Role of 3D Tomography in Breast Cancer

3D 断层扫描在乳腺癌中的作用

• 批准号: 7674447
• 负责人: STEPHEN J GLICK
• 金额: $ 36.08万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-16 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7674447
• 关键词: 3-Dimensional; Affect; Area; Biopsy; Breast; Breast Cancer Risk Factor; Breast Microcalcification; Clinical; Data; Detection; Devices; Diagnosis; Diagnostic; Diagnostic Imaging; Dose; Effectiveness; Elements; Feasibility Studies; Fibroadenoma; Goals; Grant; Human Subject Research; Image; Imagery; Implant; Knowledge; Lesion; Lesion by Morphology; Malignant - descriptor; Malignant Neoplasms; Mammography; Masks; Methods; Monitor; Morphologic artifacts; Morphology; Noise; Operative Surgical Procedures; Organ; Participant; Patients; Pattern; Positioning Attribute; Radiation; Reader; Research; Retinal Cone; Risk Assessment; Role; Screening procedure; Sensitivity and Specificity; Slice; Solid; Specimen; Stress; Structure; System; Techniques; Technology; Therapeutic; Therapeutic Agents; Three-Dimensional Imaging; Tissues; Tumor Volume; Variant; Width; Woman; X-Ray Computed Tomography; breast density; design; detector; diagnostic accuracy; image guided intervention; image processing; improved; interest; knowledge of results; malignant breast neoplasm; minimally invasive; prototype; public health relevance; soft tissue; tomography; tool

DESCRIPTION (provided by applicant):This revised application is responsive to PAR-08-147 (reissue of PAR-06-293), "Quick-Trials for Imaging and Image-Guided Interventions: Exploratory Grants (R21)". The proposed research is a feasibility study that is organ specific and is aimed at determining the ability of a dedicated breast computed tomography system (herein referred to as breast CT system) to visualize lesions. Superposition of breast structures in mammography may result in missed cancers due to 'masking' effect, or may mimic the presence of a lesion resulting in additional imaging or biopsy. Computed Tomographic (CT) Imaging of the breast can overcome this superposition problem, and provide much improved contrast, thus improving detectability. Further, CT imaging of the breast can be performed with no physical compression of the breast, alleviating patient discomfort. It can provide for 3-D lesion morphology, which could serve as a diagnostic indicator, and for better quantitative assessment of breast glandular content, a likely risk factor for breast cancer. This research is to demonstrate that image quality improvements achieved with advanced image processing approaches could improve lesion visualization and provide for better delineation of its margins, using a three-dimensional (3-D) breast imaging system with isotropic voxel size. Improved visualization of lesions and its margins would improve the confidence to determine malignancy and could potentially improve detection. Determination of lesion margins and lesion volume are also necessary for surgical planning and for accurate monitoring and early determination of the effectiveness of therapeutic agents and methods. The research plan includes studies to determine the ability of the dedicated clinical prototype breast CT system to visualize lesions; to determine if the 3-D morphology provides for improved determination of malignancy; to determine if quantitative CT numbers can provide for improved confidence to determine malignancy; and to obtain volumetric estimates of breast density, a likely risk factor for breast cancer. The results from this study will allow us to better define the role of a dedicated 3-D cone-beam flat-panel CT system in breast cancer and will allow us to determine the effectiveness of image processing approaches for improved clinical image quality. A well- designed dedicated breast CT system with advanced image processing techniques can serve as a platform technology for screening and diagnostic imaging, implant imaging, 3-D presurgical planning, monitoring preoperative treatment, and guidance in minimally invasive surgery. PUBLIC HEALTH RELEVANCE: Volumetric 3-D imaging with a dedicated breast CT system has the potential to be an effective tool for monitoring therapeutic treatments and can overcome the tissue superposition problem in mammography, which results in missed cancers and unnecessary recall of the patient for additional imaging. In this research, we propose to conduct a clinical feasibility study with a prototype breast CT system and develop and evaluate methods to improve contrast that could result in improved detection, diagnosis, and management of breast cancer.

描述（由申请人提供）：本修订申请是对PAR-08-147（PAR-06-293的重新发布）“成像和图像引导介入的快速试验：探索性赠款（R21）"的响应。拟议研究是一项器官特异性可行性研究，旨在确定专用乳腺计算机断层扫描系统（本文称为乳腺CT系统）可视化病变的能力。乳房X线摄影中乳房结构的叠加可能由于“掩蔽”效应而导致遗漏癌症，或者可能模拟病变的存在，从而导致额外的成像或活检。乳房的计算机断层摄影（CT）成像可以克服这种叠加问题，并提供大大改善的对比度，从而提高可检测性。此外，可以在没有乳房的物理压迫的情况下进行乳房的CT成像，从而减轻患者的不适。它可以提供3D病变形态，这可以作为一个诊断指标，并更好地定量评估乳腺腺体内容，乳腺癌的一个可能的风险因素。本研究旨在证明，使用具有各向同性体素尺寸的三维（3-D）乳腺成像系统，采用先进的图像处理方法实现的图像质量改善可以改善病变可视化，并提供更好的边缘勾画。改善病变及其边缘的可视化将提高确定恶性的信心，并可能提高检测。病变边缘和病变体积的确定对于手术计划以及对于治疗剂和方法的有效性的准确监测和早期确定也是必要的。该研究计划包括确定专用临床原型乳腺CT系统可视化病变的能力的研究;确定3-D形态是否提供了改善的恶性肿瘤的确定;确定定量CT数字是否可以提供改善的置信度来确定恶性肿瘤;并获得乳腺密度的体积估计，这是乳腺癌的一个可能的风险因素。本研究的结果将使我们能够更好地定义专用3-D锥形束平板CT系统在乳腺癌中的作用，并使我们能够确定图像处理方法对改善临床图像质量的有效性。设计良好的专用乳腺CT系统具有先进的图像处理技术，可作为筛查和诊断成像、植入成像、3-D术前规划、监测术前治疗和指导微创手术的平台技术。公共卫生关系：使用专用乳腺CT系统的体积3-D成像有可能成为监测治疗性治疗的有效工具，并且可以克服乳腺X射线摄影中的组织叠加问题，该问题导致遗漏癌症和不必要的患者召回以进行额外成像。在本研究中，我们建议使用原型乳腺CT系统进行临床可行性研究，并开发和评估提高对比度的方法，从而改善乳腺癌的检测、诊断和管理。