Upright, Low-dose, High-resolution, 3D Breast CT

立式、低剂量、高分辨率、3D 乳腺 CT

• 批准号: 9810897
• 负责人: Andrew Karellas
• 金额: $ 76.37万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-06-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9810897
• 关键词: 3-Dimensional; Address; Anatomy; Arizona; Benchmarking; Benign; Biomedical Engineering; Breast; Breast Cancer Detection; Breast Microcalcification; Breast-Conserving Surgery; Categories; Chest wall structure; Clinical; Clinical Trials; Data; Development; Diagnosis; Diagnostic; Diagnostic Imaging; Diagnostic Sensitivity; Diagnostic radiologic examination; Digital Breast Tomosynthesis; Digital Mammography; Dimensions; Discrimination; Disease; Dose; Early Diagnosis; Eligibility Determination; Emerging Technologies; Enhancing Lesion; Evaluation; Feasibility Studies; Future; Generations; Geometry; Goals; Image; Imagery; Information Systems; Lesion; Low Dose Radiation; Malignant - descriptor; Mammography; Measurement; Modality; Modeling; Monitor; Multimodal Imaging; Neoadjuvant Therapy; Noise; Operative Surgical Procedures; Patients; Performance; Phase; Physics; Population; Positioning Attribute; Radiation Dose Unit; Radiology Specialty; Reader; Receiver Operating Characteristics; Reporting; Research; Research Project Grants; Resolution; Risk; Roentgen Rays; Sampling; Scanning; Screening procedure; Shapes; State-of-the-Art Reviews; Subgroup; System; Techniques; Technology; Three-Dimensional Image; Three-Dimensional Imaging; Tissues; Translating; Translational Research; Universities; Validation; Woman; X-Ray Computed Tomography; base; breast cancer diagnosis; breast density; breast imaging; calcification; cancer imaging; chemotherapy; clinical decision-making; clinical practice; clinical translation; cohort; design; diagnosis evaluation; diagnostic accuracy; imaging detector; imaging system; improved; innovation; malignant breast neoplasm; next generation; predicting response; prospective; prototype; quantitative imaging; quantum; reconstruction; recruit; response; screening; simulation; study characteristics; tomography; tool; treatment planning; tumor

ABSTRACT Dedicated breast CT can eliminate tissue superposition that contributes to false-positives and false- negatives, and alleviates the need for physical compression of the breast. It provides for 3D images at near-isotropic spatial resolution that allows for viewing the breast in any orientation without the need for repeat acquisitions. It is an emerging technology, with only about five teams conducting research, worldwide. In order to develop, evaluate, accelerate its clinical translation, and to facilitate the widespread clinical adaptation of this technology, we are collaborating with GE Global Research to develop an upright patient positioning geometry with advanced technological capabilities designed to eventually allow for breast cancer screening, in addition to diagnostic imaging. The technological advanced proposed include an x-ray imaging detector with reduced system (electronic) noise, data readout rates improved by a factor of at least 2, and improved spatial sampling (pixel pitch) by a factor of 2 or more; a short-scan acquisition trajectory with angular range not exceeding 270-degrees that will improve patient positioning; and, the use of model-based iterative reconstruction techniques. All these technological advances are focused on improving posterior coverage, reducing the radiation dose to the breast so that it is similar to a standard 2- view mammography exam, and improving the visualization of microcalcifications; all with an aim of making it suitable for breast cancer screening in the future. Importantly, the upright geometry allows for rapid clinical adaptation as it allows for easy replacement of mammography and digital breast tomosynthesis systems, even in small mammography rooms, and addresses the patient discomfort observed with the prone breast CT. The research is broadly organized in two phases. In the first phase, all design factors and operational parameters will be verified through physics-based numerical simulations and empirical studies using the bench-top prototype system. In the second phase, we will conduct a clinical feasibility study that will recruit subjects from two cohorts: BIRADS 4/5, and screening population, to determine if the advanced technological approach using the upright, low-dose, high-resolution dedicated breast CT system improves the diagnostic accuracy compared to digital breast tomosynthesis. To our knowledge, this will be first study to directly compare digital breast tomosynthesis with dedicated breast CT. Thus, the proposed research will develop an innovative design concept for unprecedented impact in breast cancer imaging that will enable breast imaging without physical compression and at radiation dose similar to mammography. To our knowledge a compression-free breast CT system incorporating the aforementioned features does not exist.

摘要 专用乳腺CT可以消除导致假阳性和假阳性的组织重叠， 消极的，并强调了对乳房的物理压迫的需要。它提供3D图像， 近各向同性的空间分辨率，允许在任何方向上观察乳房， 重复收购。这是一项新兴技术，只有大约五个团队进行研究， 国际吧为了开发，评估，加速其临床翻译，并促进其广泛传播， 为了适应这项技术的临床应用，我们正在与GE全球研究院合作， 具有先进技术能力的患者定位几何结构， 乳腺癌筛查，除了诊断成像。提出的技术进步包括 X射线成像探测器具有降低的系统（电子）噪声，数据读出速率提高了一个因子， 至少为2，空间采样（像素间距）改进为2倍或更多;短扫描采集 角度范围不超过270度的轨迹，将改善患者定位;以及，使用 基于模型的迭代重建技术。所有这些技术进步都集中在 改善后部覆盖，减少对乳房的辐射剂量，使其类似于标准的2- 查看乳房X光检查，并改善微钙化的可视化;所有这些都旨在使其 适合将来进行乳腺癌筛查。重要的是，直立的几何形状允许快速的临床应用。 适应性，因为它允许轻松更换乳房X射线摄影和数字乳腺断层合成系统， 即使在小的乳房X线照相室中也是如此，并且解决了患者在俯卧乳房时观察到的不适 CT.研究大致分为两个阶段。在第一阶段，所有设计因素和操作 参数将通过基于物理的数值模拟和经验研究进行验证， 台式原型系统。在第二阶段，我们将进行临床可行性研究， 来自两个队列的受试者：BIRADS 4/5和筛选人群，以确定晚期 使用直立式、低剂量、高分辨率专用乳腺CT系统的技术方法提高了 与数字乳腺断层合成摄影相比的诊断准确性。据我们所知，这将是第一次研究 直接比较数字乳腺断层合成摄影与专用乳腺CT。因此，拟议的研究将 开发一种创新的设计理念，对乳腺癌成像产生前所未有的影响， 乳房成像，无物理压迫，辐射剂量与乳房X线摄影相似。对我们 根据现有知识，不存在包含上述特征的无压缩乳房CT系统。