Multimodal Image-Guided Intervention System for Lung-Cancer Diagnosis and Staging

描述(由申请人提供)：该项目的目标是构建一个多模式图像引导介入(IGI)系统，用于支气管镜检查的计划和指导。该系统将具有以下特点：1)易于使用，与医生的技能和经验无关；2)能够更集中、更有信心地进行组织采样，减少患者并发症；3)提供强有力的指导；以及4)更好地利用现有的图像来源。肺癌是全球癌症死亡的主要原因。多模式放射成像和支气管镜检查方面的许多技术创新最近出现在对抗肺癌的努力中。多探测器计算机断层扫描(MDCT)扫描仪提供胸部的三维(3D)亚毫米分辨率的X射线CT图像，正电子发射断层扫描(PET)扫描仪提供互补的分子成像信息，新型集成的PET/CT扫描仪结合了这两种模式的优势。最先进的支气管镜提供生动的支气管镜内视频，使导航能够深入呼吸道树周围，而补充性支气管镜超声(EBUS)显示呼吸道外解剖结构的局部视图。然而，肺癌患者的5年存活率仍低于15%，这意味着这些新工具尚未得到充分开发。现在的目标是设计一种IGI系统，将多模式成像技术整合到肺癌评估过程中。特别是，该项目是由以下假设驱动的：多模式3D成像和支气管镜检查的协同集成，加上基于计算机的图像处理，改进了目前用于肺癌诊断和分期的技术。该项目的具体目标如下：目标1：设计多模式程序规划和影像引导支气管镜检查的方法。目的2：构建一个完全集成的多通道影像引导干预系统。目标3：进行人体研究以优化和验证整个系统。如果成功，建议的多模式成像、活检和治疗计划技术可以使几乎所有患者在术前正确诊断和分期肺癌。此外，拟议的技术将极大地促进其他正在进行的发展，努力定位早期肺癌，并帮助治疗肺气肿和其他肺部疾病。最后，许多建议的基本方法应该适用于其他领域，如泌尿科、胃肠科、肾脏科、妇科和神经科。 公共卫生相关性：肺癌是全球癌症死亡的主要原因，2008年死亡人数超过130万。该项目的长期目标是构建一个多模式图像引导介入系统，以更有效地诊断和分期肺癌。

DESCRIPTION (provided by applicant): The goal of this project is to construct a multimodal image-guided intervention (IGI) system for the planning and guidance of bronchoscopy. The system will have the following features: 1) be easy to use, independent of physician skill and experience; 2) enable better-focused, confident tissue sampling, with fewer patient complications; 3) offer robust guidance; and 4) better exploit the available image sources. Lung cancer is the leading cause of cancer death worldwide. Many technical innovations in multimodal radiologic imaging and bronchoscopy have emerged recently in the effort against lung cancer. Multidetector computed-tomography (MDCT) scanners provide three-dimensional (3D) sub-millimeter-resolution X-ray CT images of the chest, positron emission tomography (PET) scanners give complementary molecular-imaging information, and new integrated PET/CT scanners combine the strengths of both modalities. State-of-the- art bronchoscopes provide vivid endobronchial video enabling navigation deep into the airway-tree periphery, while complementary endobronchial ultrasound (EBUS) reveals local views of anatomical structures outside the airways. Nevertheless, the 5-year survival rate of lung-cancer patients remains under 15%, implying that these new tools have not yet been fully exploited. The objective now is to devise an IGI system that incorporates multimodal imaging techniques throughout the lung-cancer assessment process. In particular, the project is driven by the following hypothesis: A synergistic integration of multimodal 3D imaging and bronchoscopy, coupled with computer-based image processing, improves current techniques for the diagnosis and staging of lung cancer. The specific aims of the project are as follows: Aim 1: Devise methods for multimodal procedure planning and image-guided bronchoscopy. Aim 2: Construct a fully integrated multimodal image-guided intervention system. Aim 3: Perform human studies to optimize and validate the complete system. If successful, the proposed multimodal imaging, biopsy, and treatment-planning techniques could enable correct diagnosis and staging of lung cancer preoperatively in virtually all patients. In addition, the proposed techniques would greatly facilitate other ongoing developments striving to localize early lung cancers and assist in the treatment of emphysema and other lung diseases. Finally, many of the proposed basic methods should be applicable to other areas, such as urology, gastroenterology, nephrology, gynecology, and neurology. PUBLIC HEALTH RELEVANCE: Lung cancer is the leading cause of cancer death worldwide, accounting for over 1.3 million deaths in 2008. The long-term goal of this project is to construct a multimodal image- guided intervention system for more effective lung-cancer diagnosis and staging.