A PET/CT scanner for guiding treatment of head and neck cancer

用于指导头颈癌治疗的 PET/CT 扫描仪

• 批准号: 10390411
• 负责人: RAYMOND ROBERT RAYLMAN
• 金额: $ 46.01万
• 依托单位: WEST VIRGINIA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-08 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10390411
• 关键词: Address; Algorithm Design; Algorithms; Anatomy; Area; Blinded; Carotid Arteries; Characteristics; Clinic; Clinical; Clinical Trials; Compton radiation; Computed Tomography Scanners; Computer software; Data; Detection; Development; Devices; Discipline of Nuclear Medicine; Dose; Effectiveness; Elements; Emission-Computed Tomography; Epidemic; Esophagus; Evaluation; Excision; Feedback; Formulation; Geometry; Goals; Head; Head and Neck Cancer; Head and Neck Squamous Cell Carcinoma; Head and Neck Surgery; Head and neck structure; Heterogeneity; High Resolution Computed Tomography; Histologic; Human; Human Papillomavirus; Image; Immersion; Infiltration; Intensity-Modulated Radiotherapy; Investigation; Location; Malignant Neoplasms; Maps; Metabolic; Methods; Microscopic; Modality; Morbidity - disease rate; Multimodal Imaging; Nature; Neoplasm Metastasis; Operative Surgical Procedures; Parotid Gland; Patient Schedules; Patients; Performance; Physiologic pulse; Planning Techniques; Positron-Emission Tomography; Primary Neoplasm; Privatization; Process; Production; Protocols documentation; ROC Curve; Radiation; Radiation Dose Unit; Radiation Oncology; Radiation therapy; Radiology Specialty; Radiology, Head, Neck; Recurrence; Resolution; Roentgen Rays; Role; Rotation; Salivary Glands; Scanning; Selection for Treatments; Slide; Source; Spinal Cord; Staging; Structure; Survival Rate; System; Technology; Test Result; Testing; Thyroid Gland; Tissues; Treatment Effectiveness; Underserved Population; Universities; Vendor; West Virginia; X-Ray Computed Tomography; anatomic imaging; base; bone; cone-beam computed tomography; cost; data acquisition; design; detection sensitivity; detector; draining lymph node; electron density; flexibility; head and neck cancer patient; high resolution imaging; image guided; image reconstruction; imaging Segmentation; imaging modality; imaging system; improved; industry partner; instrumentation; lymph nodes; multidisciplinary; novel; personalized medicine; pre-clinical; radiation detector; reconstruction; research clinical testing; treatment planning; treatment strategy; tumor; uptake

ABSTRACT/SUMMARY Head and neck carcinomas (HNC) are some of the most challenging cancers to effectively treat (five-year survival rates for some HNCs are as low as 25%); recurrence rates range from 8% to 43%. The number of new cases is rising due to the current, near epidemic of HPV-associated HNCs. Unfortunately, most treatments are associated with significant morbidity due to damage of sensitive structures in the region (spinal cord, salivary glands, parotid gland, esophagus, carotid arteries and thyroid gland). HNCs are treated with surgical excision, radiation therapy, or a combination of methods. Selection of therapy is based upon assessment of tumor location, size, proximity to bone, amount of infiltration into surrounding tissues and spread to regional lymph nodes performed with advanced imaging methods. Perhaps the most promising of these methods is metabolic-based imaging, specifically PET, often utilizing FDG. The non-optimal spatial resolution and fixed geometry of whole body scanners, however, limits PET in fulfilling its promise in this role by inhibiting the ability to accurately detect small tumor masses in lymph nodes, and in quantifying the size and nature of the primary tumor. Thus, there is an unmet need for improved PET/CT scanner technology to enhance treatment planning of HNCs. To address this opportunity, we propose the creation and testing of a lower-cost, flexible geometry, high-resolution PET/CT system (approaching the spatial resolution of pre-clinical PET scanners), called HNPET/CT, designed specifically for the imaging of the head and neck region. It will consist of a novel pair of large area, immersion-cooled, PET detectors and a cone beam CT (CBCT) scanner mounted on a rotating gantry whose geometry can be tailored to patient size and anatomy to be scanned. To capitalize on HNPET/CT’s high-resolution images, an image segmentation method that utilizes both CBCT and PET images will be developed and tested. We plan to explore the potential utility of HNPET/CT for enhancing therapy planning (surgical and radiation). This assessment will first be performed with anthropomorphic phantoms and then in a limited human trial. In addition to the novel detector design and adjustable geometry, HNPET/CT will introduce a new capability to the treatment planning of HNCs not yet broadly employed by end users in the clinical. It could enhance current planning techniques (reduce treatment margin size, for example), enable the effective application of advanced methods (dose painting, for example), and perhaps inspire development of new, more effective personalized treatment strategies that require high resolution, multi-modality imaging. The lower cost of the system promises the introduction of cutting-edge, image-guided treatments to under-served populations in areas treated by small or private clinics that often cannot afford such technology. This project will be performed by a multi-disciplinary academic industrial partnership joining the Departments of Radiology, Head and Neck Surgery and Radiation Oncology at West Virginia University, and Xoran Technologies, LLC.

摘要/总结 头颈癌 (HNC) 是有效治疗最具挑战性的癌症之一（五年 一些 HNC 的存活率低至 25%）；复发率从 8% 到 43% 不等。数量 由于目前 HPV 相关 HNC 几乎流行，新病例不断增加。不幸的是，大多数治疗 由于该区域敏感结构（脊髓、 唾液腺、腮腺、食道、颈动脉和甲状腺）。 HNC 通过手术治疗 切除、放射治疗或多种方法的组合。治疗的选择基于以下评估 肿瘤位置、大小、与骨的接近程度、浸润到周围组织和扩散到区域的量 采用先进的成像方法进行淋巴结检查。也许这些方法中最有前途的是 基于代谢的成像，特别是 PET，通常使用 FDG。非最佳空间分辨率和固定 然而，全身扫描仪的几何形状限制了 PET 履行其在这一角色中的承诺，因为它抑制了 PET 的能力 准确检测淋巴结中的小肿瘤块，并量化原发肿瘤的大小和性质 瘤。因此，改进 PET/CT 扫描仪技术以增强治疗计划的需求尚未得到满足 的 HNC。为了抓住这个机会，我们建议创建和测试一种低成本、灵活的几何形状， 高分辨率 PET/CT 系统（接近临床前 PET 扫描仪的空间分辨率），称为 HNPET/CT，专为头颈部成像而设计。它将由一对新颖的 大面积浸没式冷却 PET 探测器和安装在旋转装置上的锥束 CT (CBCT) 扫描仪 龙门架的几何形状可以根据患者体型和要扫描的解剖结构进行定制。充分利用 HNPET/CT的高分辨率图像，一种利用CBCT和PET图像的图像分割方法 将被开发和测试。我们计划探索 HNPET/CT 在增强治疗方面的潜在效用 规划（手术和放射）。该评估将首先使用拟人化模型进行 然后进行有限的人体试验。除了新颖的探测器设计和可调节几何形状之外，HNPET/CT 还将 为尚未被最终用户广泛采用的 HNC 治疗计划引入新功能 临床。它可以增强当前的规划技术（例如，减少治疗余量大小），使 先进方法的有效应用（例如剂量绘画），也许会激发 新的、更有效的个性化治疗策略需要高分辨率、多模态成像。这 系统成本较低，有望为服务不足的地区引入尖端的图像引导治疗 接受小型或私人诊所治疗的地区的人群往往负担不起此类技术。这个项目 将由加入放射科的多学科学术工业合作伙伴进行， 西弗吉尼亚大学和 Xoran Technologies, LLC 的头颈外科和放射肿瘤学。