Simultaneous Emission and Transmission Mammotomography

同时发射和透射乳腺断层扫描

• 批准号: 7802906
• 负责人: MARTIN P TORNAI
• 金额: $ 57.31万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-19 至 2013-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7802906
• 关键词: 3-Dimensional; Active Sites; Algorithms; Anterior; Applications Grants; Axilla; Axillary lymph node group; Biodistribution; Biological; Biomedical Engineering; Breast; Cancer Patient; Carcinoma; Caring; Chest wall structure; Clinical; Code; Computer software; Data; Data Collection; Development; Devices; Diagnosis; Diagnostic; Disease; Dose; Ensure; Evaluation; Feedback; Fever; Filtration; Functional Imaging; Funding; Gamma Cameras; Generations; Goals; Grant; Health; Healthcare; Human; Hybrids; Image; Imagery; Imaging Device; Imaging Phantoms; Imaging technology; Investigation; Lasers; Lead; Lesion; Liposomes; Magnetic Resonance Imaging; Mammography; Measurement; Mediating; Medical; Metals; Modality; Molecular; Monitor; Motion; National Cancer Institute; Oncologist; Optics; Patient Care; Patients; Performance; Phase II Clinical Trials; Photons; Play; Positioning Attribute; Progress Reports; Protocols documentation; Radiolabeled; Radiopharmaceuticals; Recurrence; Research; Research Project Grants; Research Proposals; Resolution; Retinal Cone; Role; Sampling; Screening procedure; Semiconductors; Shapes; Side; Signal Transduction; Simulate; Source; Staging; Stratification; Surface; Surgeon; Surgical margins; System; Therapeutic; Therapeutic Clinical Trial; Therapeutic heat application; Time; TimeLine; Tissues; United States National Institutes of Health; Woman; attenuation; base; density; detector; digital; expectation; flexibility; human subject; image registration; imaging modality; improved; in vivo; innovation; malignant breast neoplasm; next generation; novel; prototype; public health relevance; radiotracer; reconstruction; response; single photon emission computed tomography; standard of care; tool; transmission process; tumor; uptake

DESCRIPTION (provided by applicant): The overall goal of this proposal is to develop a dual-modality single photon emission computed tomography (SPECT) and x-ray computed mammotomography (CmT) scanner for dedicated breast and axillary imaging, and to incorporate this system into routine diagnostic breast healthcare. We are the first group to conceive, implement, and begin to clinically evaluate such a dual-modality molecular breast imaging device. In the first 5- year period of this project, three dedicated human breast imaging devices were developed and fully characterized: SPECT, CmT and a hybrid device integrating the two. The imaging performances exceeded the expectations and goals of the original Specific Aims. For the SPECT subsystem, we integrated a high- performance semiconductor detector on a novel gantry capable of arbitrary, fully 3-dimensional (3D) trajectories. We imaged smaller lesions with lower simulated biological uptake than has been imaged by others. For the CmT subsystem, we developed an innovative and robust quasi-monochromatic x-ray cone beam that can provide 3D anatomical images with isotropic resolution throughout a uniformly sampled breast volume. We have shown statistically significantly improved observer detectability of small, low contrast lesions in breast phantoms compared with 2D digital x-ray mammography. Importantly, this CmT system helped yield these results with total absorbed dose below that of dual-view screening mammography. The integrated hybrid system has been thoroughly characterized with phantom imaging studies, successfully used in imaging women with breast cancer, and yielded high quality 3D registered and fused images. This 4-year continuation proposal includes incorporation of our existing hybrid imaging device into an ongoing NIH funded hyperthermia breast therapeutics clinical trial. This trial will evaluate the semiquantitative 3D radiopharmaceutical-loaded liposome biodistributions in 40 human subjects. Using a narrow edge digital flat-panel detector developed specifically for this proposal, along with a compact x-ray source-filtration combination allowing real-time scatter correction measurements, a totally new CmT subsystem will be developed, providing enhanced anterior chest wall imaging. This new geometrically optimal and patient friendly system will be the first hybrid imaging technology to allow isotropically uniform imaging of the full breast and axillary nodes. Both subsystems will provide fully-3D high resolution data for our generalized iterative reconstruction code that will incorporate motion, scatter and attenuation corrections. The new system will be characterized and calibrated to provide absolute signal quantification to within 5% of known values. This new hybrid mammotomography system will be evaluated in 20 locally advanced breast cancer patients, so that the variance of image parameters can be determined with a modified BIRADS lexicon, and statistical power can be determined for a Phase 2 clinical trial. Given our positive developments and results thus far, we think it is likely that our new hybrid SPECT-CmT system will prove to be a valuable clinical tool. PUBLIC HEALTH RELEVANCE: The overall goal of this research proposal is to develop and evaluate dedicated three-dimensional (3D) breast imaging, termed "mammotomography," simultaneously capable of functional-emission imaging with SPECT and anatomical-transmission imaging with CT of a pendant, uncompressed breast and associated axillary regions. Significant strides were made in the first 5-year period, and this revised proposal presents a paradigm changing approach to dedicated breast imaging that is expected to result in better clinical interpretation and quantification of information from the combined imaging modalities, and ultimately lead to better diagnosis for and monitoring of breast cancer, which is of great importance in the public and personal health problem of breast cancer.

描述（由申请人提供）：本提案的总体目标是开发用于专用乳房和腋窝成像的双模态单光子发射计算机断层扫描 (SPECT) 和 X 射线计算机乳房断层扫描 (CmT) 扫描仪，并将该系统纳入常规诊断乳房保健中。我们是第一个构思、实施并开始临床评估这种双模态分子乳腺成像设备的团队。在该项目的第一个 5 年期间，开发了三种专用的人体乳腺成像设备并对其进行了全面表征：SPECT、CmT 以及集成两者的混合设备。成像性能超出了最初特定目标的预期和目标。对于 SPECT 子系统，我们在能够实现任意全 3 维 (3D) 轨迹的新型龙门架上集成了高性能半导体探测器。我们对较小的病灶进行了成像，其模拟生物摄取比其他人的成像要低。对于 CmT 子系统，我们开发了一种创新且强大的准单色 X 射线锥形束，可以在整个均匀采样的乳腺体积中提供具有各向同性分辨率的 3D 解剖图像。我们已经证明，与 2D 数字 X 射线乳房 X 线摄影相比，观察者对乳房模型中小、低对比度病变的检测能力在统计学上显着提高。重要的是，该 CmT 系统有助于获得这些结果，总吸收剂量低于双视图筛查乳房 X 光检查。该集成混合系统已通过幻影成像研究进行了彻底的表征，成功用于对患有乳腺癌的女性进行成像，并产生了高质量的 3D 配准和融合图像。这项为期 4 年的延续提案包括将我们现有的混合成像设备纳入正在进行的 NIH 资助的热疗乳腺治疗临床试验。该试验将评估 40 名人类受试者中半定量 3D 放射性药物负载脂质体的生物分布。使用专门为此提案开发的窄边数字平板探测器，以及允许实时散射校正测量的紧凑型 X 射线源过滤组合，将开发全新的 CmT 子系统，提供增强的前胸壁成像。这种新的几何优化且患者友好的系统将是第一个混合成像技术，可以对整个乳房和腋窝淋巴结进行各向同性均匀成像。两个子系统都将为我们的广义迭代重建代码提供全 3D 高分辨率数据，该代码将包含运动、散射和衰减校正。新系统将进行表征和校准，以提供已知值 5% 以内的绝对信号量化。这种新的混合乳腺断层扫描系统将在 20 名局部晚期乳腺癌患者中进行评估，以便可以使用修改后的 BIRADS 词典确定图像参数的方差，并确定 2 期临床试验的统计功效。鉴于我们迄今为止取得的积极进展和成果，我们认为我们的新型混合 SPECT-CmT 系统很可能会被证明是一种有价值的临床工具。公共健康相关性：本研究提案的总体目标是开发和评估专用的三维 (3D) 乳腺成像，称为“乳房断层扫描”，同时能够使用 SPECT 进行功能发射成像，并使用 CT 对下垂、未压缩的乳房和相关腋窝区域进行解剖透射成像。在第一个五年期间取得了重大进展，这一修订后的提案提出了专用乳腺成像的范式改变方法，预计将导致更好的临床解释和对组合成像模式信息的量化，并最终导致更好的乳腺癌诊断和监测，这对于乳腺癌的公共和个人健康问题非常重要。