIRADS微钙化受试者，以确定实施的技术进步是否转化为改善微钙化的可视化以及更好地区分良性和恶性钙化病变。因此，拟议的研究将提供一个创新的设计概念，以实现前所未有的改进，使成像没有物理压缩的乳房和辐射剂量大致类似于筛查乳房X线摄影。