Integrated three dimensional anatomic and molecular breast imaging

集成三维解剖和分子乳腺成像

• 批准号: 8042001
• 负责人: JENNIFER A HARVEY
• 金额: $ 39.34万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-01-01 至 2013-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8042001
• 关键词: 3-Dimensional; Anatomy; Area; Artificial cardiac pacemaker; Biopsy; Breast; Chest wall structure; Claustrophobias; Clinic; Clinical; Clinical Research; Contralateral; Data; Detection; Development; Devices; Digital Mammography; Disease; Early Diagnosis; Equipment; Evaluation; Event; Floor; Functional Imaging; Funding; Gamma Cameras; Goals; High Risk Woman; Image; Implant; Lesion; Magnetic Resonance Imaging; Malignant Neoplasms; Mammary Gland Parenchyma; Mammography; Manufacturer Name; Marketing; Masks; Measurement; Modality; Molecular; Monitor; Morphologic artifacts; Motion; Neoadjuvant Therapy; Noise; Obesity; Operative Surgical Procedures; Pain-Free; Palpable; Paper; Patients; Performance; Pilot Projects; Positioning Attribute; Predictive Value; Problem Solving; Protocols documentation; Publications; Reader; Recording of previous events; Research; Resolution; Risk; Role; Scanning; Schedule; Screening procedure; Sensitivity and Specificity; Shapes; Signal Transduction; Specificity; Speed; Structure; System; Testing; Thick; Time; Tracer; Translations; Ultrasonography; Universities; Virginia; Woman; Women' s Health; base; breast scanner; cohort; design; detector; digital; flexibility; high risk; human study; imaging modality; improved; malignant breast neoplasm; molecular imaging; radiotracer; reconstruction; research clinical testing; response; transmission process; volunteer

DESCRIPTION (provided by applicant): Digital x-ray breast tomosynthesis (XBT) is under development by major manufacturers of breast imaging equipment and is expected to become a clinical reality within the next few years. Although XBT is likely to improve the conspicuity of small masses compared to 2-D full field digital mammography (FFDM) by reducing the masking effect of superimposed fibroglandular breast tissue, it remains an anatomic imaging modality and therefore functional imaging modalities that can provide complementary information are desirable in order to improve specificity and positive predictive value. Molecular breast imaging (MBI) using compact gamma cameras permits functional imaging of the entire breast at high resolution and has shown promise as a complementary modality to FFDM. With the goal of obtaining functional image data that can be accurately correlated with the 3-D structural image data of XBT, our group has developed a unique dual modality tomographic (DMT) breast scanner that combines x-ray breast tomosynthesis and molecular breast imaging tomosynthesis (MBIT) on a single integrated gantry, thereby permitting accurate localization co- registration between 3-dimensional anatomic and functional image data. Our measurements have shown that compared to 2-D MBI, the use of MBIT greatly improves lesion contrast and image signal- to-noise ratio, especially for small, deep-seated lesions. The DMT scanner has been recently tested in a pilot clinical study and proved superior to XBT alone in specificity, positive predictive value, and accuracy. These preliminary results have motivated this application for funding to evaluate the scanner's clinical performance among a larger cohort of women. Prior to the proposed human study both the x-ray and molecular imaging components will be upgraded for greater detection efficiency (XBT and MBIT), shorter acquisition time (XBIT), lower noise (XBT), and improved patient positioning (XBT and MBIT). Potential clinical roles for DMT breast imaging include problem solving for women with equivocal mammographic/ultrasound studies, especially those with radiodense breasts; screening high-risk women, as an aid in biopsy target selection following a positive mammogram, particularly in patients with multiple suspicious areas; workup of palpable masses not demonstrated on mammography or ultrasound; cancer surveillance in patients with a personal history of breast cancer; pre-surgical planning for women with known cancer for determination of disease extent (multi-focal, contralateral breast); as an alternative to breast MRI for women for whom MRI is impossible because of NSF/NFD, obesity, claustrophobia, or who have cardiac pacemakers or other types of implants containing ferromagnetic components; and for monitoring response to neoadjuvant therapy. PUBLIC HEALTH RELEVANCE: The relevance of this research to women's health is that the breast scanner to be developed and tested constitutes a new type of device that can potentially improve the early detection and characterization of small cancers. The scanner acquires 3-dimensional digital mammography (structural) and 3-dimensional molecular imaging (functional) images in quick succession with the breast under mild, pain-free compression. It may be of particular value for women with dense breasts for whom normal mammography is less effective, for women with higher than average risk for developing breast cancer, and as a less costly, more accurate alternative to breast MRI.

描述（由申请人提供）：乳腺成像设备的主要制造商正在开发数字X射线乳腺断层合成摄影（XBT），预计在未来几年内将成为临床现实。尽管与2-D全视野数字乳腺X射线摄影（FFDM）相比，XBT可能通过减少叠加纤维腺体乳腺组织的掩蔽效应来改善小肿块的显著性，但它仍然是一种解剖成像模式，因此需要能够提供补充信息的功能成像模式，以提高特异性和阳性预测值。使用紧凑型伽马相机的分子乳腺成像（MBI）允许以高分辨率对整个乳房进行功能成像，并已显示出作为FFDM补充模式的前景。为了获得可以与XBT的3-D结构图像数据准确相关的功能图像数据，我们的小组开发了一种独特的双模态断层摄影（DMT）乳腺扫描仪，该扫描仪在单个集成机架上结合了X射线乳腺断层合成和分子乳腺成像断层合成（MBIT），从而允许3维解剖和功能图像数据之间的准确定位配准。我们的测量结果表明，与2-D MBI相比，使用MBIT大大提高了病变对比度和图像信噪比，特别是对于小的、深位病变。DMT扫描仪最近在一项试点临床研究中进行了测试，并证明在特异性、阳性预测值和准确性方面上级单独使用XBT。这些初步结果促使该基金申请在更大的女性群体中评估扫描仪的临床性能。在拟议的人体研究之前，将升级X射线和分子成像组件，以提高检测效率（XBT和MBIT）、缩短采集时间（XBIT）、降低噪声（XBT）并改善患者定位（XBT和MBIT）。DMT乳腺成像的潜在临床作用包括：为乳房X线摄影/超声检查结果不明确的女性（尤其是放射密度高的女性）解决问题;筛查高危女性，作为阳性乳房X线摄影后活检靶点选择的辅助手段，尤其是在有多个可疑区域的患者中;检查乳房X线摄影或超声检查未显示的可触及肿块;对有乳腺癌个人史的患者进行癌症监测;对于已知患有癌症的女性，术前计划用于确定疾病程度（多灶性，对侧乳房）;对于因NSF/NFD、肥胖、幽闭恐怖症而无法进行MRI的女性，或具有心脏起搏器或其他类型的含铁磁组件的植入物的女性，作为乳房MRI的替代方案;以及用于监测对新辅助治疗的反应。 公共卫生关系：这项研究与妇女健康的相关性在于，有待开发和测试的乳腺扫描仪是一种新型设备，有可能改善小癌症的早期发现和表征。扫描仪可在轻微无痛压迫下快速连续采集三维数字乳腺X线摄影（结构）和三维分子成像（功能）图像。它可能是特别有价值的妇女致密的乳房，对他们来说，正常的乳房X光检查是不太有效的，为妇女与高于平均风险发展为乳腺癌，并作为一个更便宜，更准确的替代乳房MRI。