The Use of 68Ga-DOTATOC and 18F-FDG PET/CT Imaging in the Evaluation of Newly Dia

68Ga-DOTATOC 和 18F-FDG PET/CT 成像在新直径评估中的应用

• 批准号: 7797848
• 负责人: Ronald Clark Walker
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-10-01 至 2013-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7797848
• 关键词: Academic Medical Centers; Acids; Adenocarcinoma; Affect; American; Appointment; Benign; Biological Markers; Biometry; Biopsy; Blood Tests; Bronchi; Bronchiolo-Alveolar Adenocarcinoma; Bronchoscopy; Calcified; Caliber; Cancer Biology; Cancer Burden; Cancer Center; Cancer Diagnostics; Cancer Etiology; Cancer Patient; Carcinoid Tumor; Caring; Cells; Cessation of life; Characteristics; Clinical; Collaborations; Computer software; Cytology; Data; Demographic Aging; Deoxyglucose; Development; Diagnosis; Diagnostic; Diagnostic Procedure; Discrimination; Disease; Distant; Doctor of Philosophy; Drops; Early Diagnosis; Educational process of instructing; Enrollment; Evaluation; Excision; Faculty; Fine needle aspiration biopsy; Funding; Future; General Population; Glass; Glucose; Grant; Grant Review; Granuloma; Healthcare; Healthcare Systems; Histologic; Hospitals; Image; Imaging Techniques; Incidence; Inflammatory; Investigation; Isotopes; Joints; Label; Lead; Lesion; Literature; Lung; Lung nodule; Malignant - descriptor; Malignant Neoplasms; Malignant neoplasm of lung; Malignant neoplasm of prostate; Measurement; Medical Imaging; Methods; Microscopic; Modeling; Neoplasm Metastasis; Newly Diagnosed; Nodule; Octreotide; Operative Surgical Procedures; Outcome; PET/CT scan; Pain; Patient observation; Patients; Performance; Population; Population Study; Positioning Attribute; Positron-Emission Tomography; Procedures; Proteomics; Pulmonary Coin Lesion; Radioactive; Relative (related person); Relative Risks; Reporting; Research; Research Personnel; Scanning; Sensitivity and Specificity; Serum; Specimen; Staging; Statistical Data Interpretation; Taxes; Techniques; Tennessee; Thoracotomy; Time; Tumor Biology; Tumor Volume; United States National Institutes of Health; Unnecessary Surgery; Veterans; Woman; X-Ray Computed Tomography; abstracting; age related; anticancer research; base; cancer diagnosis; cost effective; cyclen; experience; fluorodeoxyglucose; improved; insight; lifetime risk; male; member; men; mortality; novel; outcome forecast; public health relevance; respiratory; skills; success; sugar; uptake; wasting

DESCRIPTION (provided by applicant): Project Summary/Abstract Lung cancer is the leading cause of cancer death in Veterans and in the general U.S. population. In 2004, an estimated 173,700 Americans were diagnosed with lung cancer; of these, about 164,440 (95%) will ultimately die of their disease. Despite decades of research, the prognosis for lung cancer remains dismal, with an overall five-year survival combining all stages of 16%. Nonetheless, lung cancer can be cured if detected early, with a 5 year survival for Stage 1 of up to 70%, establishing the importance of early diagnosis and definitive treatment. The lifetime risk for developing cancer of the lung and bronchus for the general population in the US is 1 in 12 for men and 1 in 16 for women. Relative risk for male patients using VA hospitals is approximately twice that of the general population. Though the relative age-related incidence of lung cancer is declining, because of the age demographics of the US population, the total number of newly diagnosed lung cancers in the US is expected to increase from about 225,000 in the year 2010 to about 410,000 in the year 2050. Clearly there is a great societal need, especially within the Veteran population, to improve early and cost-effective diagnosis of lung cancer and to gain new insights into tumor biology that can be exploited for novel treatments. Current lung cancer diagnostic methods include the use of "PET" scans (typically combined with an integrated CT scanner into a PET/CT), which has greatly improved our ability to discriminate between benign and malignant lung nodules and to improve the staging of lung cancer. However, current clinical PET/CT, based on the distribution of a radioactive form of glucose, is limited by both false positive (FP) and false negative (FN) results. For diagnosis of indeterminate lung nodules, FN results are common for nodules less than 1 cm in diameter or for cancers that are relatively less aggressive than most (e.g. typical carcinoid tumor, well- differentiated adenocarcinoma, bronchioloalveolar carcinoma (BAC), and some metastases). These FN results delay diagnosis while the nodule is watched via CT, allowing time for possible metastases to occur and a potential cure to be missed. FN results in staging lung cancer result in the patient being treated inappropriately for his/her stage, adversely affecting outcome and wasting healthcare dollars. FP results are common with infectious/inflammatory lesions, such as non-calcified or poorly calcified granulomas, leading to unnecessary surgery or biopsies, painful and sometimes dangerous procedures that also waste healthcare dollars. We hypothesize that combining results from serial PET/CT scans usingthe standard radioactive sugar ("18F-FDG) with an experimental PET scanning agent called 68Ga-labeled DOTATOC will reduce the number of FP and FN examinations, improving accuracy for non- invasive diagnosis of lung nodules and for staging of lung cancer, and possibly to provide new insights into tumor biology that might suggest novel treatments. We will also use state-of-the-art enhancements for automatic tumor volume calculation and respiratory "gating" to improve the accuracy of these measurements. Finally we will combine these imaging data with a serum proteomic analysis and other patient information to develop a new multivariate model for the diagnosis of lung cancer. PUBLIC HEALTH RELEVANCE: Project Narrative Lung cancer is the leading cause of cancer death in Veterans and in the general population. Despite decades of research and the spending of billions of tax dollars, the overall five year survival is about 15%. The only proven way to improve survival is early diagnosis and surgical removal, when survival can increase to 70%, but this is difficult since small cancers are hard to diagnose. In this proposed study we hope to use standard PET/CT scanning plus an experimental PET/CT scan using a new PET isotope to help us improve the diagnosis of lung cancer at an earlier stage and to improve our ability to determine how far the cancer has spread. We will also combine these PET/CT scan results with new blood tests for even better accuracy and to see if these results will teach us new insights into lung cancer biology that might suggest new ways to treat lung cancer.

描述（由申请人提供）： 肺癌是美国退伍军人和普通人群癌症死亡的主要原因。2004年，估计有173，700名美国人被诊断患有肺癌;其中约164，440人（95%）最终死于肺癌。尽管经过数十年的研究，肺癌的预后仍然令人沮丧，所有阶段的五年生存率为16%。尽管如此，如果早期发现肺癌是可以治愈的，第一阶段的5年生存率高达70%，这表明早期诊断和明确治疗的重要性。 在美国，一般人群发生肺癌和支气管癌的终生风险为男性1/12，女性1/16。使用VA医院的男性患者的相对风险约为一般人群的两倍。尽管肺癌的相对年龄相关发病率正在下降，但由于美国人口的年龄人口统计学，美国新诊断的肺癌总数预计将从2010年的约225，000例增加到2050年的约410，000例。显然，社会上有很大的需求，特别是在退伍军人群体中，以改善肺癌的早期和具有成本效益的诊断，并获得可用于新治疗的肿瘤生物学的新见解。 目前的肺癌诊断方法包括使用“PET”扫描（通常与集成的CT扫描仪组合成PET/CT），这大大提高了我们区分良性和恶性肺结节的能力，并改善了肺癌的分期。然而，基于放射性形式的葡萄糖的分布的当前临床PET/CT受到假阳性（FP）和假阴性（FN）结果两者的限制。对于不确定的肺结节的诊断，FN结果常见于直径小于1 cm的结节或侵袭性相对较低的癌症（例如典型的类癌肿瘤、高分化腺癌、细支气管肺泡癌（BAC）和一些转移瘤）。这些FN结果延迟了诊断，而结节通过CT观察，使可能的转移发生的时间和潜在的治疗被错过。FN导致肺癌分期，导致患者对其分期的治疗不适当，对结果产生不利影响并浪费医疗费用。FP结果常见于感染性/炎性病变，如非钙化或钙化不良的肉芽肿，导致不必要的手术或活检，痛苦的，有时危险的程序，也浪费医疗费用。 我们假设，将使用标准放射性糖（18F-FDG）的系列PET/CT扫描结果与称为68 Ga标记DOTATOC的实验性PET扫描剂相结合，将减少FP和FN检查的数量，提高肺结节非侵入性诊断和肺癌分期的准确性，并可能为肿瘤生物学提供新的见解，可能提出新的治疗方法。我们还将使用最先进的自动肿瘤体积计算和呼吸“门控”增强功能，以提高这些测量的准确性。最后，我们将结合联合收割机这些影像数据与血清蛋白质组学分析和其他病人的信息，以开发一个新的多变量模型诊断肺癌。 公共卫生关系： 肺癌是导致退伍军人和普通人群癌症死亡的主要原因。尽管数十年的研究和数十亿美元的税收支出，总体五年生存率约为15%。提高生存率的唯一行之有效的方法是早期诊断和手术切除，此时生存率可以提高到70%，但这很困难，因为小型癌症很难诊断。在这项拟议的研究中，我们希望使用标准PET/CT扫描加上使用新PET同位素的实验性PET/CT扫描，以帮助我们在早期阶段改善肺癌的诊断，并提高我们确定癌症扩散程度的能力。我们还将联合收割机将这些PET/CT扫描结果与新的血液测试相结合，以获得更高的准确性，并看看这些结果是否会教会我们对肺癌生物学的新见解，从而可能提出治疗肺癌的新方法。