Multimodality virtual endoscopy with hybrid PET/CT units

描述（由申请人提供）：内窥镜检查是一种侵入性手术，使用柔性光纤（内窥镜）目视检查器官的内层，如气道（支气管镜）或结肠（结肠镜）。虚拟内窥镜（VE）使用计算机断层扫描（CT）或磁共振（MR）数据在计算机上重建和显示气道（VB）或结肠（VC）表面，从而消除了插入内窥镜的需要。迄今为止，基于CT或mr的虚拟内窥镜只能检查结构的表面。正电子发射断层扫描（PET）与氟脱氧葡萄糖（FDG；葡萄糖的类似物）或其他示踪剂可以表征癌组织基于分化代谢（FDG的糖酵解活性）。通过将PET与CT数据相结合，我们可以创建一种新的模式：PET增强虚拟内窥镜（PaVE），它提供了CT提供的解剖学定义，但也可以根据PET显示的糖酵解活性（与FDG）进一步评估可能的恶性受累。通过在多学科环境中对新的优化方案和软件工具的临床整合，我们的目标是提高我们在VE范式中有效结合PET和CT数据集的能力，以期提高诊断准确性并指导微创（Ml）组织分期程序，如支气管镜经支气管活检和胸部和肺部癌症的肿瘤切除。最近推出的PET/CT组合装置在一次研究中同时产生PET和CT数据集，这将有助于我们的提议。我们的机构是最早将这些混合机器应用于癌症诊断和管理的机构之一，并通过呼吸门进一步扩大了它们的使用和准确性。因此，当前的提案是这一努力的自然补充和延伸，符合PA-04-045的总体目的，特别是主题3（图像显示和分析）和4（图像引导癌症干预）。

DESCRIPTION (provided by applicant): Endoscopy is an invasive procedure in which a flexible optical fiber (the endoscope) is used for visually inspecting the inner lining of organs such as the airways (bronchoscopy) or the colon (colonoscopy). Virtual endoscopy (VE) uses computed tomography (CT) or magnetic resonance (MR) data to reconstruct and display airway (VB) or colon (VC) surfaces on computers, thereby eliminating the need for the insertion of an endoscope. To date, CT or MR-based virtual endoscopy only examines the surface of the structures. Positron emission tomography (PET) with fluoro-deoxy-glucose (FDG; an analog of glucose) or other tracers can characterize cancerous tissues based on the differentiated metabolism (glycolytic activity for FDG) they exhibit. By combining PET with CT data, we can create a novel modality: PET-augmented virtual endoscopy (PaVE), that offers the anatomical definition provided by CT, but also enables further evaluation for possible malignant involvement based on the glycolytic activity (with FDG) exhibited through PET. Through the clinical integration of new optimized protocols and software tools in a multidisciplinary environment, we aim to improve our ability to effectively combine PET and CT data sets in a VE paradigm with the prospect of increasing diagnostic accuracy and of guiding minimally invasive (Ml) tissue staging procedures such as bronchoscopic transbronchial biopsies and tumor resections for cancers of the chest and lungs. Recently introduced combination PET/CT units that yield both PET and CT data sets in a single study will be instrumental to our proposal. Our institution has been among the very first ones to pioneer the application of these hybrid machines to cancer diagnosis and management, and to further expand their use and accuracy through respiratory gating. The current proposal is therefore a natural complement and extension of this endeavor that conforms to the general purpose of PA-04-045 and especially to topics 3 (image displays and analyses) and 4 (image-guided cancer intervention).