Breast CT scanner for earlier cancer detection

描述（由申请人提供）：这是一个生物工程研究伙伴关系（BRP）乳腺CT的竞争性续期申请。在过去的4.3年中，我们已经开发了两种乳腺CT扫描仪，并且是第一个在患者中展示锥形束乳腺CT性能的团队，截至2007年1月，有94名患者接受了成像。我们还开发了在悬垂式乳腺CT几何结构中进行准确剂量评估的方法，并明确表明，在等于双视图乳腺X射线摄影的辐射水平下，可以生成高质量的乳腺CT图像。在上一个供资期的目标方面取得了良好的生产力，有12名受训人员、14篇同行审查的论文、11篇其他论文、2章、15篇摘要和21篇特邀演讲。在本提案中，我们寻求通过进一步的技术开发结合临床评价，显著扩展基本乳腺CT平台的临床实用性。将设计和制造一种新的乳腺CT扫描仪，利用现有扫描仪的基本框架，但包含滑环、脉冲X射线和螺旋采集;该系统将允许正常操作的厚扇形束螺旋扫描和使用造影剂注射的研究的锥形束乳腺成像。除了开发新的诊断成像模式，包括对比动力学曲线评估，断层合成，乳腺PET/CT和放大模式乳腺CT，理论和数值分析方法，如理想的观察者评估和计算机辅助诊断方法，提出了更好地了解乳腺断层扫描的基本诊断潜力。我们建议在bCT平台上进一步开发硬件，使其成为多功能乳腺癌分析和治疗工具，允许乳腺癌的微创图像引导治疗方案，包括机器人引导乳腺活检，射频消融和X射线消融。该研究计划描述了四个发展阶段的16个目标：（1）新硬件开发，（2）改进解释和诊断的分析工具，（3）图像引导评估和治疗乳腺癌的技术开发，以及（4）乳腺CT诊断和治疗的临床试验。两台几乎相同的乳腺CT扫描仪将在加州大学戴维斯分校和加州大学圣地亚哥分校制造和安装，两个研究中心的患者人数将能够对800多名患者进行研究，并进行许多交叉比较。非侵入性成像将在II期临床试验中进行，而微创研究将在较小的I期试验中进行。在这项研究和发现计划结束时，乳腺CT可能会被证明是诊断和治疗乳腺癌的关键临床工具。

DESCRIPTION (provided by applicant): This is a competitive renewal application for a bioengineering research partnership (BRP) on breast CT. Over the past 4.3 years, we have developed two breast CT scanners and were the first group to demonstrate the performance of cone beam breast CT in patients, with 94 patients imaged as of January 2007. We also developed the methodology for accurate dose assessment in the pendant breast CT geometry, and have unambiguously shown that excellent quality breast CT images can be produced at radiation levels equal to two view mammography. Good productivity has been achieved in the aims of the previous funding period, with 12 trainees, 14 peer reviewed papers, 11 other papers, 2 chapters, 15 abstracts and 21 invited presentations. In this proposal, we seek to significantly extend the clinical utility of the basic breast CT platform through further technical development combined with clinical evaluation. A new breast CT scanner will be designed and fabricated, utilizing the basic framework of an existing scanner but incorporating a slip ring, pulsed x-rays, and helical acquisition; the system will allow thick fan beam helical scanning for normal operation and cone beam breast imaging for studies using contrast agent injection. In addition to developing new diagnostic imaging modes including contrast kinetic curve assessment, tomosynthesis, breast PET/CT and magnification-mode breast CT, theoretical and numerical analysis methods such as ideal observer assessment and computer aided diagnosis methods are proposed to better understand the fundamental diagnostic potential of breast tomography. We propose further hardware development on the bCT platform so that it will serve as a multifunctional breast cancer analysis and treatment tool, allowing minimally invasive image guided treatment regimes for breast cancer, including robotically guided breast biopsy, radiofrequency ablation, and x-ray ablation. The research plan describes 16 aims in four phases of development (1) new hardware development, (2) analytical tools for improving interpretation and diagnosis, (3) technology development for image guided assessment and treatment of breast cancer, and (4) clinical trials in breast CT diagnosis and treatment. Two nearly identical breast CT scanners will be fabricated and sited at UC Davis and UC San Diego, and patient accrual at two sites will enable the study of over 800 patients, with many cross comparisons. Non-invasive imaging will proceed in Phase II clinical trials, while the minimally invasive studies will be performed in smaller Phase I trials. At the end of this program of research and discovery, breast CT will likely be shown to be a key clinical tool for the diagnosis and treatment of breast cancer.