Quantitative Assessment of the Benefits and Risks of Clinical PET/CT and SPECT/CT

描述（由申请人提供）：本申请涉及广泛的挑战领域（05）比较有效性研究和特定挑战主题，05- eb -101：先进成像程序的比较有效性。近年来，多模态PET/CT或SPECT/CT的使用大幅增加。解剖成像模式和功能成像模式的使用为诊断提供了额外的图像数据集，可以改善功能数据的重建，并且可以通过注册两幅图像来帮助定位示踪剂摄取。毫无疑问，在医学影像界，多模态成像是有益的。然而，对于许多应用程序或潜在应用程序，这种益处尚未得到客观证明和定量测量。使用第二种方式也会增加风险，例如，在PET成像研究中增加CT扫描时，辐射剂量会增加。临床研究表明，多模态成像的优势大于风险，成本昂贵，耗时，可能需要大量的患者。由于CT和核医学成像技术的快速发展，这一领域的回顾性研究受到限制，这意味着此类研究的数据不足。这项工作的目标是开发和测试新的方法，以客观地评估与多模态成像系统相关的收益和风险，以便患者和医生能够对其使用做出明智的决定。这些新方法将提供一种廉价的方法来评估和比较基于任务的多模成像系统。我们开发的技术和软件可以用来生成信息，临床研究人员可以使用这些信息来集中精力进行临床研究。根据本提案开发的工具将免费提供，以便其他研究人员可以在各种任务和应用的多模态成像系统和协议的设计和评估中使用它们。

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (05) Comparative Effectiveness Research and specific Challenge Topic, 05-EB-101: Comparative Effectiveness of Advanced Imaging Procedures. The use of multimodality PET/CT or SPECT/CT has increased substantially in recent years. The use of both an anatomical imaging modality and a functional one provides an extra image dataset for diagnosis, can improve the reconstruction of the functional data, and can help localize tracer uptake by registering the two images. There is little doubt in the medical imaging community that multimodality imaging is beneficial. However, this benefit has not been objectively demonstrated and quantitatively measured for many applications or potential applications. There are also increased risks associated with using a second modality, for example, the increased radiation dose when a CT scan is added to a PET imaging study. Clinical studies that would demonstrate that the advantages of multimodality imaging outweigh the risks and costs are expensive, time consuming, and may require large numbers of patients. Retrospective studies in this area are limited by the rapid advancements in the technology used for CT and nuclear-medicine imaging, which implies that data for such studies is in short supply. The goal of the proposed work is to develop and test new methods for objectively evaluating the benefits and risks associated with multimodality imaging systems so that patients and physicians can make informed decisions about their use. These new methods will provide an inexpensive way to evaluate and compare multimodality imaging systems using task-based measures. The techniques and software that we develop can then be used to generate information that clinical researcher can use to focus their efforts in clinical studies. The tools developed under this proposal will be made freely available so that other researchers can use them in the design and evaluation of multimodality imaging systems and protocols for a variety of tasks and applications. PUBLIC HEALTH RELEVANCE: We will develop and validate methods that researchers can use to assess the benefits and risks associated with multimodality PET/CT and SPECT/CT imaging. The immediate impact of this work will be the availability of software for computing and comparing task performance using realistic models of imaging systems, relevant clinical tasks, and accurate patient models. This software will be made freely available so that other researchers can use it in the design and evaluation of multimodality imaging systems and protocols for a variety of tasks and applications.