NA-MIC virtual colonoscopy

描述（由申请人提供）：结肠癌是美国男性和女性癌症死亡的第二大原因，如果发现并切除前体结肠息肉，可以预防结肠癌。该项目的长期目标是开发一种图像可视化和分析工具包，以促进结肠癌的早期发现。虚拟结肠镜检查（VC），也称为计算机断层结肠镜检查（CTC），是一种很有前途的结肠癌筛查技术。然而，要使VC成为一种实用的筛查工具，它应该能够方便地显示结肠粘膜，并且在检测息肉时应该具有较高的准确性。目前VC的问题包括在存在残余粪便物质的情况下难以看到整个粘膜表面，以及放射科医生诊断表现的差异。粪便标记CTC （ftCTC）是一种使用不透射线的口服造影剂标记结肠内粪便和液体的方法，可以有效地将其与息肉区分开来。非泻性ftCTC （ncCTC）是一种新兴的技术，用于消除肠道准备中使用的严格的泻性清洁。电子清洗（EC）也是一种新兴的技术，用于去除VC图像中标记的粪便物质，在图像采集后有效地清洁结肠并显示结肠粘膜。计算机辅助检测（CAD）可以自动检测VC图像中的息肉，具有较高的灵敏度和特异性，可以提高放射科医生的息肉检测性能。该项目的短期目标是为ncCTC开发和验证新的可视化和CAD方案，并将其集成到全国医学成像计算联盟（NA-MIC）工具包中，从而开发NA-MIC VC系统。这个原型VC系统将把NA-MIC工具包扩展到磁共振成像和神经成像之外，并将建立一个易于扩展的VC研究平台，以鼓励新的研究努力，并为研究合作提供动力。我们假设新的NA-MIC VC系统将允许结肠粘膜表面的可视化，并将提高放射科医生在ncCTC中检测息肉的表现。为了探索这些假设，我们提出以下具体目标：具体目标1：开发ncCTC中整个结肠粘膜的可视化方法。具体目标2：开发一种不使用EC检测ncCTC息肉的CAD方案。具体目标3：验证VC系统的性能和效益。NA-MIC VC系统的成功开发将大大扩展NA-MIC工具包，为VC研究提供一个复杂的平台，包括VC研究工具以及可有效用于临床试验的VC系统。这样的风险投资平台将鼓励新的研究努力，并为研究合作提供动力。该系统还具有提供基于ct的息肉检测方案的潜力，该方案对患者来说是高度可接受的，并且高度准确。这样的VC系统将显著推进基于ct的结肠癌筛查的临床实施，促进结肠癌的早期诊断，最终降低结肠癌的死亡率。公共卫生启示：这个项目的意义在于，NA-MIC VC系统的成功开发将大大扩展NA-MIC工具包，包括一个复杂的平台，包括一套VC研究工具，以及一个可以在临床试验中有效使用的VC系统。这样的风险投资平台将鼓励新的研究努力，并为研究合作提供动力。该系统还具有提供基于ct的息肉检测方案的潜力，该方案对患者来说是高度可接受的，并且高度准确。我们期望NA-MIC VC系统能够提高放射科医生在CTC结肠息肉检测中的表现，并将成为筛查大患者群体的可靠和可接受的选择，从而早期发现结肠癌并降低结肠癌死亡率。

DESCRIPTION (provided by applicant): Colon cancer, the second leading cause of cancer deaths for men and women in the United States, can be prevented if precursor colonic polyps are detected and removed. The long-term goal of the proposed project is to develop an image visualization and analysis toolkit that advances the early detection of colon cancer. Virtual colonoscopy (VC), also known as computed tomographic colonography (CTC), is a promising technique for colon cancer screening. However, for VC to be a practical screening tool, it should allow for easy visualization of the colonic mucosa, and it should have high accuracy in detecting polyps. Current problems with VC include the difficulties in visualizing the entire mucosal surface in the presence of residual fecal materials, and variations in diagnostic performance among radiologists. Fecal tagging CTC (ftCTC) is a method of tagging stool and fluid remaining in the colon with a radiopaque oral contrast agent, allowing the material to be effectively differentiated from polyps. Non-cathartic ftCTC (ncCTC) is an emerging technique for eliminating rigorous cathartic cleansing from the bowel preparation used in current CTC. Electronic cleansing (EC) is also an emerging technique for removal of tagged fecal materials in VC images, effectively cleansing the colon after image acquisition and visualizing colonic mucosa. Computer-aided detection (CAD), which automatically detects polyps in VC images, has the potential to detect polyps with high sensitivity and specificity, and to improve radiologists' polyp detection performance. The short-term goal of this project is to develop and validate novel visualization and CAD schemes for ncCTC, and to integrate them into the National Alliance of Medical Imaging Computing (NA-MIC) toolkit, thereby developing a NA-MIC VC system. This prototype VC system will expand the NA-MIC toolkit beyond magnetic resonance imaging and neuroimaging, and will establish an easily-extensible VC-research platform that would encourage new research efforts and provide impetus for research collaboration. We hypothesize that the new NA-MIC VC system will allow the visualization of the mucosal surface of the colon, and will improve radiologists' performance in the detection of polyps in ncCTC. To explore these hypotheses, we propose the following specific aims: Specific Aim 1: To develop visualization methods of the entire colonic mucosa in ncCTC. Specific Aim 2: To develop a CAD scheme for detection of polyps in ncCTC without the use of EC. Specific Aim 3: Validate the performance and benefit of the VC system. Successful development of the NA-MIC VC system will substantially extend the NA-MIC toolkit for providing a sophisticated platform consisting of tools for VC research as well as a VC system that can effectively be used for clinical trials. Such a VC platform will encourage new research efforts and provide impetus for research collaboration. The system also has the potential to provide a CT-based polyp detection scheme that is highly acceptable to patients and highly accurate. Such a VC system will significantly advance the clinical implementation of CT-based colon cancer screening, promote the early diagnosis of colon cancer, and ultimately reduce the mortality due to colon cancer. PUBLIC HEALTH REVELANCE: The significance of this project is that successful development of the NA-MIC VC system will substantially extend the NA-MIC toolkit to include a sophisticated platform comprising a set of tools for VC research as well as a VC system that can be used effectively in clinical trials. Such a VC platform would encourage new research efforts and provide impetus for research collaboration. The system also has the potential to provide a CT-based polyp detection scheme that is highly acceptable to patients and highly accurate. We expect that the NA-MIC VC system will improve radiologists' performance in the detection of colonic polyps in CTC, and will be a reliable and acceptable option for screening large patient populations, resulting in early detection of colon cancers and reduced mortality due to colon cancer.