Improve the diagnostic accuracy of CBCT for oral lesions

提高CBCT对口腔病变的诊断准确性

• 批准号: 10427072
• 负责人: OTTO Z ZHOU
• 金额: $ 51.23万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-02 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10427072
• 关键词: Algorithms; Cancer Patient; Carbon Nanotubes; Clinical; Collimator; Computer software; Data Set; Dental; Dental Clinics; Dental Prosthesis; Dentistry; Detection; Development; Devices; Diagnosis; Diagnostic Neoplasm Staging; Dose; Early Diagnosis; Early treatment; Exposure to; Goals; Healthcare Systems; Image; Imaging Device; Imaging technology; Iodine; Magnetic Resonance Imaging; Malignant Neoplasms; Medical Imaging; Metals; Modeling; Modification; Morphologic artifacts; Neoplastic Processes; Oral Diagnosis; Patient imaging; Patients; Performance; Production; Prognosis; Radiation Scattering; Radiation exposure; Research; Resolution; Roentgen Rays; Role; Scientist; Screening for Oral Cancer; Source; Specificity; Spottings; Staging; Survival Rate; System; Technology; Translating; United States; X-Ray Computed Tomography; base; bone invasion; cancer imaging; cancer type; clinical practice; cone-beam computed tomography; contrast enhanced; cost; design; design and construction; detection sensitivity; detector; diagnostic accuracy; driving force; experience; imaging capabilities; imaging modality; improved; malignant mouth neoplasm; maxillofacial; multidisciplinary; oral lesion; prototype; radiologist; reconstruction; screening; soft tissue; spectral energy; tumor; virtual

ABSTRACT Oral cancer accounts for 2.5% of all cancers in the United States. It has one of the lowest five-year survival rates among the major cancer types. Early diagnosis and treatment are critical to improve the prognosis of oral cancer patients. Contrast enhanced computed tomography (CT) and magnetic resonance imaging (MRI) are currently the most widely accepted imaging modalities for diagnosis and staging of oral cancer. However, because of their high cost, high patient radiation exposure (CT), and large footprint, CT and MRI are not the standard imaging modalities used in dental clinics. In addition, oral lesions in the CT images are frequently obscured by metal artifacts caused by dental prostheses, reducing the sensitivity and increasing false diagnosis. CT is known to have a high specificity but low sensitivity for detection of oral cancers. Cone beam CT (CBCT) reduces the radiation exposure to the patient, the cost to purchase and to operate, as well as the footprint, compared to CT. It has found wide applications in dentistry. However, CBCT’s role in oral cancer imaging and staging is currently limited, despite its wide availability. This is primarily due to its poor soft tissue contrast resolution, which makes it difficult to visualize the tumor mass, and neoplastic processes are frequently overlooked. The role of CBCT in preoperative assessment of bone invasion from oral cancer has been evaluated in only a few studies with inconsistent results. The presence of strong metal artifacts also degrades the quality of the CBCT images, as in the case of CT. We propose a multisource spectral volumetric CT (mSCT) technology to 1) increase the soft tissue contrast of dental CBCT; 2) reduce the image metal artifacts; and 3) improve the tumor delineation in contrasted CT imaging. These will be achieved by 1) retrofitting the conventional CBCT with a unique carbon nanotube (CNT) x-ray source array invented by our team; and 2) incorporating dual energy CT (DECT) and virtual monoenergetic image (VMI) capabilities at low cost. The device maintains all the clinical functionality and utility of CBCT and its desirable attributes. The technology has the potential to not only enable precision imaging of oral lesions using the widely available CBCT after modification, reducing the cost and patient radiation exposure compared to the current clinical practice, but also improve earlier detection of oral cancer through either screening or/and opportunistic imaging. The Specific Aims are: 1) Optimizing mSCT to achieve high soft tissue contrast resolution; 2) Reducing metal artifacts and improving tumor delineation by incorporating spectral filter based dual-energy and virtual monoenergetic imaging; 3) Constructing a prototype mSCT scanner and characterizing its system performance; and 4) Demonstrating increased soft tissue contrast, reduced metal artifact and improved oral lesion delineation in mSCT compared to CBCT.

抽象的 口腔癌占美国所有癌症的2.5％。它具有最低的五年生存之一 主要癌症类型的发生率。早期诊断和治疗对于改善口腔预后至关重要 癌症患者。对比增强的计算机断层扫描（CT）和磁共振成像（MRI）为 目前，对于口腔癌的诊断和分期，最广泛接受的成像方式。然而， 由于其成本很高，患者辐射暴露高（CT）和大占地面积，CT和MRI不是 牙科诊所使用的标准成像方式。另外，CT图像中的口腔病变经常 由牙齿假体引起的金属伪像掩盖，降低了灵敏度并增加了错误的诊断。 已知CT具有高特异性，但对于检测口服癌症的灵敏度较低。 锥束CT（CBCT）减少了对患者的辐射暴露，购买和操作的成本， 与CT相比，占地面积。它在牙科中发现了广泛的应用。但是，CBCT在 目前，口腔癌的成像和分期有限，目的地为广泛的可用性。这主要是由于它的贫穷 软组织对比度分辨率，这使得难以可视化肿瘤质量，肿瘤过程是 经常被忽视。 CBCT在术前评估口腔癌的骨骼侵袭中的作用已有 仅在少数研究中进行评估，结果不一致。也存在强大的金属伪影 如CT，降低了CBCT图像的质量。 我们提出了一种多源光谱体积CT（MSCT）技术至1）增加软组织对比度 牙CBCT; 2）减少图像金属伪像； 3）改善肿瘤描述与CT相比 成像。这些将通过1）用独特的碳纳米管（CNT）改装常规CBCT来实现这些 X射线源阵列由我们的团队发明；和2）掺入双能CT（DECT）和虚拟单声工 图像（VMI）功能低成本。该设备维持CBCT的所有临床功能和实用性 它的理想属性。该技术不仅有可能对口腔病变进行精确成像 修改后使用广泛可用的CBCT，减少成本和患者辐射暴露 对于当前的临床实践，但也通过筛查或/和/和 机会性成像。 具体目的是：1）优化MSCT以实现高软组织对比度分辨率； 2）减少金属 通过合并基于光谱过滤器的双能和虚拟的伪像和改善肿瘤描述 单核成像； 3）构建原型MSCT扫描仪并表征其系统性能； 4）证明软组织对比增加，金属伪像减少和改善的口腔病变描述 在MSCT中与CBCT相比。

项目成果

Volumetric computed tomography with carbon nanotube X-ray source array for improved image quality and accuracy.

采用碳纳米管 X 射线源阵列的体积计算机断层扫描可提高图像质量和准确性。

• DOI: 10.1038/s44172-023-00123-x
• 发表时间: 2023
• 期刊: Communications engineering
• 作者: Xu,Shuang;Hu,Yuanming;Li,Boyuan;Inscoe,ChristinaR;Tyndall,DonaldA;Lee,YuehZ;Lu,Jianping;Zhou,Otto
• 通讯作者: Zhou,Otto