Dual-energy Electronic-cleansing CT Colonography for Colon Cancer Screening

描述(申请人提供)：筛查是目前最有效的结肠癌早期检测方法。计算机体层摄影(CTC)或虚拟结肠镜检查已成为一种有效的非侵入性结肠癌筛查技术，可以替代光学结肠镜检查(OC)。然而，目前的CTC检查需要检查前的泻剂肠道准备，基本上与OC的要求相同。人们感觉到的不适和不便与CTC检查前严格的泻剂肠道准备相关，已被认为是广泛接受结肠筛查的主要障碍。将非泻剂肠道制剂应用于CTC检查的主要技术障碍是缺乏有效的电子清洗(EC)方案来减去CTC图像中标记的粪便物质，因为当前EC方法中遇到的净化伪影太严重，无法提供诊断质量的非泻剂CTC图像。双能量CT(DECT)是一种新的成像技术，它可以根据两个不同能量的同步CT采集得到的CT衰减值来区分材料。非泻剂双能CTC(DeCTC)，即将DECT应用于非泻剂CTC图像采集，具有显著提高EC质量的潜力。在这个项目中，我们将开发一种非泻剂去CTC的EC方案，称为双能量EC(DeEC)，在该方案中，患者将接受非泻剂肠道准备并使用DECT扫描仪进行成像。在图像采集后，通过一套在双能量环境下开发的新的图像处理方法，所提出的DeEC方案将有效地去除CTC图像中结肠中残留的粪便物质。脱CTC的材料区分能力为消除当前EC方法中存在的主要清洗伪影提供了一个新的维度，从而提供了诊断质量的CTC图像。出于评价目的，我们将建立一个非泻剂去甲氧西林数据库。拟议的DE-EC方案的质量和性能将在体模研究、手动清洗研究、计算机辅助息肉检测(CAD)研究和观察者研究中进行评估。这项研究的创新之处在于，尚未尝试非泻剂去CTC及其DeEC方案的开发。拟议的DeEC计划的成功开发和验证将为放射科医生提供清洁的CTC图像，用于检测结肠癌，并将患者从主要的结肠筛查中解脱出来。这种DeEC辅助的非泻剂deCTC检查可以显著提高筛查依从性、安全性和结肠癌筛查能力。因此，拟议的研究将大大提高结肠息肉和癌症的筛查率和早期发现。 公共卫生相关性：拟议的DeEC计划的成功开发和验证将为放射科医生提供用于检测结肠癌的具有诊断质量的清洁CTC图像，它将使患者从主要的结肠筛查中解脱出来。这种经EC清洗的非泻剂去CTC检查将大大提高结肠癌筛查的速度，从而提高结肠癌的早期发现率，从而降低结肠癌死亡率。

DESCRIPTION (provided by applicant): Screening is currently the most effective way for early detection of colonic cancer. Computed tomographic colonography (CTC), or virtual colonoscopy, has become an effective technique for non-invasive colon cancer screening that can be an alternative to optical colonoscopy (OC). However, current CTC examinations require pre-examination cathartic bowel preparation, essentially identical to that required for OC. The perceived discomfort and inconvenience associated with the rigorous cathartic bowel preparation before a CTC examination has been identified as the main barrier to wide acceptance of colon screening. The main technical barrier in applying non-cathartic bowel preparation to CTC examination is the lack of an effective electronic cleansing (EC) scheme for subtraction of tagged fecal materials in CTC images, because the cleansing artifacts encountered in current EC methods are too severe to allow non-cathartic CTC images of diagnostic quality. Dual-energy CT (deCT) is a new imaging technique that allows materials differentiation based on CT attenuation values derived from two synchronous CT acquisitions at different energies. Non-cathartic dual-energy CTC (deCTC), i.e., applying deCT to non-cathartic CTC image acquisition, has the potential significantly to improve the quality of EC. In this project, we will develop an EC scheme for non-cathartic deCTC, denoted as dual-energy EC (deEC), in which patients will be examined with non-cathartic bowel preparation and imaged with a deCT scanner. After image acquisition, the proposed deEC scheme will effectively remove the residual fecal materials in the colon in CTC images by a set of novel image processing methods developed in a dual-energy context. The capability of material differentiation in deCTC provides a new dimension for obviating the major cleansing artifacts existing in current EC methods, and thus provides CTC images of diagnostic quality. For evaluation purposes, we will establish a non-cathartic DE-CTC database. The quality and performance of the proposed DE-EC scheme will be evaluated in a phantom study, a manual cleansing study, a computer-aided detection (CAD) of polyps study, and an observer study. This research is innovative in that the non-cathartic deCTC and the development of its deEC scheme have not yet been attempted. The successful development and validation of the proposed deEC scheme will provide radiologists with cleansed CTC images of diagnostic quality for detecting colon cancer, and it will release the patients from the main concern regarding colon screening. Such an deEC-aided non-cathartic deCTC examination could substantially increase the screening compliance, safety, and the capacity for colon cancer screening. Thus, the proposed research will substantially raise the screening rate and the early detection of colonic polyps and cancers. PUBLIC HEALTH RELEVANCE: The successful development and validation of the proposed deEC scheme will provide radiologists with cleansed CTC images of diagnostic quality for detecting colon cancer, and it will release patients from the main concern regarding colon screening. Such an EC-cleansed non-cathartic deCTC examination will substantially increase the rate of colon screening and thereby advance the early detection rate of colon cancer, leading to a reduction in colon cancer mortality rates.