Automated Volumetric Molecular Ultrasound for Breast Cancer Imaging

乳腺癌是美国女性癌症相关死亡的第二大原因。而当 乳房X光检查是目前的一线成像方法，其诊断准确率在女性乳腺癌患者中非常有限。 致密的乳房组织。在这些患者中，超声波被用来补充乳房X光检查以改善乳房 癌症检测和定性。然而，它经常导致假阳性结果与多个 不必要的回电，活组织检查，相关的医疗保健费用，以及女性的心理压力。超音波 使用对比剂进行分子成像，靶向肿瘤上的肿瘤相关分子特征 新血管生成，如激酶域受体(KDR)，是一种新兴的策略，已经显示出很有前途 在临床前动物模型和最近的试点中检测和表征乳腺癌的结果 本组进行的临床试验。然而，目前的限制包括它对操作员的依赖，有限 解剖覆盖，以及缺乏广泛传播的乳房超声的优化临床成像系统 分子成像。斯坦福大学和斯坦福大学之间这种跨学科、学术和产业合作的目的 大学和西门子医疗解决方案美国公司将开发、优化和临床测试一种新的操作员- 基于商用和广泛使用的独立式全乳腺超声成像系统 自动人体乳腺体积扫描仪(ABVS)，支持改善乳腺癌的分子成像 临床上的影像检查。我们还将开发成像策略，以减少在 乳腺的超声分子成像，包括组织信号泄漏和 乳头发出声学阴影。为了评估临床应用的可行性和有效性，新的体积超声 分子成像系统随后将在患有乳腺局灶性病变的妇女身上进行临床测试，使用组织学和 以免疫组织化学KDR染色水平为金标准。该提案中使用的技术可以是 集成在ABV以外的类似其他商业设备上(仅在美国就约有1600台 已经在常规临床实践中使用)，因此将对普通公众产生直接影响。

Breast cancer is the second leading cause of cancer-related deaths in women in the United States. While mammography is the current first line imaging approach, its diagnostic accuracy is very limited in women with dense breast tissue. In those patients, ultrasound is used to supplement mammography for improved breast cancer detection and characterization. However, it often results in false positive findings with multiple unnecessary callbacks, biopsies, associated health care cost, and psychological stress for women. Ultrasound molecular imaging using contrast agents targeted at cancer-associated molecular signatures on the tumor neovasculature, such as kinase domain receptor (KDR), is an emerging strategy that has shown promising results for breast cancer detection and characterization in preclinical animal models as well as in a recent pilot clinical trial performed by our group. However, current limitations include its operator-dependency, limited anatomical coverage, and the lack of an optimized clinical imaging system for wide-spread breast ultrasound molecular imaging. The purpose of this interdisciplinary, academic-industrial collaboration between Stanford University and Siemens Medical Solutions USA, Inc. is to develop, optimize, and clinically test a new operator- independent whole-breast ultrasound imaging system based on a commercially available and widely used automated human breast volume scanner (ABVS), supporting molecular imaging for improved breast cancer imaging in the clinic. We will also develop imaging strategies to mitigate common artifacts encountered in ultrasound molecular imaging of the breast, including spurious contrast signal from tissue signal leakage and acoustic shadowing from the nipple. To assess feasibility and efficacy in the clinic, the new volumetric ultrasound molecular imaging system will then be clinically tested in women with focal breast lesions using histology and KDR staining levels on immunohistochemistry as gold standard. The technology used in this proposal can be integrated on similar other commercial devices beyond the ABVS (in the USA alone, approximately 1600 units are already used in routine clinical practice) and will therefore have immediate impact on the general public.