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

描述(由申请人提供)：该计划的目标是改进在介入性C臂上进行的锥束计算机断层扫描(CBCT)成像，以指导肝肿瘤的导管导向栓塞术以及多种其他介入性操作。目前肝导管定向治疗的标准是使用介入性C形臂和注射造影剂来显示肿瘤及其供血血管。C型臂CBCT可用于了解病变解剖结构，从而实现肿瘤和供血血管的3D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侵入性等方面的一些重要限制，当前的C-ARM CBCT远远没有针对应用进行优化。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，我们通过开发创新的扫描和基于优化的重建，重点解决C-臂CBCT在图像引导的肝肿瘤导管输送方面的实际局限性，并展示其在图像引导的肝肿瘤治疗临床任务中的转换潜力。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)开发扫描和基于优化的重建以进一步改进C-臂成像，以及(3)验证、表征和评估基于优化的重建。该项目具有很高的临床和技术意义，因为它可以直接对肝癌和其他形式的癌症，特别是肺癌和肾癌的介入和治疗产生重大影响，还因为它可以促进先进的C型臂CBCT技术的开发，以解决稀疏视野、截断和有限角度范围问题等技术挑战，具有极高的实用价值。该项目具有很高的创新水平，因为它包括许多创造性的想法和方法，以增强工作流程，减少对比度、辐射剂量和患者不适。

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.