Development of Advanced C-arm Cone-Beam CT for the Treatment of Liver Cancer

描述（由申请人提供）：该项目的目的是改善在介入c臂上进行的锥形束计算机断层扫描（CBCT）成像，特别是用于指导肝肿瘤的导管定向栓塞，以及多种其他介入手术。目前肝导管定向治疗的标准护理使用介入c型臂和注射造影剂来显示肿瘤及其供血血管。c臂CBCT可用于了解病变解剖结构，实现肿瘤和供血血管的三维可视化。然而，由于检查时间、辐射剂量、图像质量和对工作流程的干扰等许多重要限制，目前的c臂CBCT还远远没有优化应用。这些限制可以通过开发创新的CBCT扫描和基于优化的重建来解决。在该项目中，我们将重点解决c臂CBCT在图像引导肝肿瘤导管输送中的实际局限性，通过开发创新的扫描和基于优化的重建，并展示其在图像引导肝肿瘤治疗的临床任务中的转化潜力。该项目的具体目标包括：(1)开发基于优化的重建，以改进当前的c臂成像；(2)开发基于扫描和优化的重建，以进一步改进c臂成像；(3)验证、表征和评估基于优化的重建。该项目的临床和技术意义是很高的，因为它可以直接影响肝癌和其他形式的癌症，特别是肺癌和肾癌的干预和治疗，并且因为它可以导致先进的c臂CBCT技术的发展，以解决诸如稀疏视图，截断和有限角度范围等技术挑战，具有极高的实用价值。该项目具有高水平的创新，因为它包括许多创造性的想法和方法，以增强工作流程，减少对比体积，辐射剂量，和病人的不适。

DESCRIPTION (provided by applicant): The objective of this program is to improve cone-beam computed tomography (CBCT) imaging performed on an interventional C-arm for guiding catheter-directed embolization of liver tumor in particular, and multiple other interventional procedures. The current standard of care for hepatic catheter directed therapy uses an interventional C-arm and injected contrast agent to visualize tumor and its feeding vessels. C-arm CBCT can be used to understand the lesion anatomy, allowing 3D visualization of the tumor and feeding vessels. However, current C-arm CBCT is far from being optimized for the application due to a number of important limitations concerning exam time, radiation dose, image quality, and intrusiveness to workflow. These limitations can be addressed through the development of innovative CBCT scans and optimization-based reconstructions. In the project, we focus on tackling the practical limitations of the C-arm CBCT in image- guided liver-tumor catheter delivery through the development of innovative scans and optimization-based reconstructions, and demonstrating their translational potential to clinical tasks of image-guided liver-tumor treatment. The specific aims of the project include (1) to develop optimization-based reconstruction for improving current C-arm imaging, (2) to develop scans and optimization-based reconstruction for further improving C-arm imaging, and (3) to verify, characterize, and evaluate optimization-based reconstructions. The clinical and technical significances of the project are high, because it can directly impact significantly intervention and treatment of liver-cancer and other forms of cancer, particularly, in the lung and kidney, and because it can lead to the development of advanced C-arm CBCT technology for addressing technical challenges such as sparse-view, truncation, and limited-angular-range problems of extremely high practical merit. The project has a high level of innovation, because it includes numerous creative ideas and methods for enhancing workflow and for reducing contrast volume, radiation dose, and patient discomfort.