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

描述（由申请人提供）：本项目旨在改进在介入C形臂上进行的锥形束计算机断层扫描（CBCT）成像，以指导肝肿瘤的导管导向栓塞，尤其是多种其他介入手术。肝导管导向治疗的当前护理标准使用介入C形臂和注射造影剂来可视化肿瘤及其供血血管。C形臂CBCT可用于了解病变解剖结构，允许肿瘤和供血血管的3D可视化。然而，由于在检查时间、辐射剂量、图像质量和工作流程侵入性方面存在许多重要限制，目前的C形臂CBCT远未针对该应用进行优化。这些局限性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，我们专注于通过开发创新扫描和基于优化的重建来解决C形臂CBCT在图像引导肝脏肿瘤导管输送中的实际局限性，并展示其在图像引导肝脏肿瘤治疗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，以改善当前C形臂成像;（2）开发扫描和基于优化的重建，以进一步改善C形臂成像;以及（3）验证、表征和评价基于优化的重建。该项目的临床和技术意义很高，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形臂CBCT技术的发展，以解决技术挑战，如稀疏视图，截断和具有极高实用价值的有限角度范围问题。该项目具有很高的创新水平，因为它包含了许多创新的想法和方法，用于增强工作流程和减少造影剂体积，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.